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    Preparing non-managerial staff for future promotion into management is one way to create the next generation of leaders in your medical practice, but building the business case for leadership development for frontline workers can be tricky.

    Discover a DIY approach to professional development for frontline medical practice staff to become ready for managerial roles in the future.A Sept. 13, 2022, MGMA Stat poll found that about half (53%) of medical groups train or provide professional development to staff to move into managerial roles, compared to 47% that do not. The poll had 517 applicable responses.

    An MGMA Stat poll from May 2022 provides further insight into how to achieve this: Among 553 healthcare leaders who responded, their answers on the most important areas for new managers to learn ranged from operations/IT (31%) and revenue cycle (27%) to human resources (26%), analytics (11%), and “other” (6%).

    Building the bench

    For businesses in healthcare and beyond, there is no shortage of consultants and pricey programs intended to provide the training needed to help promising candidates get their feet wet in people leadership; however, an era of stagnant reimbursement and rising costs might prompt a do-it-yourself approach to save money and build on institutional knowledge.

    That’s how leaders at Austin Retina Associates, Austin, Texas, approached the need to improve its pipeline of internal management candidates. As Mike Lyons, PHR, director of human resources, noted during a session at the 2022 Medical Practice Excellence: Pathways Conference, it meant designing an engaging training program with education on the “foundational skills that all leaders need.

    “Our goal as senior leaders in any organization is to have a ready bench of people who can take over for a leadership role,” Lyons said. “At any time, you may have a new vacancy, and so you want people who are ready and eager to step up.”

    As Megan Odell, MHHR, director of patient experience, detailed, Austin Retina Associates has 17 locations across Central Texas with about 200 employees, and the group traditionally never had to hire external candidates for managerial-level jobs. But the emergence of new tech jobs nearby brought two big changes: Many new young people in the community and much more competition for them as workers.

    Many younger job applicants are asking for opportunities to grow and advance through their careers at a single employer, which Odell said the group recognized by starting to build a pathway to management to stand out as an employer in a competitive market for labor amid the Great Resignation.

    The cost of poor management versus the cost of training

    Whether the leader is clinical or administrative, “the cost of a poor hire is just astronomical” when you consider lost productivity, time and money spent searching, and the impacts to performance and patient experience, Odell said.

    “We wanted more growth, we wanted employees to feel like they could be here as part of a career, and we wanted them to be engaged,” Odell added, so the group began advertising the potential for learning and growing (“we’re investing in you”) as a recruitment tool.

    The senior leaders in the organization already understood the expenses involved with traditional leadership training: Hiring consultants, or the transit, lodging, meals and registration fees for attending conferences. Based on their own investments and education, they decided they would attempt to take what they learned and build their own program.

    “As a leadership team, we have been going to conferences for years, we’ve been seeing podcasts and watching webinars, and that has been part of our nature, just being managers,” Odell said. “So all the books we’ve read and the little one-liners that we [picked up] here or there” became the foundation for customizing a curriculum to fit their goals and the culture they had built, which helped make the group’s offering more relatable.

    “It was more credible, because we were able to give our own energy and our own passion behind the different pieces of advice that we have learned over the years that we felt helped make us better managers,” Odell noted.

    Content elements of the program

    Establishing trust and incorporating the values of the organization were major elements of the content developed for the program. “If you don’t even know what your core values are, start there,” Odell said. “Is this who we are? Does this represent what we’re trying to deliver to our community? It’s very important to incorporate your values.”

    Additionally, the program was designed to emphasize basic people skills so that managers could develop better relationships, as well as service and compassion. “It’s all about how we can try to be more empathetic [and] better put ourselves in the patients’ shoes and understand where they’re coming from,” Odell said.

    Building main learning objectives

    From polling senior leaders and team leads about the things they would want to learn, the group identified its main learning objectives for the leadership development program:

    • Awareness of and adapting to other personalities
    • Giving feedback
    • Active listening
    • Fostering fun
    • Creating team culture
    • Practicing self-care
    • Continuous improvement/Lean.

    Program attendees took an OCEAN (openness, conscientiousness, extraversion, agreeableness, neuroticism) personality assessment to better understand their own traits, and each one read a book of morale in the workplace to learn and discuss with other participants, with 60 days of mentoring with the training leaders following the main program.

    Melissa Hartig, MSHA, COE, CMCO, director of finance and compliance for Austin Retina Associates, said that clear directions were essential to teaching people skills. “We found that it was very effective if we actually told people what we wanted them to know and what we wanted them to learn and be able to practice at work,” Hartig said. These concepts, along with learning about personality, helped “to overcome some of the barriers to team building,” she added.

    “For example: A high openness person is open to change, and they might be a great person to have on board to push through some new software and champion a new idea,” Hartig said, “whereas a low openness person, they like stability — they might be a little less open to that, and you might have to work on getting them to do it for the team, getting them to learn something new; they tend to be very good at what they already do and don’t like to learn more.”

    Other key takeaways from OCEAN assessments included:

    • High conscientiousness employees are really good at planning. “They love to have checklists, they mark stuff off,” Hartig said. “A lot of times these employees end up being supervisors, because they can really get things done.”
    • A low conscientiousness person struggles a lot more with planning; however, they can be more flexible, because they’re accustomed to getting through their day without a structured plan. “When things go wrong, they’re OK with it; they can pivot and do something else,” Hartig said.

    “It really helped our teams to start understanding why people were the way that they were and how they needed to flex their personality styles and understand why people were different,” Hartig noted, adding that other assessment tools such as Myers-Briggs or DISC can provide a “baseline of figuring out where they are, why someone is different,” and how leaders can meet them on their level.

    Practicing constructive feedback

    The leadership program’s focus on improving manager feedback to workers adapted a concept from the Manager Tools Podcast to teach participants a four-step process for effectively providing constructive feedback:

    1. Asking: “Can I share an observation?”
    2. Noticing: “I noticed that you’ve been coming in late a lot.”
    3. Sharing the impact: “That really puts us behind.”
    4. Requesting: “Could you work on that?”

    Lyons said the program participants were asked to write specific examples from their work to roleplay with each other and practice the steps. “The only way to really get better at a skill is to practice it,” Lyons added. “We want to have them practice the skills in the training session with each other in a safe environment.”

    Learn more

    Find the full story about Austin Retina Associates’ program in the October 2022 issue of MGMA Connection magazine, coming out next month.


    Our ability at MGMA to provide great resources, education and advocacy depends on a strong feedback loop with healthcare leaders. To be part of this effort, sign up for MGMA Stat and make your voice heard in our weekly polls. Sign up by texting “STAT” to 33550 or visit Polls will be sent to your phone via text message. 
    Do you have any best practices or success stories to share on this topic? Please let us know by emailing us at  

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