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Manager's Minute Archive
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Every week we'll have a new Manager’s Minute - quick one-minute tips to help with managing your practice submitted by the AOA Practice Management Committee. Topics can cover just about anything that might be useful in your day-to-day operations, from HR and accounting to incentive programs and tech tips to speed you through your day. Current Manager’s Minutes can be found on our AOA website home page, and old minutes will be archived here so you can search past tips.

operations, from HR and accounting to incentive programs and tech tips  

06/23/2017: MIPS/MACRA - Are You Ready?

If you’re like most managers, you know about the major changes to the CMS quality reporting, but aren’t sure yet what you are really supposed to do. Start here: It’s an easy-to-follow resource to explain what’s going on and will give you choices for how you want to participate. The highest incentive comes from the full-year participation. You can choose to submit the minimum, which will avoid the negative adjustment; it just won’t get you any incentive either. If you want to at least get some incentive, you could aim for the 90-day submission, which must be started no later than Oct. 2. If this is your choice, it’s recommended that you start now and monitor your status so you have time to make adjustments before the last start date of Oct. 2. You’ll certainly learn more at the AOA conference in Las Vegas in September! Watch the AOA website for more resources too.

06/16/2017: Don't Overplan

One of the biggest mistakes many new managers make is to assume that if a little planning is good, then a lot of planning is better. You can overplan. Most people who overplan box themselves into a corner that reduces their ability to adapt. Our world is fast-paced and ever-changing. You need to acknowledge and accept that sometimes you’ll be on target and sometimes you won’t. Don’t create unnecessary anxiety. Create a roadmap and know you just might need to detour a few times.

06/09/2017: The Fruit of Lessons Learned

Sometimes you’ll succeed…and sometimes you’ll fail. Don’t look at failure as failure. Lessons learned from failed efforts are often more valuable than a task that just went as expected. Recovering from failure is something that takes an inordinate amount of tact, skill and grace.

Don’t react or make decisions based on the fear of failure or of being wrong, rejected or emotionally uncomfortable. These very situations are the greatest opportunities for growth, learning and improved performance.
To fail well:

  • Accept failure as a normal and healthy part of life.
  • Keep trying.
  • Set realistic expectations.
  • Talk about failure (let feelings and facts out by talking with a neutral party).
  • Deal with root causes, not symptoms.
  • Develop alternatives.
  • Imagine the worst outcome.
06/02/2017: Motivate Your Employees to TRAIN

Training doesn’t have to be boring. Find training sources that use MP3 formats or videos instead of pages they have to read. Distribute training items and let everyone listen when they have time rather than scheduling a meeting and training everyone at once. Consider generating a quiz that employees can answer and turn in for a prize drawing, which could be just about anything from a great pen to a gift card for lunch or even an hour of PTO.

05/26/2017: Overcome bad rapport with your employees

You won’t hit it off with everyone, and as a manager, you will have some difficult and unpopular decisions to make. To turn those bad vibes around, try these steps:

  • Define - and agree on - a goal of trying to improve working relationships to find agreeable solutions.
  • Have a frank conversation in private about your relationship problems and then focus on the issues causing the problems. Try this: “Susan, I believe we’ve gotten off on the wrong foot on this task. It seems to me that whenever I have a suggestion, you interrupt me and don’t really listen to the full idea. And you assume it won’t work before you even try it. My ultimate goal is to complete this task successfully, AND for you and I to have a respectful working relationship. What do we need to do to get there?”
  • Focus on improving the way you and the other person communicate and treat each other.

You need to be the one to initiate and maintain this positive change.

05/12/2017: Can I Ask An Employee About a Medical Condition?

If you notice strange behavior, performance issues, fatigue, irritability, etc. - even subtle changes - you might want to privately ask your employee if something is going on that you should know about. But you may feel constrained, believing you can’t legally inquire. Failing performance is not something you can ignore just because you have a fear that it might be a disability that you’ll have to accommodate.

Under the Americans with Disabilities Act (ADA), an employer may inquire about whether a medical condition exists that is affecting his or her ability to perform the essential functions of his or her job. You may also inquire about medical problems if you have received reliable information from a third party such as a family member. Try these words: “Is there anything that I should know about that might be affecting your performance? Recently, I’ve noticed X…” Mention performance specifics. If the employee mentions a disability, even if she or he doesn’t use that word, you are required to take proper steps and make accommodations if needed. Document everything.  

