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Changing the culture of the practice is very hard to do without eliminating the ringleaders. Our technicians were like the "mean girls club." They criticized the entire hospital including the owner and myself. After a battle of more than a year, I discovered the ring leader was one of the associates. Once she left, the change began. When a couple more of the mean girls moved on, the culture moved in a different direction! The wall is down!

Leadership training and Team building is the best way to change things. Begin by listening to the owner/s and associates to get their perception. Then meet individually with every person and listen to perceptions, perceptions are neither right or wrong it is simply the picture we form in our minds of someone or situation it is developed by who we are the experiences we have had and so on. Leadership training is holding managers accountable too, success begins with the success of others. Happiness in the work place and individual growth and potential is the legacy as a manager you can get passionate about. Taking fear out of the workplace replacing it with good processes and procedures but more importantly bring people in and giving them the skills to become the best they can be. Currently working with a team right now that had the same issues, happy to say they are not going to need me other than to weave in and out because it has been very effective. Best Wishes! Patti Please feel free to contact me. Best wishes.

Crosstraining is the best solution I know to stop the front vs. back mentality. Your team should all read FISH by Stephen Lundin, so these techs will see they are creating a toxic work enviroment - by their choice. The focus should be on serving the client not this unprofessional nonsense. Fid the ringleader and fire them if necessary. It will usually wake up the rest.

I believe it starts with your leaders in the respective areas. We had a very similar situation and the two managers met to try to come up with a solution. Things did not change, so I got involved in their meeting. It was very apparent that the head receptionist was not interested in fostering a team environment and was indeed a big part a problem in that she was leading her team to believe there were conflicts. I ended up relieving her of the supervisory duties and all is well now between the front and back. We have two supervisors that are commited to keeping it that way.
Jodi Peretti

I have a theory on the us versus them/ front versus back phenomenon. I believe it begins with a lack of respect for the work of one group by another and I believe that it is taught to the staff by the ownership/management of the practice. And you know where I think it REALLY all begins? With the phone. I believe that the tech staff, assistants, doctors, owners and some managers believe that answering the phone is beneath them. That's the 'receptionists' job. And there begins the idea that "I'm better" and the start of resentment and antagonism. Not to get too Dr. Phil on you or anything...;)

Obviously, this is entirely unacceptable; but the 'back' staff apparently has the 'culture' that it is. They must be held accountable for that client & patient wait time. We have a 'travel sheet' on which the charges are circled. When more clients started complaining about long wait times; we put some new spots on the top of it for staff to log time for: Appt time___, Client In (arrival)____, Room In____, Room Out____, Client Out (checked out)_____, Occasionally we have also written in Dr In___ & Dr Out____. Turns out, most of our clients really were not waiting too long. It helped us to see where the delays/bottlenecks were so we could address them too. But it also held the staff member more accountable for that client's wait time. Yes, the staff resisted this; but their resistance was short-lived. At the time we initiated it; the 'back' staff was blaming the 'front' and vice-versa. As it turned out, there really was not a long wait for the most part. The Dr in/out also helped with one complaint where a client stated a 'consultation' fee was inappropriate -- the Dr had been in the room discussing their concerns for their pet for 55 minutes straight! Now, we rarely fill in those spots; although we do when we have a new staff member or wait-time complaints.
I also think a big part of your solution must also come from the doctors too. If the doctors can 'see' that a chart is up & waiting to be 'roomed' they can be prompting the 'back staff' to get that client & patient into the room. We have a chart 'rack' in a prominent location where the receptionists place the chart when they 'hand' it over to the back. If the back staff wants to 'look good' to the doctors, this prompt should help a lot. If, however, the doctors do not understand why the client has additional wait time, they will likely not be prompting at all & may end up contributing to your communication issues.
Good luck!

Wow...that needs to stop. I agree with Jowee that this is jeopardizing the patient who has to wait while the technicians behave like 5 year olds. About 3 years ago we started having our receptionist directly hand the chart to the technician, and it became their responsibility to call them into the room. We did this because to often when the receptionist called them in, the owner would begin to discuss why the patient was in for an appointment, the receptionist would then have to explain in to the technician, and it became a game of chinese telephone. This has also resolved the problem of a technician being unaware that the appointment has arrived. I know this probably is not possible in all hospitals, but I hope it helps.

The technicians' behavior jeopardizes patients whose care has to wait for their game to end. Many years ago I was one of three technicians hired to replace three fired simultaneously for this behavior. They need to realize this is not a game they can win as it jeopardizes not only the patients but the business as well... makes the clients wait and lowers the morale. Short of firing them, I suggest hiring a business culture consultant (we have one) to show the management and the front desk staff how to confront this issue with the technicians; let the technicians know that this is not acceptable behavior in the workplace; and cross-train to give the technicians appreciation and and a healthy respect for the challenges the client care team has to deal with on a daily basis.

Depending on the number of your staff you have you may consider assigning the role of incoming tech or recieving tech that way there is an assigned person for the front desk to go to when relaying the information.