Case Study: The New Director

[Guest guest]

1. Is the situation resolvable?

YES, but it will not be easy.

2. Is this unexpected after 6 weeks on the job?

Depends on how he made his entrance. I would have to

question his communication style with his staff if they fired off a letter

to the V.P. after only six weeks. The case study does not say if they came

to him first, but by the tone of the case I would assume they did not.

Also, did he ever go to them to discuss the situation. The case states he

gathered information (see #3 below), but did he ever acknowledge that to

his staff?

I would also question how well he interviewed. Did he not talk

with some of the staff before taking this job? I would like to think he

saw some of this coming and decided to take the job anyway. If not, I

would question how well he interviewed for this job.

3. What symptoms are present?

Staff frustration, high caseload, low morale, no program

development ==> all summed up, a lack of leadership within the department.

Another symptom present is what I call the " whine syndrome " whereby staff

expect management to solve all of their problems. Therapists are

professionals and purport to be on the same level as physicians, therefore,

like physicians, sometimes they need to solve their own problems (when it

is within their ability) instead of foisting everything onto the manager.

Also, with cost containment being what is is nowadays, management

hierarchies are being eliminated, so there is much less management time to

solve small problems.

4. What are the real problems here?

Lack of leadership. The staff seem to feel they are

floundering without any direction. Also, needs they feel are important

(staffing, program development) are being neglected. Another major problem

seems to be a lack of communication between Fred and his staff.

Fred needs to determine why they cannot hire staff,

especially now that the job market is tightening up. Can interviewees see

the tension in the department? Does that scare them off? Are the salaries

non-competitive? What are the factors keeping people from hiring on?

On Fred's side of things, he has a real problem with

Jan. Her perception of P.T. will hinder any efforts he may undertake to

gain her support. After all, if P.T.'s are technicians, then anyone can

manage them, right?

5. What actions should Fred take with the Staff?

COMMUNICATE, COMMUNICATE, COMMUNICATE. It sounds like there

is minimal communication. If he has not already, he should meet with them

and brainstorm with them about all of the problems. Let them get things

off their chests. Then take the list and prioritize it and organize it

into an Improvement Plan. Then decide who can do what. He must NOT let

the staff think he can solve everything, instead they have to offer their

support in trying to turn some things around (i.e., program development)

and give them some ownership in the department.

6. What actions should Fred take with Jan?

Ouch, this will not be easy. It might help to sit down with

Jan and get in detail exactly what she things P.T.'s do (and O.T.'s, SLP's,

etc., depending on who he manages). At that point he can purse, gently,

educating Jan in areas in which she has misperceptions. Maybe he can

change her outlook if she is given good information.

7. What actions should Fred take with the department as a whole?

Set up twice per month staff meetings to review what is

happening and progress made on the list that was discussed above. Above

all Fred needs to be honest in describing roadblocks, then outline his

plans to workaround those roadblocks. If he cannot workaround them then

he needs to be honest and inform staff on the limits that they operate

under.

8. Should Fred be treating a full case load at this point? If not,

how much time should he devote to patient care versus managing the

department? Will staff lose even more respect for him if he doesn't help

with patients?

NO, he should not be treating a full caseload. That

may provide short term benefits in getting patients seen, but the staff do

not seem to appreciate his " pitching in. " It is clear that they thing his

priorities rest in trying to stabilize the department. I believe the staff

are correct on that, especially since Fred is the only administrative

member of the staff.

9. What will be different in 6 months if Fred is successful in

turningthings around?

Morale is improved. It may not be wonderful, but at

least the staff should realize that he is taking steps to correcting

certain things and making progress on the Improvement Plan.

Staff levels are improved. However, as stated above, he needs

to figure out why people do not hire on to work at this facility. Only

then can he take steps to reverse their current course.

Jan's perception is different and more supportive of

rehab services. Without her support many of Fred's efforts will be

difficult to impossible to implement (e.g., raising salaries if he deems

that necessary, etc.).

A more consistent communication mode is in place for Fred and

his staff to interact, exchange ideas, suggest improvements, etc. That, in

my opinion, is the most important thing for Fred to accomplish as soon as

possible as everything will flow from it.

Mark Dwyer, MHA, PT

Kansas City, Kansas

mdwyer1@...

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