Two important comments: You can NOT tell other employees that an employee is being given an accommodation, as this will inform them that the employee has a disability. (The employee can tell; you can NOT.) And, as an employer, you are not required to accommodate every disability. If the condition puts the safety, health or performance of the employee at risk or if the condition’s accommodation “creates undue hardship on the employer,” you have options. Seek legal advice before taking action that affects that employee’s work status.


Someone once said that there is nothing sweeter than a person hearing the sound of their own name. Calling someone by name makes them feel acknowledged and important.

Here are a few tips to help you remember names:

  • Listen when introduced to someone new.
  • Look at the person and make a silent association between their name and something else that will help remember.
  • Exaggerate that silent association.
  • Repeat the association to yourself a few times.
  • Use the person’s name in conversation – “Nice to meet you, Carol” – because saying the name out loud helps you remember.

Everyone feels like they have to do more with less these days. Here are a few hidden sources you can tap to ensure you are getting the most out of every revenue dollar:

  • Ride your vendors: Your vendors could increase prices or decrease quantity sizes without telling you. Watch what you order and make sure your vendors are competitive with others.
  • Check every order: Review packing slips and invoices with every delivery to ensure you received exactly what you ordered, that there are no extra charges or incorrect quantities, and that nothing is damaged.
  • Conduct and maintain inventory: Everything from office supplies to medical supplies should be inventoried. This helps keep your staff honest and makes sure things aren’t walking out the door. It also ensures that you don’t have a huge stockpile of items that could expire on the shelf.
  • Stagger your staff: Do you really need your entire staff to start all at the same time every day? Stagger your workers so you can increase support as volume increases and either let them leave early and/or avoid overtime once the need decreases.
  • Renegotiate your lease: One of your largest expenses could be your lease, so renegotiate it as often as you can. Make sure your landlord is providing all the services you are paying for so you aren’t absorbing extra cost just to get things provided for you.
04/21/2017: keep your remote workers engaged

Gallup reports that approximately 37% of today’s workforce works remotely. And, if “engaged” by their management, they feel just as if not more valued than a traditional office worker. What should you do for your remote workers?

  • Make sure everyone knows they are a part of the team.
  • Establish a time and method for regular check-ins.
    Focus on what your remote workers are achieving, not when they are working (unless you have mandated required working hours).
  • Get to know your remote employees so you can interact personally with them.
  • Schedule regular face-to-face meetings. You can use Skype but you need in-person meetings periodically as well.
04/14/2017: the skinny on i-9 forms - avoid the fines!

U.S. Immigration and Customs Enforcement (ICE) is tripling its I-9 audits this year. If you are audited and assessed penalties for form errors, fines can range from $216-$2,156 per violation, and there can be multiple violations per form. And hiring illegal immigrants can result in fines up to $21,563 per violation. Follow these best practices:

  • Have a standard process in place, especially if you have multiple people responsible for filling out forms.
  • Educate your employees on the implications of not filling out forms correctly.
  • Ensure originals, not photocopies, of identification documentation are provided for review so that you can ensure they are not fraudulent.
  • Purge all I-9s once they have met the maximum retention period. Forms must be retained either 3 years after the date or hire or one year after the employment ends, whichever is later. Be aware there are record keeping fines if you retain the forms past the destruction date too!
  • Conduct in-house audits every year and fix mistakes as soon as you find them.
04/07/2017: microsoft office in-office training

Almost every office uses Microsoft Word or Excel. Your office probably has a "guru" who creates templates and spreadsheets with little effort - or it might even be you. Giving your office staff additional skills with these two programs can provide greater efficiency and give you the ability to assign additional tasks to your staff, and it can help them in their tasks outside the office too! Consider holding a class in your office after hours or on a Saturday for any staff wanting to increase their understanding of either of these programs. Start with the basics and work your way up, possibly through a series of classes. You'll be surprised at how many of them will take you up on it. And if you can increase their skill set, they will feel more empowered and responsible. Throw in pizza for those unpaid sessions and you'll find most of your staff will take part!

03/31/2017: there's nothing more powerful than peers teaching peers

Employee attendance at seminars or other training venues is common practice at many companies. Take this a step further by asking employees who attend training to give a brief in-service presentation to their peers and managers when they return. This serves several purposes: Employees will retain the information better if they teach it to others, and new information is shared. It will also create a supportive environment so that new systems or information learned in training seminars will be more easily integrated.

