Office Sabotage: Are Your Employees Victimizing You?

Jeffrey Helfand, DO, MS © 2010Jeffrey Helfand, DO, MS © 2010

Office Sabotage:Office Sabotage:

are your employees victimizing you?are your employees victimizing you?



YOUR OFFICE STAFF CAN BE ONE YOUR OFFICE STAFF CAN BE ONE OF THE MOST IMPORTANT OF THE MOST IMPORTANT

PREDICTORS OF YOUR OVERALL PREDICTORS OF YOUR OVERALL PRACTICE PROFITABILITY!!!!!!PRACTICE PROFITABILITY!!!!!!


Importance of Your Medical Office StaffImportance of Your Medical Office Staff

Your front office is where patients form Your front office is where patients form their first opinions of you as their health their first opinions of you as their health care providercare provider

Many medical malpractice suits result Many medical malpractice suits result from events unrelated to the outcome of from events unrelated to the outcome of the care you providedthe care you provided

A warm, caring, courteous greeting from A warm, caring, courteous greeting from your staff will result in greater respect for your staff will result in greater respect for you, and a better experience for the you, and a better experience for the patientpatient


Importance of Your Medical Office StaffImportance of Your Medical Office Staff

Not greeting patients, or greetings that seem Not greeting patients, or greetings that seem cold or hollow, or perceived as non-professional cold or hollow, or perceived as non-professional will almost always result in a poor beginning to will almost always result in a poor beginning to your doctor-patient relationshipyour doctor-patient relationship

Rudeness or non-professional conduct by your Rudeness or non-professional conduct by your staff becomes a staff becomes a liability liability for you!for you!

Negative first impressions are very difficult to Negative first impressions are very difficult to overcome!overcome!


““Moments of Truth”Moments of Truth”

"Anytime a customer comes into contact with "Anytime a customer comes into contact with any aspect of a business, however remote, any aspect of a business, however remote, is an opportunity to form an impression."is an opportunity to form an impression."

Moments of Truth: Jan Carlzon 1987: Ballinger Publishing Co.Moments of Truth: Jan Carlzon 1987: Ballinger Publishing Co.

Jan Carlzon, then President of Scandinavian Airlines, Jan Carlzon, then President of Scandinavian Airlines, which was failing, turned it around to become of the which was failing, turned it around to become of the

most respected airlines in the industry, refers to most respected airlines in the industry, refers to what he has termedwhat he has termed “moments of truth” “moments of truth”


““Moments of Truth”Moments of Truth”

Definitions:Definitions:

1) A critical or decisive time on which much 1) A critical or decisive time on which much depends; a crucial moment. (Dictionary.com)depends; a crucial moment. (Dictionary.com)

2) In 2) In customer servicecustomer service, the instance of , the instance of contactcontact or or interactioninteraction between a between a customercustomer (patient) and a (patient) and a firm firm (medical practice) that gives the customer (medical practice) that gives the customer (patient) an opportunity to (patient) an opportunity to formform ( (or changeor change) an ) an impression about the firm (medical practice). impression about the firm (medical practice). (BusinessDictionary.com)(BusinessDictionary.com)


““Your Moments of Truth”Your Moments of Truth”

According to Customer Service Speaker, Shep According to Customer Service Speaker, Shep Hyken; every business has its “Moments of Hyken; every business has its “Moments of Truth”, good, bad and averageTruth”, good, bad and average

Your front desk is the principal point of contact Your front desk is the principal point of contact for your patients, and therefore the place where for your patients, and therefore the place where many “moments of truth” will occurmany “moments of truth” will occur

Your staff will undoubtedly influence these Your staff will undoubtedly influence these “moments of truth” “moments of truth”

Your patients will remember both the especially Your patients will remember both the especially good, or bad “moments of truth” (good, or bad “moments of truth” ( Shep Hyken, Shep Hyken, CSP, CPAE, Shepard Presentations, LLC: CSP, CPAE, Shepard Presentations, LLC: http://www.hyken.com/Shep_Hyken_Articles.html) )


““Typical Medical Office Moments of Truth”Typical Medical Office Moments of Truth”

Telephoning for an appointmentTelephoning for an appointment

Arriving at the office (is it inviting and Arriving at the office (is it inviting and neat or does it look worn or in disrepair?)neat or does it look worn or in disrepair?)

At the reception desk (are your staff At the reception desk (are your staff pleasant or grumpy?)pleasant or grumpy?)

HowHow long is the wait? long is the wait?

What do you mean you don’t accept my What do you mean you don’t accept my insurance?insurance?



