Eliminating office politics through team building - Practice Management

Physician Executive, Jan-Feb, 2004 by Rick E. Weymier

With all of the pressures on physician practices due to declining reimbursements and increasing expenses, an organization cannot afford to operate in a dysfunctional manner.

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Dysfunction is directly related to the inability of a group of individuals to work in an effective and collaborative manner, with everyone working towards the same goals and objectives, irrespective of their defined roles within the organization.

In other words, it is critical that the organization operates as a functional team. When a group of individuals become an effective team, the team does not tolerate negative behavior and office politics. Building and maintaining a strong team should be the primary focus of the physician practice to ensure that it can effectively meet the needs of its patients.

Building an effective team from an existing group of individuals, with a wide range of skills, roles and education levels, in a fast-paced environment filled with challenges and critical decision-making requirements may appear to be a daunting task. Building a team requires time, commitment, objectivity and the willingness to make hard decisions. In order to accomplish this in a successful manner, the team needs a plan to follow.

In October 2003, I had the opportunity to hear Patrick Lencioni speak. He is the author of The Five Dysfunctions of a Team. As I listened, I came to the realization that his approach to identifying the dynamics within existing groups of individuals and providing a methodology for them to transition into an effective team can be used by medical practices that are serious about making teamwork their top priority.

His excellent book walks the reader through an understandable example of how to build a team. At the end of the book, he provides worksheets, additional definitions and tips for implementing the transition to an effective team.

Here's some information I learned from listening to Lencioni and reading his book.

If you were to ask the various members of a medical group what the objectives of the practice were, you would get a wide variety of responses from providing quality clinical care and good customer service through executing favorable payer contracts and managing expenses. All of these are vital functions of a medical practice, but often the individuals who focus on each of these goals miss the opportunity to gain the critical advantage that teamwork brings. Patient care is delivered, but the satisfaction levels of patients, staff and physicians are less than optimal.

You have to eliminate negative office politics and work as a team because, no matter how much you try to focus on business, patients pick up on the underlying tension within a practice. The evolving issue of consumer-driven health care is putting more of the decision making in the hands of the patient. A group cannot afford to lose patients or gain a negative reputation over this matter.

There is a direct correlation between how patients feel after interacting with the staff and providers in non-clinical areas, and the perception of the quality of care provided. A perceived dysfunctional team causes patients to question the quality of care received.

When conflict arises, it is essential that the group's leader immediately address the situation head on and not let it gain a life of its own. In the long run, both your staff and patients will be glad that you did.

The physicians and the practice administrator are the first team. The rest of the group has to have confidence in the first team's abilities, and they have to present a collective, confident and united front to all of the staff.

There should be little tolerance for disruptive behavior and lack of teamwork. Irrespective of an individual's skill level or contribution to the group, people who do not support the team need to leave the organization. Having a negative influence within the group will be more damaging in the long run than the loss of a key player who does not support the team's unified goals and objectives.

Teamwork offers the best chance for your group to be successful. There is nothing that an individual can do that an effective team cannot do better, every time.

Make sure that all staff feels that they are a valuable part of the team; make them important. Every individual in the group should have a task or responsibility that has a material impact on the overall performance of the team.

Physicians and other leaders have egos that dictate that they appear to be infallible. In order for the team to be collectively great, leaders need to be able to admit mistakes and assume responsibility for circumstances that do not turn out favorably. Having a sense that their leaders are "real people" will reinforce the team spirit. Mistakes and errors are bound to happen. Take advantage of these events as learning experiences.

Office politics involves gossip, complaining, unfounded criticism and other forms of negative, nonproductive behavior. An effective team will challenge their peers and demand elimination of negative behavior. An effective team knows that disruptive behavior will not be tolerated.