03/24/2017: a winning offer of employment

When you make an offer to a new employee at any level, you do yourself a huge disservice if all you talk about is the pay. A position with your company is much more than just what goes into the bank account at the end of the day – it’s also about benefits, perks and job satisfaction. And it’s about career progression, if that is available in your company. When talking with a potential employee, address the "total offer package," not the hourly rate or salary. Include vacation/PTO, health benefits and other insurance specifically mentioning company contributions, your 401K program and how much your company contributes, education support and training, ability to be considered for any internal job openings, and progression through supervisory roles. Also make sure to mention company events such as Casual or Jean Days, charity support/donations, annual company picnic or Christmas party. And what you do for employee birthdays or anniversaries.  Remember, you are trying to convince this terrific individual to accept a position with your company so you pull out everything you can so they choose YOU. Your company is more than just a paycheck; it’s where they’ll spend more of their time than what they do at home with their family…they have to want to be there too.

03/17/2017: documenting employee performance issues or incidents

Properly documenting employee performance issues will save time, energy and money in the long run if you have to let them go, especially if they decide to turn around and sue you. Follow these simple rules:

  • Document performance and conduct conversations on the same day as they take place so they are most accurate.
  • Always include the date, your name/title, employee’s name/title and those of any witnesses.
  • Do not abbreviate, editorialize or characterize in your write up. State facts – what you said, what she or he said. No speculation.
  • End your write up (and your conversation) with the take away: State the action plan you agreed to along with clear expectations you set for your employee.
  • Do not manage your employee through emails - do it face to face.
  • Maintain all employee write ups in the personnel file – not in your drawer or on your computer.
  • Medical documentation is subject to various privacy laws and should be kept separate from disciplinary discussions.
03/10/2017: financial discussions

One of the most difficult discussions you will have with a patient is about finances. Most of the time, it falls to the billing personnel, but the "touchiest" ones will fall to the manager for various reasons. Your best strategy is to have both the financial problem and potential solutions determined before the patient ever enters your office. Have your financial options - such as a payment plan or an outside financing solution (e.g., CareCredit) - prepared for the patient if there is no other recourse. When the patient sees you are prepared to help, he or she should be appreciative, and the solution more easily agreed on.

02/24/2017: too much email? automate with outlook rules

Are you being buried every day with email? Do you get emails that you always forward to the same staff member? Do you get lots of emails from a discussion forum or Listserv and like to read them at one sitting? These tasks and many more can be automated using Microsoft Outlook Rules.

By exploring the Outlook Help - or by doing a quick Google search on “Manage Rules” for your version of Outlook - you’ll discover how easy it is to set up automatic rules. You can set up rules based on the sender’s email address, subject line, or other relevant criteria. You can then automatically copy or forward to another person or group, move or copy to an Outlook folder for later review, and even discard the original to your Deleted Folders. The options are terrific! Using Outlook rules will dramatically cut down on the time you spend reviewing and handling email. Try it today!

02/17/2017: 4 keys to creating a positive work environment

EMPOWER - Empower your staff to make decisions and create a plan. The idea is to allow the freedom to empower them to create work how they want to. This is letting them know that you trust them to get the job done. 

OFFER REWARDS - Positive reinforcement is a powerful tool that should not be underestimated. This shows your staff that you care about them; it also encourages them to work harder and boost morale. Acknowledge your hard-working employees. This will create a competitive environment within the practice. When your staff feels like they are doing good work, they want to rise to the occasion even more.

LISTEN - Listen to your staff's ideas. They’re the ones that are completing the tasks every day. By listening and implementing their ideas, you are telling them that their opinions and ideas matter. 

HAVE FUN - Fun happens when people feel well-connected with a team where there’s mutual respect, open communication, and acceptance of who people are, and everyone’s collaborating and working toward the same goal. One office has NFL Jersey Fridays - this allows staff to show off their favorite team. Consider creating a fun team-building activity to spark creativity!

02/10/2017: need another creative way to boost physician and staff morale?

There are endless ways to boost morale! Most physician practices recognize a day during the calendar year as their “anniversary” date, or “founder’s day”. Consider designating this day/date as an annual Employee Appreciation Day, and/or designate the week leading up to, or surrounding, this day as Employee Appreciation Week. As part of the day’s/week’s activities, consider inexpensive appreciation gifts branded with the practice logo or gift cards. Gifts can be in the form of restaurant gift cards, gas cards, tote bags, cooler bags, director’s chairs, Tervis Tumblers, etc. Culminate the day’s/week’s activities by closing early, or extending the lunch period, to allow for a hotdog/hamburger cookout or catered luncheon and outdoor activities. Activities could include a cake walk, outdoor games, tailgate party, etc. If you fundraise for a charitable organization throughout the year, consider a “Pie in the Eye” or “Dunking Booth” fundraiser where employees pay for the opportunity to throw a pie in the face of, or dunk, their favorite (or not so favorite) doctor, manager or supervisor. Whatever you do, make it both fun and memorable. It fosters camaraderie amongst your physicians and staff, and - most of all - encourages laughter and good times.