““Negative Moments of Truth”Negative Moments of Truth”

Poor telephone manners by your staff Poor telephone manners by your staff

Perceived staff unwillingness to Perceived staff unwillingness to accommodate the patient (usually when an accommodate the patient (usually when an urgent appointment is requested)urgent appointment is requested)

““Terminal hold” Terminal hold”

Staff at the front desk ignore the patient, Staff at the front desk ignore the patient, appear unfriendly, uncaring or argue with the appear unfriendly, uncaring or argue with the patientpatient


““Negative Moments of Truth”Negative Moments of Truth”

Office staff are grumpy or seem not to Office staff are grumpy or seem not to cooperate with each other cooperate with each other

Staff bad mouth the doctor or co-workersStaff bad mouth the doctor or co-workers

““Passing the buck”Passing the buck”

Not informing patients about long waiting Not informing patients about long waiting times (due to an unforeseen emergency) and times (due to an unforeseen emergency) and not giving them the option of waiting or not giving them the option of waiting or reschedulingrescheduling



Sabotage: DefinitionSabotage: Definition

NounNoun1. any underhand interference with 1. any underhand interference with production, work, etc., in a plant, or production, work, etc., in a plant, or factory, etc., as by enemy agents during factory, etc., as by enemy agents during wartime or by employees during a trade wartime or by employees during a trade dispute. dispute. (Merriam-Webster Dictionary)(Merriam-Webster Dictionary)

2. any undermining of a cause. 2. any undermining of a cause.

Verb (used with object)Verb (used with object)

3. to injure or attack by sabotage. 3. to injure or attack by sabotage.

Synonyms:Synonyms: disable, vandalize, cripple.disable, vandalize, cripple.


Workplace SabotageWorkplace Sabotage

when employees intentionally damage a company’s when employees intentionally damage a company’s property or products, impair its reputation or subvert its property or products, impair its reputation or subvert its processes processes

usually the result of either a real or perceived injustice to usually the result of either a real or perceived injustice to the employee. the employee.

can be classified as the “Mad Saboteur”, usually a major, can be classified as the “Mad Saboteur”, usually a major, one-time event, or as “insidious sabotage”, one-time event, or as “insidious sabotage”, comparatively minor, ongoing sabotage comparatively minor, ongoing sabotage

examples include destroying equipment, stopping examples include destroying equipment, stopping production, working slowly, lowering product quality, bad production, working slowly, lowering product quality, bad mouthing the company and modifying work procedures mouthing the company and modifying work procedures


Types of SabotageTypes of Sabotage

Sabotage can be either unintended or Sabotage can be either unintended or intentionalintentional

How do your staff treat your patients?How do your staff treat your patients?

How do you treat your staff?How do you treat your staff?

Is your staff subconsciously telling your Is your staff subconsciously telling your patients that they are unhappy at work? patients that they are unhappy at work?

Actions can speak louder than words, and it Actions can speak louder than words, and it may be the nonverbal message that comes may be the nonverbal message that comes acrossacross


Unintentional SabotageUnintentional Sabotage Poor telephone manners, front desk staff seem to Poor telephone manners, front desk staff seem to

ignore patients, are grumpy or argue with ignore patients, are grumpy or argue with patientspatients

““Attitude”Attitude” problems problems

Enforcing “rules” regarding scheduling urgent Enforcing “rules” regarding scheduling urgent appointmentsappointments

Lack of staff cooperation, staff are disorganized Lack of staff cooperation, staff are disorganized and seem confused or unfamiliar with office and seem confused or unfamiliar with office policies and procedurespolicies and procedures

““Passing the buck”Passing the buck”

Long waits without any explanation as to why or Long waits without any explanation as to why or an estimate of how long the wait will bean estimate of how long the wait will be



Intentional SabotageIntentional Sabotage

Avoiding work, hiding or destroying files, Avoiding work, hiding or destroying files, billing slips and insurance claims formsbilling slips and insurance claims forms

Incorrect or slow submission of insurance Incorrect or slow submission of insurance claims, or incorrect billing procedures, claims, or incorrect billing procedures, leading to loss of practice incomeleading to loss of practice income

Badmouthing physicians or other staff in front Badmouthing physicians or other staff in front of patients of patients

Gossip and “back-stabbing” in the back officeGossip and “back-stabbing” in the back office ““Losing or misplacing” patient messages or Losing or misplacing” patient messages or

other critical patient related informationother critical patient related information


The Office BullyThe Office Bully


Intentional SabotageIntentional Sabotage

Taking critical clinical staff out of the office Taking critical clinical staff out of the office communications loopcommunications loop

Undermining or bullying other office staffUndermining or bullying other office staff

Embezzling funds or using practice funds to Embezzling funds or using practice funds to make private purchasesmake private purchases

““Poisoning” employees against management or Poisoning” employees against management or other co-workersother co-workers


Why Employees Sabotage Your Why Employees Sabotage Your PracticePractice

To gain revenge against management or co-To gain revenge against management or co-workersworkers

Venting personal anger or frustration resulting Venting personal anger or frustration resulting from non-work related issues and problemsfrom non-work related issues and problems

To gain a competitive advantage over other To gain a competitive advantage over other employees or increase their value in the eyes of employees or increase their value in the eyes of their employertheir employer

Fear of change in office dynamics and workflow, Fear of change in office dynamics and workflow, or fear of increased work load and or fear of increased work load and responsibilities, etc.responsibilities, etc.


