In previous blogs I have gone over the $1,000,000 associate error I made, and laid out the single biggest issue in creating a win-win associate arrangement …… Finances.
If you have not read either of those, I strongly suggest you go there now and read them first to get a frame of reference, and to avoid living in “associate hell” yourself.
What I want to cover today is the next biggest reason why people descend into associate hell …….. Training and Accountability!
Most docs that are considering associating are doing so because they are uncertain as to their skills and talents as a doctor and/or a business person.
They realize that University did not properly equip them for life in the real world, fast lane of business, and so want to “mentor” with someone that has “been there and done that.”
To that end, one of the first responsibilities of a senior doc looking for an associate is to clearly define the OUTCOMES that the associate must achieve in order to be great at the role.
Most people I interact with Innately want to do a good job, but their manager or boss has not been clear on exactly HOW to be good at their job/role.
Creating an outcomes assessment clearly defines this metric, and you can use this as a training guide in the future.
Within an outcomes assessment for any role on the team there are things that are more temporal or primal to the role than others.
In other words, things that need to be learned early on in order for the new recruit to get some traction in their role, or learned so that other concepts can be learned and layered on top.
For the sake of simplicity we denote those as A’s and usually they have to be trained on or learned in the first few weeks.
We then go and review and denote all the B’s, which are the next layer of outcomes that must be learned to be competent at the role. These are things that usually must be learned/trained on in the first month or so.
The next layer is C’s which are usually things that need to be trained on in the first few months and everything else are denoted as D’s.
There will likely be varying numbers of A’s, B’s, C’s and D’s.
For example, there could be 7 A’s, 15 B’s, 16 C’s, and 7 D’s etc.
This now becomes the basis of the training protocol for the role. You “estimate/guess” [I like to call it a guesstimate} the amount of time it will take to train on A1, A2 and so on.
Once you have agreed to how many days/weeks, and how many hours per training you are going to work with your associate, you can then plug in the outcomes from the document to get a clear training plan for the new associate.
For example you might say that for the first 6 months you are going to train and mentor them for two one-hour sessions.
A1 is a one-hour session so it conveniently fits into Session one on week one. Now you know exactly how long you are going to train for and what you are going to train on in your first training session.
A2 is a 2.5 hour marathon training so it goes into the second hour of week one as well as the first hour of week two and half of the second hour of week two and so on.
This training protocol should be set up as an Appendix in the associate contract of employment. It ensures the new recruit is going to get some training and there is accountability on both sides for the follow through of this important part of an associate agreement.
Speaking of associate agreements/contracts, I think it is absolutely imperative that there is a written associate contract of employment written up and agreed to by both parties.
This should include all the pertinent points of employment right from dress code, to compensation, to vacation time, and dispute resolution to name a few.
As stated previously the associates business plan and marketing plan are appendix’s in the document as is the outcomes assessment and training protocol we just discussed.
Speaking further on accountability it is crucial that the frequency and number of team meetings that the associate is required to attend be stated in the contract.
This should include the weekly team meetings, quarterly outcomes assessment reviews, and the annual general planning meeting (if you do one… and if you don’t what are you waiting for) done in the fall to plan for the next year.
Accountability is crucial in a win-win agreement and this should be reflected in all aspects of the interaction between the two docs.
All too often the senior doc wants to dodge the responsibility for being accountable to the things they committed to in the contract because they are busy and distracted.
This is NO EXCUSE and I counsel my docs to give the associate permission to call them out and hold them accountable for keeping their end of the bargain.
Although I touched on it in part one of this series, it is so important I want to talk about accountability on the financial side of things once again.
The two year business plan that the associate created should have a column for goals and one for “actuals” relative to the number of new clients seen, number of services given, revenue received etc.
This should be tabulated by the 10th day of the new month for the month previous and reviewed by both docs in a meeting.
If the associate is on target they should celebrate together! If the associate is not on target they should review what is wrong.
Were the goals too lofty?
Is the implementation of the marketing plan not going optimally?
Are their holes in the patient education protocol or the implementation of it?
By reviewing this in a set rhythm it will not get overlooked and the plan can be repeatedly reviewed and reset or implementation issues can be addressed.
This increases the probability of having a successful associate so that everyone wins!
If you would like to connect with me about your particular needs for an associate, and how to create outcomes assessments or contracts, I can be reached at email@example.com