Enhancing Practice Performance

Find new managers by promoting within

How to ensure your star staff members excel in management roles.

One of the many benefits of working in an ophthalmology practice is the opportunity for brisk professional growth. In small practices, it is common for office managers to start their careers as the practice’s front desk receptionist. In medium and large practices, technicians, billers and front desk staff often become supervisors and department managers.

But, despite its numerous benefits, upward career mobility and internal promotion create challenges for both the individual worker and the practice.

Here is a list of success factors to help you navigate the common collateral difficulties of internal promotion.

1. Desire for the position

A successful manager has to want to be one. Too often, the most senior worker in the department who “knows everything” is promoted despite not having a strong desire for the position or full knowledge of what it takes to be a manager.

If the main motivation is a pay increase or that they don’t want to disappoint you by admitting they never really wanted to be a manager, the results will disappoint you at the very best — or worse, they will eventually leave the practice once they burn out in a job they never wanted.

2. Selecting the best candidate

In your practice, multiple staff members may express interest in career growth. Test the waters by passing out small assignments, such as organizing the company picnic or chairing a task force to select new uniforms.

Formally post all appropriate jobs, and open the interview process for internal promotion for all those interested. It takes more time than just selecting who you want, but by providing a fair opportunity for promotion to a new position, the candidates not selected generally accept the new supervisor with better spirits as opposed to feeling sore about not having a chance at the position.

3. Train and educate

Superstar receptionists and technicians may only be that ... until they receive more education and training. Not all management skills come naturally.

If you commit to promoting from within, you must also commit the resources of time and funding to increase the odds of your new manager succeeding. These resources include devoting your personal time and attention to mentor, sending leadership candidates and new leaders to training meetings and purchasing educational books, periodicals and online resources.

4. Set clear expectations, and don’t assume

Re-orient newly promoted managers as if they were new to the practice. This may seem silly at first, because they are already very familiar with the practice, but it sets a new tone.

Have them meet with each fellow manager as a new peer, observe every part of the practice with fresh eyes ... especially departments to which they have had little exposure. Provide written goals and expectations so that your new leader marches in the same direction that you are taking the company as a physician or administrator.

5. Provide structured administrative time

Accommodate the fact that most department heads in ophthalmology are “working” supervisors. Most middle managers have binary jobs. On average, they may supervise only 10 hours a week and do the same job as their staff the rest of the week. Such working supervisors need structured time for administrative work.

It can feel safer, especially for newer supervisors, to fall back into just doing the work and avoid the new managing part of their jobs. This is compounded when a doctor, used to being assisted by their superstar worker, continues to have demands that exceed reasonable limits for someone with an expanded job description.

Closely assess the amount of effort it takes for the new tasks you have assigned to the new manager, and insist that the manager set appropriate boundaries allowing time for those tasks.

6. Expect “peer to supervisor” transition issues

Managers promoted from within may struggle with managing their former co-workers. Friendships may still exist, causing conflicts and the appearance (or reality) of favoritism. The new manager may be hesitant to address problems directly or take a too-lenient approach to adverse staff behaviors. Former peers may test the new manager’s authority, push back or even actively sabotage.

If you are the administrator leading such a new manager, you can overcome these early difficulties with frequent, brief check-in meetings (focused mostly on the positives you see) and role-playing (pretending you are the difficult worker and asking your new manager to find ways to get through to you). This can be a safe way for new leaders to practice finding the right balance between being over- and under-directive in their tone.

7. Evaluate and give frequent feedback

Once you develop goals and expectations together, review these at least monthly. But, don’t wait for the monthly meeting if a problem arises. Direct, prompt feedback can help address and resolve issues before they become bad supervisory habits. Some administrators prefer a weekly, brief check-in meeting with each of their direct reports.

8. Provide supplemental mentoring

A formal mentor, in addition to the manager’s direct supervisor, can help support the new manager and accelerate development.

This can take several forms. Your new tech manager could meet with a strong head tech from a friendly, collaborating ophthalmic practice in your community. A retiring supervisor could mentor the replacement for a few months or longer. Consultants, in addition to working for administrators and practice boards, commonly provide formal adjunctive training for their clients’ mid-level managers.

9. Encourage promotion

You probably have one or more future leaders hidden among your ranks who simply need encouragement and grooming. Perhaps they have management experience in a different field, as a shop or restaurant manager, but they don’t talk about that until you ask.

Every time you promote a rank-and-file worker to a leadership role in your practice, it is a wonderful opportunity to remind your entire staff that your practice tries to promote from within. All staff members should see their current position as a stepping stone to greater career opportunity.

10. Know when not to promote from within

Sometimes you just don’t have the right candidates within the organization, especially in a smaller practice. The odds of any one tech in a four-person department having the requisite leadership skills and interest are small.

Hiring from the outside can recharge the practice with new ideas and approaches. Outsiders may take more time to get up to speed on your organization. But, they may bring more experience as a manager in their area of expertise and come up to speed faster than a brand new manager hired from within. OM