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    Owen J. Dahl
    Owen J. Dahl, MBA, FACHE, LSSMBB

    It is important to have a perspective of your role in your organization: Are you managing, leading or both? In a crisis, the tendency is to manage — to get through the issue or the day. This has been essential at least in the initial phase of the COVID-19 pandemic. You have had to address patients, employees, suppliers, payers and so much more.
    Do you find yourself staying in this crisis mentality due to issues that constantly arise? Do you have time to stop and think about the future? Can you do both or do you delegate and free up time to do what you do best and/or what your organization needs?
    A manager works with and through resources to accomplish a desired result. You may manage resources [e.g., personal protective equipment (PPE)] to an optimal level by distributing and sharing based on the biggest need. But that’s only part of the equation. A bigger and equally important (if not paramount) concern is how you manage the team. During this crisis it is essential to maintain high-quality staff, reduce their level of anxiety and prepare them for the future.
    In times of crisis, managers should keep these key ideas in mind:

    • Don’t always react; act as necessary. How effective are you when you react to a situation as opposed to being prepared to address it through thought and awareness? There are on-the-spot decisions that have to be made, but if you reflect on most of your decisions, thoughtful processing leads to better outcomes.
    • Delegate. According to former U.S. Sen. Byron Dorgan, “You can delegate authority but not responsibility.” This speaks volumes about how you approach a situation that would benefit from others’ help or may require others to act. We must delegate authority and responsibility to those who need it at the appropriate time.
    • Be flexible. There may be similarity in 80% of situations and the opportunity to build based on past experiences. The other 20% require new actions based upon new circumstances. It is important to recognize these situations and to adapt your approach to managing them or an individual.
    • Listen. We often talk about communication and sharing information about the practice with staff. This is essential. But it is equally important to listen to staff and their situation. Listening is a skill we often don’t practice because we’re too busy. Employees have concerns about their family and the future; they need an outlet to meet their needs.
    • Include yourself in the narrative. Don’t be afraid to share your concerns and situation with the staff. After all, you are human.
    • Trust yourself and others to make it through.
    • Look ahead. Think about today, tomorrow and next year when you are dealing with each issue.

    Leadership is somewhat different. Leaders offer direction as well as many of the points noted above. As Warren Bennis put it in Learning to Lead: A Workbook on Becoming a Leader. “managers do things right while leaders do the right thing.” This suggests that planning for the future is an essential part of being a leader. That means being optimistic and realistic at the same time.
    The three-phase plan presented by federal officials for reopening the country outlines potential changes for businesses, schools and other organizations coming in a matter of weeks or months. What happens during that time and after is anyone’s guess, but now is the time for practices to develop a full-scale plan for recovery.
    Identify and accept that there are barriers to the future, which include “the way we’ve always done it” (TW2ADI). The independent nature of each physician breeds the belief that their way is always the best way.
    Still, most practices will need to review key processes, such as patient access concerns.

    • If your practice is currently only handling telehealth visits, this could be a time to consider changes to your front office and waiting area to optimize that space when patients return.
    • With a new mix of virtual visits, your practice likely will need to revisit scheduling and wait times.
    • If you rapidly adopted telehealth technology, it’s time to start thinking about long-term needs and reimbursement, to optimize further use and development.

    This list could be huge, and leaders should identify and prioritize the practice’s future needs now before the surge in deferred care comes later this year.
    In assessing the response to COVID-19, it is also important for a leader to accept that there have been failures. This is not to dwell on negative outcomes, but rather to use them as learning opportunities. Focus on what can be done to improve and lead your practice into the future.
    The leader and the manager aren’t necessarily different people; they are different roles that one individual can play, and individual strengths will vary. One is not better than the other, and both roles are necessary to transition your practice to the new normal.

    Owen J. Dahl

    Written By

    Owen J. Dahl, MBA, FACHE, LSSMBB

    Owen Dahl, MBA, FACHE, CHBC, LSSMBB, is an independent consultant with more than 40 years of experience managing medical practices and providing healthcare consulting services. Owen has worked as a chief executive officer (CEO) for a physician practice-management company with combined revenues of more than $75 million and 18 groups under contract, as CEO for a merged hospital with a 300-bed facility, and as president of a physician practice-management and billing company. Owen has presented at several state and national MGMA meetings, as well as to audiences from the Association of Otolaryngology Administrators, Association of Dermatology Administrators/Managers, American College of Rheumatology, American Academy of Dermatology and others. He has also authored Think Business! Medical Practice Quality, Efficiency, Profits; The Medical Practice Disaster Planning Workbook; coauthored Lean Six Sigma for the Medical Practice: Improving Profitability by Improving Processes, and written several articles and provided interviews for numerous journals. Owen is an adjunct professor at the University of Houston, Clear Lake, and is conducting a distance learning program at the University of New Orleans. He has also taught at Our Lady of Holy Cross College and Loyola University.

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