Do You Delegate the Decisions?

ExecTech Management Consulting

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Do You Delegate the Decisions?

We often hear practice owners say, “Yes, I delegate as much as I can to my staff, but they don’t do it right. They don’t take responsibility.”

But when we watch the day-to-day operations in these practices, we find these doctors insist on being the “decider” for everything: scheduling details, patient requests, paper clip locations, supply orders, telephone scripts, toilet paper arrangements, everything.

These bosses say things like, “I get the big bucks to make all the decisions.” “I’m the only one with any intelligence.” “I let the staff make a decision once and they were wrong . . . I won’t try that again!”

When Delegation is Not Really Delegation

If you expect staff members to take responsibility for a job, you must also let them make the decisions for the job.

For example, your office manager Julie is now in charge of staff schedules. She assigns the work shifts for all staff members each week. Julie settles conflicts, controls overtime and deals with personal requests.

All goes smoothly until you bypass.

Steve says, “Can I have Friday off?” You make a big management mistake and say, “Sure Steve!” You should have said, “Go ask Julie.”

After you bypass Julie a more few times, she gives up. She dumps responsibility for the duty. She sends all the problems to you. “Go ask the doctor if you can work overtime.”

The right approach is to train Julie on how you want the decisions made and then leave her alone. You let her get on with it and, as long as her decisions are mostly right, you keep your mouth shut.

Otherwise, you get stuck with all the problems. People constantly interrupt you with questions. Your people become irresponsible. You become stressed out and overworked. Your practice does not grow.

How to Create Decision Makers

Fortunately, you can train your people on how to make great decisions! Just use these steps with the staff member who you wish to take charge of a new job.

Step One: You gather the information and make all the decisions for the job as the staff member watches.

Step Two: Have the staff member provide you with the information. You make the decisions as you explain the reasoning behind your decision. Reveal your thought processes!

Step Three: Your employee gathers the information and proposes decisions for your approval. Whenever the staff member’s decision is good enough, you go with it. “Is that your decision? Good. Go with it.” Only change the decisions that will simply not work and explain why. Then ask the employee to come up with another decision until he or she gets it right.

Step Four: The employee gathers the data, makes and implements the decisions, and reports the results to you. Again, whenever possible, go with the employee’s choices. You do not have to be the decider.

Step Five: The staff member does everything and makes all the decision. The staff member does not bother you unless he or she needs your help. You check the results from time to time. You focus on the big picture.


Your new receptionist does not know how to deal with telephone calls. On her first day, you answer a few calls while she watches. You decide how to handle each call.

Second, you have her answer the calls and put each caller on hold. She tells you who is calling and why they are calling. You tell her how to deal with each caller.

Once she does that well, you move to the third step. On her second day, you have her answer each call and put each caller on hold. She tells you what the caller wants and how she believes she should handle the call. You either approve her course of action or give her advice on a better course of action.

By her third day, you move to step four. She handles the calls on her own and reports the results to you.

Finally, she handles the calls on her own with occasional assistance from you.

Bang! You have an awesome, responsible receptionist!

Another Example

You want your assistant to educate patients on some home care. She has watched you go through the process several times (Step One), so you explain when you want her to give the instructions and how to handle all the questions, objections and concerns (Step Two).

Your assistant gives the next set of instructions and handles all the concerns as you watch (Step Three). You say nothing unless absolutely necessary. You watch her do this three times.

You then let her complete the home-care instructions step with every patient who needs it. She tells you what happened in each case (Step Four). You check with a few patients and they are all happy with her clear explanations, willingness to listen and patience with their concerns and questions. She adds a new step to call each patient that night to ensure all is well. You are delighted.

You and your assistant agree she can handle this job and all the decisions related to it. You never deal with home-care instructions again.

20 Jobs You May Be Doing That You Can Delegate

□ Patient education
□ Case presentations
□ Patient complaints
□ Staff training
□ Staff schedules
□ Staff personal problems and conflicts
□ Management of practice finances
□ Supply cost reduction
□ Janitorial and grounds maintenance
□ Mail management
□ Legal standards compliance
□ Practice statistic calculations and graphs
□ Computer data backups
□ Office appearance upgrades
□ Patient referral requests
□ Patient referral thank-you notes
□ Review website requests
□ Mystery call tests
□ PR, charity and holiday events
□ Website management and promotion

You keep the big-picture jobs like policy and planning, associate management and promotion.

For all the other jobs, you take your people through the five steps and then let them get on with it. Your top employees will take it from there.

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