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A recent interview with Hospital Administrator Bethany Mihalik, CVPM, CVT, MHRM, CCFP (BM), and practice owner Andrew C. Sloyer, DVM (AS), yielded insights into how an owner and management professional built a relationship of trust and mutual respect. 

Background: Hospital administrator Bethany Mihalik (BM) was recommended for a practice management position with Neffsville Veterinary Clinic, a 10-doctor animal hospital in Lancaster, PA. Neffsville was established in 1970 and in 1990, the owners created a practice management position.   

With years of practice management experience and expertise in human resources, finance, technology, and other key areas, Mihalik thought that she was capable of contributing more to the clinic than what was outlined in the job description. 

AS:  Neffsville is a large, busy practice. When we were ready to hire a new practice manager, we relied on the existing job description to expedite the hiring process and did not explore the broad and diverse roles a manager could play to foster growth and reduce redundancy in operations.  

BM: The position, as described, reflected the role of the current manager, which was inwardly focused with an emphasis on clinic operations. My skills were different. I am more outwardly focused and zero in on how the business operates in a competitive context. 

The owners had invested time, energy, and financial resources in the practice.  It was clear that---even if currently unspoken---they had high expectations for its future.  My goal was to understand their vision so I could identify where my skills and experience---especially in hiring, human resources, and technology---could be applied to ensure growth and success. 

Asking the owners strategic questions and listening to the responses helped me understand how I could be instrumental in building their vision and transformed a surface-level conversation into a meaningful discussion. 

AS: We were intrigued by Bethany’s question and a bit surprised. The practice had been treading water for years without a clearly articulated direction. She turned a surface-level conversation into a meaningful discussion. Her confidence in asking the question and demonstrated competence in following up on our responses by identifying actions and initiatives that supported our ideas, inspired trust in her abilities and judgment, even though we were yet to see all that she could do.   

During the conversation, she mentioned that she worked with the owner of her current practice for five years. The owner was so confident in Bethany’s abilities that she took an extended trip to Africa with Bethany in charge. This was a valuable and compelling piece of information. I know how difficult it is to be away from the practice and appoint an employee to step in for you. Not only was the owner away for several weeks, she was on another continent! 

Intervening events: The day after Mihalik signed a letter of intent and gave her two months’ notice to her current employer, Neffsville had to dismiss a top employee---who handled payroll and benefits-- for embezzling practice monies. An immediate replacement was needed and Mihalik agreed to step in. She worked at Neffsville evenings and weekends to recover passwords, connect with vendors, and make sure staff was paid, all before officially starting her position! 

BM: Taking on the position in the interim allowed me to show the owners what I could do.  

AS: Bethany kept the practice afloat and then some. We saw how adept she was at taking on new responsibilities and she updated us about what she was adding to her plate, why she was doing it, and its impact on the practice. 

BM: When I started full-time with Neffsville, my focus was on the success of the practice and I relied on KPIs, metrics, and other measures of success and growth. Then, and now, I update the owners using various platforms---the good, the bad, and challenging. I try to be sensitive to the amount of information I share. Weekly meetings are a great opportunity to provide updates, but during annual reviews, I look for feedback from the owners on my performance. 

AS: One of the most significant transformations ushered in by Bethany was her ability to collect and interpret data, reach conclusions, and make recommendations. Previous managers had snowed the owners under with mountains of data. There was no way, given our heavy schedules, that we had the time to make sense out of what we were given. 

BS: To build trust you have to understand the practice and be aware of how the owners envision its future so that you can move the practice in that direction:

• Ask questions about the practice’s future and listen carefully. Consider and discuss how you can apply your skills to build and contribute to that vision. 
• Share information on a regular basis using email, or other platforms. Let the owners and staff know what you’re working on. Part of building trust and respect is respecting the owner’s time and knowing when and how much information to share.  
• Be visible and available to pitch in when needed. 
• Don’t be silent. Much of what the manager does is done in isolation.  By increasing your profile, you are showing the owners and staff what you contribute to the practice. 
  

• True self-confidence grounded in who she is and what she can believe she can accomplish. 
• A commitment to and passion for work. Confidence is no substitute for hard work, but confidence combined with hard work is a powerful combination. 
• A high level of competency---as well as energy--- that covers a broad range of skills that are necessary to manage a practice. 
• The awareness to analyze work situations and make independent informed decisions. 
• A desire to take initiative and not be sidelined waiting for directives. 

These are just a few of the attributes that were instrumental in establishing a trusting relationship with Bethany. The strong trust that has developed has allowed me to feel confident that Bethany is using her impressive skills to improve the practice.