Middle Management &

Your Practice

WA Veterinarian Magazine

by Jim McCutchan, DVM

Mar/Apr 2015

Are you a veterinarian and practice owner feeling bogged down by the seemingly insurmountable tasks of scheduling, inventory management, performance reviews and the like? Do you wish you could spend more time caring for patients and building client relationships? Are you starting to forget what the patient exam room even looks like …  because you are always in the office?

Believe me, many of us have been there.

As a veterinarian-owner, striking the ideal balance between practicing medicine and managing the business is tough – but it is critical for you and your practice’s success and well-being.

If you haven’t already, it could be time to consider adding a middle manager (or two or three) to your group. This may be especially true for those small-animal daytime practices with one or two doctors that are looking to grow, or that are already struggling to meet the demands of growth.

But first, let’s identify the positions we are referring to when we talk about middle management. Typically, middle management can include the practice manager, lead technician and lead receptionist. In some cases, it can also include a medical director.

Having a practice manager, lead tech and/or lead receptionist in place allows you to leverage leadership within your organization. Middle management helps you create a consistency of processes, as well as establish dependability and accountability among your staff.

This all leads to a high-performing culture within your hospital and delivers to your clients a positive, consistent experience.

Middle management within a veterinary setting usually handles the following five broad areas: people, processes, facility, equipment and inventory.

Within these areas, major focuses include:

  • Communication
  • Scheduling
  • Teaching and mentoring
  • Performance reviews
  • Staff recognition
  • Performance corrections
  • Employee relations/HR
  • Recruiting
  • Training
  • Coaching
  • Cheerleading
  • Delegating
  • Marketing and PR
  • Finances/bookkeeping
  • Safety regulations
  • Inventory control
  • Materials management
  • And the list goes on!

With your middle managers handling some or all of the above responsibilities, you as the veterinarian-owner are able to leverage your time and talent better; you can practice veterinary medicine more and focus on building those ever-important client relationships. If your practice manager and/or other middle managers are able to free up your time to see just a couple more patients a day, it is a good investment and business decision.

Speaking of investing, you’ll definitely need to do some investing in the growth and development of your middle management. As far as finding the right person for the right role, most of that growth will be from the inside: Certain staff members will just be the obvious choices for the positions you need to fill. Of course, in some circumstances, you will need to hire from outside the organization. But in my experience, one’s growth to middle management often happens organically, within the organization.

As you are looking to promote or hire your practice manager, lead tech and/or lead receptionist, keep in mind a few qualities you’ll want them to have. First, these individuals must possess leadership qualities. They’ll also need to be flexible to adjust to the ups and downs of a practice and all those “from out of nowhere” issues we veterinary professionals deal with on a daily basis. You’ll want people who have exceptional organizational skills, acumen for communication, and aptitude for continuous learning.

Once your middle managers are in place, the veterinarian-owner should work to create opportunities for their learning and training. For example, you can make resources available to them through veterinary associations. Ensure they have access to online education and encourage them to pursue those opportunities. Even just providing applicable books and periodicals can be a helpful resource.

A special note about human resources: I think it is very key that HR education be a component of every supervisor’s training. Supervisors represent your business and there is some liability that comes with that. Be sure all managers are appropriately educated in this area.

So what are the middle management wins? The veterinarian-owner ends up with more time to practice medicine, and more time to develop relationships with clients and community. Your time becomes much more productive and efficient. The hospital staff members win because they feel supported by their peers who have risen to the next level.

Describing the important role of middle managers, Andrew McAfee writes in the Harvard Business Review:

“[Paul] Osterman identifies [in his book The Truth About Middle Managers] several key responsibilities of middle managers: They form teams and try to help them run smoothly. They serve as ambassadors to other teams, a task that demands ‘significant and subtle relationship skills.’ They make decisions and trade-offs that ‘escape the attention of top management yet are central to the organization’s performance.’ And they ‘act as the transmission belt between the top of the organization and the bottom.’”

In my own hospitals, promoting lead technicians to the middle management level has been a huge plus. Our staff members feel much more supported. They can now go directly to someone within their own peer group (versus a veterinarian, who in some cases might seem intimidating or slightly out of reach) to discuss any issues, positive and negative. The lead tech acts as a conduit of communication to the veterinarian – that “transmission belt” mentioned above. We have learned a lot of important information that we otherwise might not have. In effect, the lead techs become champions for the staff they manage. We are able to communicate a lot better with our staff. And it’s been fun to watch our lead techs and lead receptionists grow in their careers.

In the end, all of this creates a joy that will permeate your organization and your practice, and that joy will be felt by the clients, staff, veterinarians – and even by the pets.

I like to call it good veterinary karma.

Jim McCutchan

Dr. Jim McCutchan is one of the owners of Pilchuck Veterinary Hospital. He can be reached at (360) 568-3111 or [email protected].

“In my own hospitals, promoting lead technicians to the middle management level has been a huge plus.”