Should These Owners Crack Down on Lackluster Staff—or Are They Overreacting?

AS THE EXHAUSTING DAY of clinic came to an end, Dr. Lambeau was looking forward to attending this evening’s Chamber of Commerce meeting. They weren’t something he went to often, but tonight’s topic was around small business staffing — something he needed help with.

After arriving, the host asked attendees experiencing staffing issues to raise their hand — nearly everybody did. How incredible, he thought to himself, that this many local business owners were having the same kind of problem — he felt comforted in some weird way. As he scanned the room looking to see who all of the hands belonged to, he saw Dr. Maguire — an OD who practiced across town.

Once the presentation concluded, Dr. Lambeau made a beeline to Dr. Maguire, “Hey Sara, good to see you here!”

“I wish we were here for better reasons, but it’s good to see you too,” Dr. Maguire replied.

Without making much small talk, Dr. Lambeau got straight to the topic at hand. “I knew staffing was a common issue, but I was surprised at how few people are having the issues that I am — I have employees, but they just don’t want to work!”

Dr. Maguire nodded, “Yeah, it seems the majority of folks are unable to find people to hire — qualified or not. Tell me more about what you’ve been experiencing.”

“I have great employees — they know their jobs inside and out, rarely call in sick and patients love them,” Dr. Lambeau began.

“So, where’s the problem?” Dr. Maguire interrupted.

Dr. Lambeau continued, “It is like pulling teeth to get them to do the simplest tasks in a timely manner — like keeping trial contacts maintained, checking in and notifying patients as soon as their glasses arrive…”

Dr. Maguire excitedly interrupted again, “Keeping artificial tear samples in rooms!”

“Yes…” Dr. Lambeau said hesitantly. “Are you okay, Sara?”

“I am floored that we are literally experiencing the same thing.” Dr. Maguire continued wide-eyed, “It’s like our employees are all talking and creating an alliance against us!”

“I don’t think that’s the case”, Dr. Lambeau chuckled. “The one that kills me is when insurance benefits aren’t checked until an hour before the appointment, instead of days before. Sometimes the findings create a hole in the schedule — if we knew these things sooner, that hole could have been filled.”

“They are mastering the art of procrastination,” Dr. Maguire said, adding, “Mine do busy work instead of these necessary tasks — I could care less if the pens at the front desk are sanitized and the magazines in the lobby are organized.”

Both doctors sighed. “I legitimately worry that if I push my employees at all they’ll quit and I’ll be stuck in the same boat as everyone else in this room — not having enough workers,” Dr. Lambeau said.

Dr. Maguire’s eyes got big, “I agree completely. So, what do we do? All these years we worked hard to own a practice; we finally get here, and we have to accept lackluster work just to keep the doors open?”

Judy S.
Little Chute, WI

I thought that having an employee in her early 50s would be great! I thought that like me, she would have a similar work ethic. However, this is not the case. During and after COVID, she was working from home. This means wearing jeans and tennis shoes and doing only what she had to. I feel like this has destroyed many people’s work ethic and basic sense of “give a crap.” Like other doctors, ours is afraid to admonish her too much, afraid she will quit. These things need to be addressed because it affects the whole office!

Maryanna P.
Boynton Beach, FL

I’m a general manager and agree 100%. I’ve worked at various offices and it’s the same situation. Employees on their phone, patients not confirmed for appointments until the end of the day, turning patients away even though they have an opening because they don’t want to pull the authorization. It is becoming a serious problem and difficult to find a solution without losing staff.

Amber S.
Chester, VA

I do think work ethic overall is in decline. Some of this is healthy; I am glad to have a better work/life balance than my parents’ generation did. However, many employees just want to do the bare minimum these days and don’t seem invested in the practice. I think the ODs in this situation should have an open conversation with the employees. What are their reasons for only doing the menial tasks? Have the ODs made their priorities clear? Make sure everyone is on board with the big picture. Delegate tasks so everyone has something they’re responsible for… so there are no excuses.

Jill C.
Port Orchard, WA

I have been in the industry for 30 years, starting out as a tech, progressing to tech supervisor, office manager and administrator. The scenario depicted is not only very real, but one of the most frustrating components of trying to manage a practice. New hire candidates show up to interviews in unprofessional attire and lack a track history but demand salaries beyond what they are qualified to do. Once hired, they lack dependability, a good work ethic, or investment in the practice. Overwhelmingly, I have experienced a sense of entitlement: not what the employee can bring to the practice, but what the practice can provide to them. We have had no option but to lower our standards. Turnover has never been higher.

Michael M.
Swansea, IL

I often find that employees who slow-walk everything are poorly trained or undercompensated. I have two employees who do the work of four (or more) people because they don’t want to have to work with incompetent coworkers. I pay them well, and treat them like family, because without them I am nothing, and they have become so well trained that they often have a problem sussed out before I even see the patient, and this means medical problems as well as optical solutions. Some of my colleagues bemoan the fact that they can’t find or keep good people, but the management practices they describe often leave me with my jaw hanging! You can’t expect good employees when you’re a lousy employer: paying minimum wage and treating employees like a necessary evil is no way to build trust or cooperation.

Ben T.
Miami, FL

They are not overreacting; a step back wouldn’t hurt. A little coaching needs to be done on some of the details. Setting expectations and accountability will fix this.
No buckling down, get the team engaged. Engagement happens when people are clear on what they have to accomplish and have a part in creating the system and process.
Work ethic and cultural shifts happen non-stop. As long as the leadership is ahead of the curve, these doctors will shift from being reactive to proactive.

Trevor M.
Salt Lake City, UT

Virtual assistants can really help out here. Specifically for things like insurance verification — this can be a task for a VA to do. We have found out that when offices hire VAs there is less burnout of in-person staff.

Beth P.
Slidell, LA

It seems impossible to find employees who want to come to work to work. It seems their mindset is to fill a seat and do only what will get things by for the day! We have experienced the same issues for years and it is only getting worse. As a practice administrator, I need to be confident employees are putting patients’ needs first. Just last week we had a staff meeting and I reiterated that it is up to every staff member to assist in doing everything possible to bring in revenue, otherwise they are a liability. The doctor and I have come to terms with having to constantly remind staff of minor things, recirculate memos and SOPs, continue auditing closely. And yes — for heaven’s sake don’t ask them to clean or straighten up! Having to micro-manage is not my preference; it takes time away from my main responsibilities.

Whitney H.
Missoula, MT

The doctors are not overreacting. It is not unreasonable to want their employees to complete tasks integral to keeping the clinic open. While I understand they may be reticent to put boundaries in place for fear of losing staff, boundaries are exactly what are needed. Sometimes, a simple conversation regarding why certain tasks are more important than others; sanitized pens is nice, but if there are holes in the schedule then the clinic is losing money. That affects everyone’s bottom line. If that proves ineffectual, having daily checklists to complete before closing every day could also help. I don’t think that work ethic is necessarily on the decline, but the cultural shift does ask employers to change the way they manage in order to get business done.