Want to automate repetitive tasks? Try macros! If you use Microsoft Excel or a similar spreadsheet product for the numbers in your work life, consider using macros. What’s a macro? In computers, a ”macro” (for "large"; the opposite of "micro") is any programming or user interface that, when used, expands into something larger.

In MS-Excel, a macro allows you to literally record repetitive steps for replay multiple times in the future. The details of creating a macro will vary based on the version of Excel that you use, but simply explore the Help function. You can also Google "macros" and your version of Excel to find a wealth of online tutorials, including videos.

So, take a step back and evaluate your Excel workload. I bet you’ll find a few opportunities to automate your keystrokes - and save time in the process.

01/27/2017: How to Share the Results of Your Patient Satisfaction Surveys

When your patients comment on their patient satisfaction surveys, you should share all of those comments - both positive AND negative - at your manager and physician meetings. These comments should subsequently be reviewed with each department so everyone is aware of the patient perspective and the importance of these surveys. From there, gather each department to let them help find the solutions to reduce complaints. Employees who help generate a solution have a vested interest in seeing that solution succeed and feel more important to the organization.

01/20/2017: have a mile-high pile of magazines on your desk?

As managers, our time becomes more precious every day. Our practices demand more and more of our time, and interruptions can be unmanageable. Yet, it is more important than ever to stay up on trade reading so our knowledge is relevant. Try this technique to identify the relevant reading quickly, then spend time in the details when life gives you the inevitable moment where you have to wait.

Many of our trade journals still come in printed format. The first time you see a journal, scan the table of contents, then flip through the pages with purpose. See an article that interests you? Tear it out and put it in a reading folder. Toss the rest of the journal and move on with your day. Then, when you know you’ll have a moment where you might be waiting (e.g. travel, early to a meeting, doctor visit), grab your reading folder and read the information in full.

Paper is low-tech but very portable. Even if you get journals online, try the same technique and print what you’re really interested in digesting. This’ll keep your reading stack lean and mean.

01/13/2017: Made a Mistake at Work? Take the Direct Approach to Resolve It

Everybody makes mistakes; it’s inevitable. But it’s what you DO when you make a mistake that counts. In a recent study, it was found that 79% of the people react to those mistakes by blaming others or hiding or just denying that they occurred. The right thing to do, according to New York Times bestselling author Mark Murphy, is to take an “active approach” in response. Personally – that means face-to-face – apologize so the other person can see that you are sincere. It’s hard to show that in an email. The person you wronged will feel better, and, if you do it publicly, others will actually notice that you’ve accepted responsibility and will think better of you as well. Tackling mistakes directly – part of being transparent as a manager - is one of the keys to being happier at work.

01/06/2017: Steps to diffuse team conflicts

Managers should take quick action to mediate conflict and limit collateral damage, writes John Rampton, an investor, online marketer and founder of the online payment company Due. Rampton offers seven suggestions on how to approach workplace conflicts:

  1. Find the root of the problem.
  2. Establish open communication.
  3. Encourage employees to put the company first.
  4. Propose a possible compromise.
  5. Encourage people to chat outside of the office.
  6. Don't let team members spend too much time together.
  7. As a last resort, switch up the team.
12/22/16: How accessible is your practice? try calling your main phone line

Most phone systems provide the ability to track abandoned calls, wait times, average entry time in each call queue, and number of voice mails. This information should be tracked on a daily basis and sent out to the management staff for monitoring. Staffing changes, including altering hours of call center operators, can better accommodate high-volume call times. Additional users in other locations can be added to a call queue that may be overloaded.

12/16/16: Dealing with Difficult Patients

We all have been there, whether you encounter a patient who is demanding, angry or downright rude. It is how we handle the difficult patient that will determine a positive outcome. The best way to deal with an angry patient is to remove them from the reception area and take them into your office and listen. Let the patient talk without interruption. Eye contact is extremely important, as it conveys to the patient honesty and your openness to listen to their complaint. Body language is just as important as what we say. Keep your hands and arms placed in front of your body, but not crossed as this can seem confrontational. Watch your language as best as you can so not to escalate their anger. Address the patient calmly; try not to talk negatively to the patient. Use statements such as “I can understand why you feel that way.” Try to remain neutral, and demonstrate control of the situation.

12/9/16: oh no! an employee tells you that "morale Is low"

Have you ever been approached by one of your employees and been told “Morale is low?” As administrators and office managers, we frequently struggle with how to

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