The Rule Book


Rules, rules, rules.  I know. We hate them.  Your staff may hate them.  So sometimes, we say, there shouldn’t be any rules.  I thought so too, when I was younger.  I don’t think that way any more.  Here’s why.

At one time, I thought that everyone was on the same plane. We all work hard. We all are adults.  We know that to make a practice work, we just act like adults all the time and everything will be okay.  So we don’t need rules. But here’s what happens in practical life.  A staff member has a personal problem which is affecting her work.  Another staff member gripes to the other staff members about that.  Now all staff members are in “gripe mode.”  And when they are in gripe mode, they are not looking out for the best interests of the practice.

If you have encountered a practice that constantly has office dramas, then you either don’t have rules or you aren’t enforcing the rules that you have.  Good staff members don’t want to work with office drama, they don’t want to have to look over their shoulders to see the next hatchet drop.  They want to create. They want to help their doctors and patients. They want a productive day, help their patients, and be paid a reasonable wage to get that done.

We have a rule book, which establishes the basic ground rules for working in the practice. It covers things like time off, sick days, how we treat each other in the practice, policies on how the doctor is to be supported both in the office and outside the office, rules on physical appearance, etc.  Two of the most important rules that we have are. 1. No natter.  That means gossip in the office is not allowed. The simplicity of it is that if you have a problem with a staff member, you work it out with the staff member directly. If you can’t work it out, then write up the problem to the office manager for help in working it out.  Natter occurs when the offended staff member starts talking to other staff members about the first staff member. What’s the problem there?  The other staff members can’t do anything about the problem so they are drawn in to something they can do nothing about. They gossip with each other. And the tone level of the office drops as a result. When the tone level of the office drops, patients sense it, the doctors sense it, acceptance rate is lowered, fewer referrals come in, etc., etc., etc.  The no natter rule, if enforced, eliminates office drama.  And if there is a natterer, she is corrected by asking her to look at the rule that she signed on to.  Yes, she signs on to all rules before she ever starts working in the office. She initials each of the rules which are kept in her personnel folder.  If she continues to natter, she is replaced.  You cannot afford to have a chronic natterer in your office.  Good staff will leave in the presence of such a person.

The other important rule is “No Case on Post.”  “Case” is a negative mental state that comes from problems outside the office.  You’ve heard the saying, When you come into the office, your problems remain outside the door.  That’s what No Case on Post means.

You are in practice to help people. So are your good staff.  Establish a rule book for your practice so that all members of the staff know what the practice is all about.  You will have staff members who are attracted to those rules, will take solace in the fact that those rules are being applied across the board.  You’ll therefore have a happy office with happy staff and happy patients.  Have signed agreements to each of the rules from every staff member.  For most of your staff, that’s the last time you and they will ever have to look at the rule book.  For the staff member that occasionally violates the rule, and it happens, it’s only then a simple reminder to correct that staff member on what she already signed on to.