Avoiding SabotageAvoiding Sabotage

Treat your staff well. A little kindness goes a long Treat your staff well. A little kindness goes a long way!way!

Provide an employee handbook to each employee Provide an employee handbook to each employee with written guidelines and office policies for with written guidelines and office policies for ethical and fair treatment of patients and other ethical and fair treatment of patients and other employees (provide both positive and negative employees (provide both positive and negative inducements to encourage the behavior you want).inducements to encourage the behavior you want).

Instill a culture of fairness in all your employees. Instill a culture of fairness in all your employees. Discuss your expectations with each employee at Discuss your expectations with each employee at hiring , and again to your entire staff periodically.hiring , and again to your entire staff periodically.



Provide a safe and confidential way for employees Provide a safe and confidential way for employees to express concerns or issues they may have with to express concerns or issues they may have with other employees (consider using an HR other employees (consider using an HR consultant for sensitive issues), as well as issues consultant for sensitive issues), as well as issues in their personal lives that may affect their ability in their personal lives that may affect their ability to concentrate and function at workto concentrate and function at work

If at all possible, try to involve employees in any If at all possible, try to involve employees in any changes in office dynamics or workload that may changes in office dynamics or workload that may ultimately affect themultimately affect them



Have a zero tolerance policy for bullying, non-Have a zero tolerance policy for bullying, non-cooperation between employeescooperation between employees

There is a concerted effort to make workplace There is a concerted effort to make workplace bullying a wrongful employment practice at the bullying a wrongful employment practice at the Federal level. Federal level.

The Healthy Workplace ActThe Healthy Workplace Act, has been , has been introduced in more than a dozen states. To introduced in more than a dozen states. To

protect themselves, employers must recognize protect themselves, employers must recognize workplace bullying and know what to do to workplace bullying and know what to do to

minimize the present and future risk.minimize the present and future risk.



Three steps you can take:Three steps you can take:

Make sure your written policies prohibit all Make sure your written policies prohibit all harassing, abusive and violent conduct.harassing, abusive and violent conduct.

Quickly respond to any complaint of improper Quickly respond to any complaint of improper behavior—even if it is not technically illegal—in behavior—even if it is not technically illegal—in the same way as you respond to a complaint of the same way as you respond to a complaint of harassment based on a protected category (such harassment based on a protected category (such as sexual harassment). as sexual harassment).

Most important, make sure your actions are Most important, make sure your actions are aligned with your words. aligned with your words.



Developing Positive “Moments of Truth”Developing Positive “Moments of Truth”

Personal touches from doctors and office staff to your Personal touches from doctors and office staff to your patients: have your staff show them they care!patients: have your staff show them they care!

Have your patients provide feedback about their visit Have your patients provide feedback about their visit experienceexperience

Make sure your staff greets every patient as they enter the Make sure your staff greets every patient as they enter the office with a pleasant “Hello” or even some small talkoffice with a pleasant “Hello” or even some small talk

Inform patients in advance when possible of unexpected Inform patients in advance when possible of unexpected long waits or cancellationslong waits or cancellations

Train your staff in proper telephone manners and etiquette Train your staff in proper telephone manners and etiquette (if necessary bring in a consultant to help with this, the cost (if necessary bring in a consultant to help with this, the cost will be well worth it)will be well worth it)


Developing Positive “Moments of Truth”Developing Positive “Moments of Truth”

Try to avoid having your staff make patients wait Try to avoid having your staff make patients wait too long on the phone. Have them offer a call back too long on the phone. Have them offer a call back if it appears the wait will be longer than 1 or 2 if it appears the wait will be longer than 1 or 2 minutesminutes

Encourage your staff to provide easy access to Encourage your staff to provide easy access to urgently needed office appointments (consider urgently needed office appointments (consider alternative scheduling procedures such as block alternative scheduling procedures such as block scheduling or open access scheduling)scheduling or open access scheduling)

If at all possible, do not use an automated phone If at all possible, do not use an automated phone answering systemanswering system

Encourage your staff and physicians to become Encourage your staff and physicians to become involved and express their thoughts on eliminating involved and express their thoughts on eliminating delaysdelays


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Office Sabotage: Are Your Employees Victimizing You?