Your patient coordinator goes on vacation and your office grinds to a halt. Whoever is left behind ends up texting and calling her while she’s on the beach. It’s no fun for anyone, and it makes you look bad in front of patients.
If that’s ever happened in your practice, you don’t have a staffing problem. You have a documentation problem. And every large, stable practice I’ve worked with has solved it the same way.
There are a lot of shiny objects in marketing and practice management vying for your attention. The latest social media craze. The newest extension for your Google ads. They’re all fine, and they’ll help you grow. But there’s one fundamental that all large practices have in place, and without it, you’re signing up for headaches and eventual failure.
I named my company Think Basis because every business needs to think about its foundation. The basis for stability and growth. This article is about the least glamorous, highest-payoff piece of that foundation.
Key Takeaways
- Every stable, growing practice has a business operations manual. Not the government-mandated one. The one that documents how your office actually runs.
- If your office can't function when one person is away, that person is holding your practice hostage, whether she means to or not.
- Build the manual in 3 steps: identify every task, have each staff member write out her own steps, then swap roles and test until anyone can follow them.
- A manual cuts training time for new hires, stops bad habits from spreading, and is what makes adding staff and locations possible.
Why one sick day can shut down your practice
If you’re a typical office, you have one or two doctors and an assortment of staff. The receptionist knows her job. The office manager knows hers. But more likely than not, they can’t do each other’s jobs consistently and accurately.
So what happens when one of them gets sick? Or goes on vacation? What I usually see when the patient coordinator goes away is the office grinding to a halt.
In some ways, that reliance makes your staff feel important. The fact that the office can’t run without one key member fills her with a sense of unjustified importance. She gets rewarded for making your life harder. I discourage this kind of negative incentive structure, and so should you.
As a business owner, you should be horrified by that situation. You’re putting your practice in the hands of whoever happens to hold the most undocumented knowledge. You’re letting the inmates run the asylum.
The one document every large practice has in place
I’m referring to your practice manual.
Not the manual mandated by the government. Not the one that covers medical protocols and fire exits. Your business manual. The one that frees you from internal office politics and petty fiefdoms. The one that lets your staff deliver quality service with consistency, no matter who is standing at the desk.
It’s not exciting. It will never trend on Instagram. And it’s worth more to your growth than any marketing tactic you’ll read about this year, because marketing fills a pipeline and broken operations drain it. I’ve written elsewhere about the marketing mistakes that empty a consultation calendar. This is the other half of the equation: what happens after the phone rings.
What a practice manual actually does for you
Despite your staff’s insecurities, the manual is the key to liberating them.
Ask your team to imagine going on vacation and truly being on vacation. No calls from the office. No pile of work and unhappy coworkers waiting on their return. A complete manual lets each of your staff step into the others’ shoes. They won’t have full proficiency, but they’ll get things done.
Your practice doesn’t have to grind to a halt. You don’t have to let anyone hold you hostage because only one person knows how to order implants or book surgical time.
How to build your practice manual in 3 steps
Building your practice manual is a 3-step process: identify, create, test.
1. Identify your processes. Look at what you’re doing. Figure out what each person’s job is and write it out as a task list for each position. This clarifies things for the manual, and it also exposes issues and redundancies. If you’re like most doctors, you don’t actually know everything your staff does every day. In this case, ignorance is not bliss.
2. Create the manual. Have each staff member write out every step of her own tasks, in enough detail that anyone could pick up the manual and follow it. Having each person document her own duties spreads the work out. You’re crowdsourcing the manual to the people who know the tasks best, and no single person carries the whole project.
3. Test the processes. Steps one and two are useless if people can’t follow the result. The way we solved this ended up being simple: swap. Each person takes a coworker’s written process and attempts to complete the task start to finish with no guidance. If the tester runs into problems, make notes and kick it back for more detail. Keep going until every staff member can complete every documented task with no help.
Once you’re confident the processes are clear and actionable, make sure everyone knows where the manual lives. A manual nobody can find is a manual you don’t have.
Your staff will resist. Push through it.
At first, your staff will fight the manual. They’ll fear for their jobs and assume you’re preparing to replace them.
It’s not about replacing them. It’s about you taking control of your business and treating it seriously. It’s insurance against catastrophe at the employee level. Your patients deserve to have their needs met no matter the circumstances, and the manual guarantees they will be.
But talking to you as a business owner, I’ll be honest about the part you don’t say out loud in the staff meeting.
The uncomfortable truth: it makes everyone replaceable
Think about your current hiring process. If you have to fire someone, you’re dreading the retraining. The new hire shadows an existing employee for days or weeks. Your veteran team loses productive time playing teacher. Bad habits get passed from person to person with no agreed-upon standard, and since you’re not there supervising, there’s no quality control.
And that assumes your staff stays. What happens when someone quits with no notice, or leaves on a medical emergency? Chaos.
With a manual, all of that changes. A new hire studies the document and attempts each task associated with her job, bothering your team only when she hits complications. Then you or your manager evaluate how well she learned.
A practice manual saves money and time on every hire, eliminates poor training and inherited bad habits, gives your practice stability no one person can take away, and makes adding staff or a second location possible instead of terrifying.
This isn’t theory. We grew Toronto Cosmetic Clinic from 4 staff to 44 in six years, taking them from under $100K to multiple 7 figures. Marketing generated the demand, but documented processes are what let the team absorb it without the wheels coming off. When you’re ready to hire above the front desk, start with my guide to hiring a practice manager. And if you’re eyeing expansion, the manual is prerequisite reading before opening a second location.
If you want the demand side handled while you build the operations side, that’s our job. See how we work with surgeons at our plastic surgery marketing agency page, or get in touch.
It’s not shiny and it’s not exciting. But it is the basis for success, and it’s the only way to handle the kind of growth we bring to our clients.