The Owners Perspective:
Qualities an owner will often look for when collaborating with a manager, initially, are integrity and dedication to the profession. With these building blocks, a relationship can be initiated. But as with all relationships, it takes work and time to build the most basic foundation of the relationship, “trust.” To grow this aspect of the relationship, certain areas are critical. The first is open communication between both manager and owner. Identification from the owner of past managerial problems can be one way to start to establish trust. Owners will recognize the desire for the manager to succeed by not repeating past mistakes. Receiving input from the owner in regards to a job description, how the owner defines the role of practice manager, and following up with a discussion as to realistic expectations and goals will help to establish that both parties are on the same page. This needs to be put in writing and reviewed periodically. Identifiable goals and the completion of those goals, will add confidence to the relationship as well as building more trust. If either owner or manager have had bad experiences in the past, consider taking small steps together and schedule regular meetings (minimally weekly) together. If the owner suggests approaches to certain problems and it’s not working, then both parties should sit down together and discuss the issue. Managers should not make changes on their own if they are dealing with an owner who is having trust issues. This type of owner will have a hard time with changes without consultation occurring first. Empathy between both parties is critical, argumentative and defensive discussions defeats and undermines trust, but it is important to understand that both parties have to agree to disagree to be effective as well.
Owners can generally be placed into two categories. The first group is those that micro-manage day-to-day functions and involve themselves in final approval. The second group are those that are able to “let things go” and only become involved in the major issues and decisions of the practice. A manager needs to be able to determine which type of owner they are dealing with in order to determine the best approach. Obviously the second group is easier to deal with but the first group is probably the one who needs the practice manager the most. So it becomes critical to slowly build that trust factor with these owners, communicate frequently, take small identifiable steps together, and identify reasonable goals and expectations. The second group of owners will delegate more to the manger but will still look for the end results that were communicated and agreed upon between the manager and owner. It’s still critical to have regular scheduled meetings to inform each other on issues. These owners look for end results as they identify it and with these positive results, trust is achieved.
By gaining trust, you will get the respect and the support that, as managers, you critically need to function well in your position.
The Manager’s Perspective:
From an owner’s standpoint, trust is vital. It is imperative that practice managers understand this is the foundation of the owner/manager relationship. Trust is established over time. It is not something that is automatic nor is it given out freely. Every owner’s level of trust with his or her manager will be different. It is up to the manager and the owner to create a plan to work toward earning and keeping that trust.
As managers, we may feel a great deal of pride and ownership in our practice and think that it is our job to run the business. In fact, our role is really to support the business owner in whatever capacity the business requires and to do so in a way that is in line with the owner’s comfort level. Sometimes owners do not know what role they want their manager to play. In this case, it is up to the manager to help develop appropriate methods with the owner while everyone figures this out. If the manager is well-seasoned, they will be able to do that. If not, it will be up to the owner to take the reins in setting guidelines.
Ideally, the manager’s duties should be well established at the onset of the job. As the job evolves, regular meetings between the manager and the owner provide opportunities to give and receive feedback and/or set new duties and guidelines. Managers normally are responsible for day-to-day business, employee activities, staff development, etc. They may also be responsible for other management or administrative duties related to the business itself. These duties can include A/R, internal and external marketing, AP, benchmarking, budgets, inventory, etc. Some of these duties will be performed in conjunction with the owner. Using the VHMA's management job descriptions can help define the position and the tasks associated with it.
The more responsibility the owner gives the manager, the greater the level of checks and balances needed. Owners often give their managers tasks that involve money, legal issues, or other things that are necessary for the business to be profitable. When managers are entrusted with duties in financial areas, a checks and balance system must be put into place so the owner can monitor these activities. For example, if the owner assigns the manager to be in charge of accounts payable, the owner should have access to passwords and check the accounts on a frequent basis. Or if the owner is relying on the manager to complete payroll, the owner should review payroll reports on a regular basis. Legal and ethical practices are assured by having these controls in place.
Management must continually focus on creating and maintaining trust in the owner/manager relationship. Doing so will ensure a relationship that is healthy and enjoyable for both the owner and the manager.