It happens in all group practices, when the time comes when you need to have a discussion with a clinician about a need for improvement or change. This is typically one of the least exciting parts of owning a business with employees. Whether tension has already risen with an employee or you are just plain nervous about communicating your concerns, effective communication strategies and the willingness to help your clinicians grow (and you growing through your own discomfort!) is essential to having a thriving practice and good relationships with your employees.
There are various reasons you may need to sit down and talk with one of your clinicians:
- They are not following protocols likes doing notes on time, checking intake paperwork to make sure it is filled out correctly, they are not taking copays or payments from clients, etc.
- They are taking too much time off or canceling on clients last minute.
- They are not marketing themselves as per your expectations.
- They are having difficulty with client retention.
- They are establishing unhealthy boundaries with clients or other clinicians.
This list can go on depending on your business expectations. But one thing is sure: You will need to effectively communicate with your staff so that they understand and have the ability to adjust their behaviors. There is a great DBT technique that can be used when you need to discuss an issue or concern with your employees. It is called DEAR MAN. It is an acronym whose goal is to foster open communication, reduce resentment and unmet needs, and improve overall relational health.
Let’s take a look at what DEARMAN is and apply it to a common concern as a group practice owner:
D Describe the situation as clearly and detailed as possible. It may look like this: “I have noticed that you have not been completing your notes in a timely fashion.”
E Express yourself, your perspective, and how the situation affects you. “When you don’t complete your notes on time, it affects my goal of having the practice run in an ethical manner, and creates resentment from others who complete their notes on time.”
A Assert yourself instead of being aggressive (or passive aggressive). Begin to find a solution. “It is important for us to work towards a solution. How can I help you follow through on the practice expectations regarding completing notes?”
R Reinforce: Make sure they understand why they should change their behavior, what the positive outcomes and benefits are. “Thanks for understanding my concern. I know you are a valuable clinician in this practice and seeing you thrive is a goal of mine.”
M Stay Mindful: Don’t deviate to other issues, keep to the concern at hand. If the clinician deviates from the discussion or becomes defensive or angry, stay mindful of your responses, both verbally and nonverbally. “I realize that you work late into the night and prefer not to stay later to complete your notes, which is why I give clinicians until the end of each week to complete them.”
A Appear confident even if you are nervous. Remember, if you don’t believe in the importance of your request or concern, so will the clinician.
N Negotiate when you are not able to get what you need or want. This does not mean giving in, doing something you don’t want, or letting the clinician not follow through with your request. Is there a compromise? “I see that although completing notes by the end of the week on Fridays is our practice rule, and that you work until late Friday nights. Would completing all of your notes except Friday’s by the practice end date help? Your week can end on Thursdays so that your Friday client notes can be completed the following week. How about that?”
As you can see, this can be a really effective way to communicate with your staff. You can even print out the DEARMAN acronym and have the clinician and you take turns using this model so that you both feel like you are on the same page.
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