Conflict is part of every healthy relationship. If handled appropriately, it should not escalate into a full blown argument or fight!

Conflict results when two or more people disagree with each other. There are different types of conflict, or rather, varying degrees of gravity in conflict.

Areas that commonly cause conflict, in today’s world, are:

• Lack of communication
  
• Lack of communication
  
• Unfulfilled expectations
  
• Lack of communication
  

Sure. They could be broken down further, but basically I believe it all comes down to communication. Or rather, the lack of it.

How many times have you been involved in arguments/conflicts with another person only to find that if you had communicated better, clearer or more regularly, the whole conflict could have been avoided? In fact, the whole argument in the end probably boiled down to the lack of communication? You blamed the other person(s), or they might have blamed you, for not communicating something to them?

Or perhaps someone promised you something and didn’t come up with the goods? How could this have been avoided?

The cause of common types of complaints/conflict

• Unreasonable or wrong expectations
  
• Poor communication
  
• Service related
  

How do you avoid unreasonable or wrong expectations? By communication!

Don’t promise something you cannot deliver. Instead, why not understate your promise? Only promise something that you KNOW you can deliver! Then if you over-deliver, the other party will be pleasantly surprised.

Communicate any unexpected events to the other party. Don’t leave someone wondering for weeks what is happening to the item they ordered, or the problem you were going to solve for them, or the service you were going to deliver. Keep the other party up to date with what is happening, and by communicating, you can thus avoid unreasonable or wrong expectations.

Communication

• Keep in contact with your client or partner, particularly in regards to problems and issues
  
• Return calls and emails on time
  
• Contact clients every three months (if this is your partner, don’t leave it that long though!!!)
  
• Place extreme importance on communication
  
• Know your priorities
  
• Don’t procrastinate – do it now! And keep the other party informed of any progress!
  
• Have an attitude of excellence
  

Keep in contact with your client by returning phone calls and emails on time. If there is something you need to do for the client, inform the client of what you have done. When problems occur, ensure your client is informed every step of the way until the problem is fully resolved. Inform the client of your progress. Be transparent in all issues and expectations. i.e. Be clear, honest and confident! If there is no specific reason, at least contact your client once every three months to keep up the contact.

Ask the client for feedback. Value the client and their complaint as this gives you an opportunity to improve your service not only for this client but all other clients. Let the client know what steps you have taken to rectify their complaint. Thank them for their assistance/feedback.

It is difficult to successfully manage clients with unreasonable expectations. Not everyone can be satisfied, but you CAN reduce the problem. Most client conflicts are financially or emotionally motivated.

Conflicts can have positive and negative effects on a relationship. If dealt with appropriately, it will bring with it relief and an opportunity for the relationship to grow.

When things are written down, misconceptions can be avoided.

Supply your clients with a handbook/guide, outlining your customer service standards, how you operate, and everything they need to know about your service. “Induct” new clients by going through (and explaining!) the handbook when they sign the contract or take up your services. You could even do the same for future employees. An employee handbook is something that can be referred to and act as a guide and reference for the employee.

Dealing with other staff

Do not be judgmental if an employee has made a mistake, but instead, explain how the situation may have occurred. Identify the problem and put procedures in place to ensure that this does not happen again. Patiently explain to the employee how the company would like to have this type of matter dealt with next time. Often extra training in these situations, even role play, can assist in the prevention of future mistakes.

Problem solving and managing conflict

There are many approaches to problem solving, depending on the nature of the problem and the people involved in the problem. A rational approach to managing conflict is to

• identify/describe the problem (break down into components)
  
• analyse causes
  
• identify alternatives
  
• assess each alternative
  
• choosing one
  
• implement it, and
  
• evaluate whether the problem was solved or not.
  

Be professionally persistent to see the resolution of a problem through to its full completion.

“Speak in anger and you’ll give the greatest speech you’ll ever regret.”  Anonymous

A Practice Manager is a demanding role requiring skills and knowledge in a diverse range of areas including:

• Good time management
• A whole lot of legal requirements
• Human resource management
  • Team building
  • Managing up & down
  • Recruitment | Selection | Induction
  • Workplace relations
• Financial management
  • Payroll
  • Debtors
  • Budgeting
• Risk management

A good Practice Manager will continue  to hone these  skills through additional training and self-study;  networking and research. There are many courses you can do,  such as certificate and diploma courses, not forgetting the value of  life and job experience.  These courses provide an excellent outline and introduction, but when thrown into the real-life situations that’s when you really learn.

Time management.
Let’s start with good time management.

How do you not only manage your own time but that of the whole team; from the medical professionals to the frontline team?   A whole lot of discipline and organisational skills help; that’s how.  Delegation skills also come in handy!

I often get asked “How do you do it all? Where do you find the time?”
The answer is:  I don’t really “find” the time.  We all have the same number of minutes in a day.  Once they are gone, they are lost forever.  You simply cannot “buy” time.  You  have to manage it well.  Without the support of a strong team I would not be able to do what I do.

In the words of William Penn “Time is what we want most, but what we use worst”.

I cover this in more detail in my book  “Juggling” which is about time, stress, and conflict management.

Overdue patient accounts, Third party accounts & Debt collection

Do you know how many of your patients have not paid their account in the last 30/60/90 days?
Do you regularly keep an eye on outstanding accounts?
What about your other debtors?  I’m talking about third party accounts for legal reports, employment medicals, you know the sort.  No money means no cash flow for the practice.

Why do you let your debtors get away with this?

Let me put it in simpler terms.
You work and expect to get paid for it.  Imagine if your employer would suddenly turn around and say you’ll only get paid half of your wages and the other half you’ll get when the debtors pay the business?
You’d be pretty cheesed off to say the least!

But this is exactly what you are letting those overdue debtors get away with!

You go to a store and buy goods and have to pay for them.  Simple isn’t it?  When have you ever gone into a store and told them to meet your payment conditions?

Expect the same from your patients and third party account payers.

You provide a service and you want to get paid for it.
Have a disclaimer with your payment policy on accounts, information sheets etc.

There will be extenuating circumstances from time to time, and we should be flexible.  After all, we don’t want to lose a good customer, but do this all the time and people take advantage of you.

If you are a private billing practice, then get your patients to pay in full on the day of consultation.  Ask third parties to pay in advance (eg upon completion of a report but before posting it).  You might be pleasantly surprised how the cash-flow will improve in your practice.

I work in a practice where we have less than 2% of creditors who do not pay their accounts on time.  It is achievable!  Let me know of your success or if you need some help.  I regularly conduct training sessions on this subject.

A common dilemma for Practice Managers is :

What do you do with patient x-rays?

• Do I dispose of them?
• Do I keep them?
• What are the legal issues?

Why are X-rays a problem ?

Most practices find that they get swamped with patient x-rays .

Costs of storing XRays

- storage & processing costs

physical space in a clinic

lost / misfiling

Privacy

Legal

What is is the solution?

Well, I have tackled the same problem in different ways over time, and I will share the one that works for me.  I will also tell you some of the other methods I have tried as they have been successful in other practices.  What works for one may not necessarily work for another.  It depends on the size of the practice, the number of resources (eg receptionists) available, the type of patient, the storage space available, just to name a few.

In order to determine what you might do with an x-ray we should first look at the cycle of the x-ray and then decide at which point we bring it to an end.

This is the age of computers and internet, and most radiology companies now keep their x-rays on file which can be accessed by doctors via secure remote network access. Contact your radiology company for more details or contact me and I will have a chat with you. This would solve the whole problem of x-ray storage instantly of course.  However, realistically, some doctors do still want to have a look at the actual films in their rooms.  Back to square one!

So the patient goes off to have an x-ray, then they make another appointment to get the results, and during this time the couriers deliver the films and results (although these are more often than not get downloaded straight into the clinical records these days).   So now we store the films until the patient gets in.  The doctor will then ask for the films before or during the appointment and then the doctor forgets to give the films to the patient or the patient forgets to take them.  We now have to store the x-rays again until the patient picks them up.  A never ending circle if you let it get the better of you.

So why not actively stop the cycle at any given point?  Put the responsibility back on the patient.  Actively ensure the patient does not leave your clinic without the films.  Ask them to sign a consent form to have their x-rays destroyed if they do not take them.  Advise the patient that x-rays may be required for comparisons in the future so it may be in their interest to hang on to them.

You may already have x-rays that are a number of years old where the patient has not returned.  You can start with these, but make sure you don’t collect any new ones in the meantime! You can either destroy films after the required number of years (the same rule that applies to archiving and destroying patient files), or you could write a letter asking the patient to contact the clinic or their films will be destroyed after a certain amount of time.  Make sure you give them plenty of time to respond.  (They may be overseas!).  Always keep a copy of their consent form to destroy x-rays.  You may also want to check with your insurance company to see if they have any special requirements.

Operational Tips

In our practice, if a patient has films they need to pick up, we put a comment in the “alert” section of their file so that doctors and the front desk team are reminded to hand over the films.  If a letter has been sent asking the patient to collect their x-rays, this is also recorded.  Remember to keep a “paper-trail” (even if it’s an electronic one) for medico-legal purposes.

This site has been developed by a practice manager with over 20 years experience in her role.  From a solo practice to a large practice, from specialists to general practice, Andrea has extensive experience in her ever-changing role  and is dedicated to providing you with the resources required to make you the best you can be in your field.

This website has been developed specifically with the practice manager in mind, so whether you want to ask a general question or have a more specific issue,  require  one-on-one training or a group workshop or request a presentation for your practice,  it is my aim to provide you with a solution.