Making Conversations Count! Developing True Relationships in Your Healthcare Practice Focusing on Physicians and Administrators

By Susan Fink Childs, FACPME
July 31, 2019

What messages are we really sending as we converse with employees? We communicate with every action and reaction throughout the day, hopefully with respect and in the interest of collaborative patient care.

Each of us has our own style and demeanor. From the recipient’s point of view, perception is reality. Your style of communication is accepted as your standard, and your “name” is on every conversation relayed by staff.

Susan Childs

Susan Childs

As simple a thing as saying, “good morning” (and the way it is said) can set a precedent for the way your entire staff responds. This article offers recommendations, approaches, and strategies that fully support your efforts as an administrator and will result in increased staff member engagement and communication.

We communicate with every action and reaction throughout the day, hopefully with respect and in the interest of collaborative patient care. Each of us has our own style and demeanor. From the recipient’s point of view, perception is reality. This article offers recommendations, approaches, and strategies that can fully support and enhance your staff’s engagement and communication. Your “name” is on every conversation and correspondence relayed by every member of your staff at every level of care. You must ensure the message is conveyed clearly, safely, and compassionately. The way you communicate is accepted as your standard.


Whether you are speaking with one person or a crowd, being honest and sincere will show. Also keep in mind that the conversation most typically is about them, not you. Tip: This is also the perfect “in” to promote the healthcare system’s mission and goals; if you live it and believe it, most likely, so will they. To further personalize staff engagement, employees should consider whether they would recommend the practice to a family member.


 For some of the most common forms of communication, such as e-mails and routine office tasks, there are basics that can assist with a polite and concise message:

  • Include a salutation with a courteous tone affirming the recipient’s value and role. Even a “Thank you for your efforts” matters.
  • Make sure your message reflects cooperation and commitment to teamwork.
  • Consider defining the timing of tasks precisely with details and parameters. “ASAP” may mean “now” to one person but “in the next few days” to another.


You can improve communication in your office by implementing a few simple guidelines:

  1. Avoid never-ending chain e-mails. Take the time to look around the corner and actually speak with somebody face-to-face. Some of us don’t even read the second half of our e-mails. With face-to-face conversation, you may get it done in one-tenth of the time and avoid bothering the 35 other people who were included in the message and are not sure whether they are expected to respond.
  2. When you look at a person, look the person in the eye and greet him or her fully. That person is your focus. You may need to walk away from outside stimulants to give your full attention to that person. Put your phone, computer, and iPad down, and face the person you’re talking to. If this leads to a confrontation with somebody, you may just have to walk away and resume at a different time.
  3. Be a part of where you are. Engage in the conversation and in the meeting. You may have to resist the urge to check your e-mail 20 times but doing that looks like you are not paying attention to the person who is talking to you. It’s that simple. Why am I here talking to you, trying to set up a payment plan, if you’re not focused on what I am saying? Or why am I, your staff member, trying to talk to you about how I can get better at my job when you’re not going to pay attention to me? I’m a good worker, and I’ll find a boss who will.
  4. Break bread and bring chocolate! Have you ever noticed that when you share a meal or have a cup of coffee with someone, both of you relax just a little? This is a great “tool” that can actually help someone open up a little sooner. It can create bonds, and it’s delicious too. Try it! Bring some chocolate to the next staff meeting, talk about shared goals in a patient-centered culture, and watch the magic happen!


As an employee establishing myself as the manager of the practice, one of the challenges is establishing physician trust, which is earned in different ways with each provider. It is essential to meet with each provider individually.


When communicating with staff, our approach directly affects their response. Staff can feel intimidated and hesitant to speak up in a dysfunctional environment. We are territorial creatures, and this is one way to protect our jobs. Fears such as, “I will be passed over for a raise,” “I will be picked on by coworkers,” or “I will be fired” greatly affect employees’ responses.


One of my best bosses told me her job was to support me in doing the best job I can. What a feeling! Every staff member should feel that strength, and that is what each of your employees should feel as they approach their work! This is also another perfect time to reflect on expectations.


Consider each meeting a collective where we feed off each other’s ideas—and also as the foundation of your ongoing rapport. Establish individual and practice-wide needs and priorities. Display respect by beginning and ending on time. Be present and listen. Every employee has a voice.

Meeting for the first time with staff?

Listen first—this is their time with you. This person must be your universe right now. Whether this meeting is an introduction or reviewing policies, any topic you think best is a good way to get started to establish “like” goals. Take notes, ask questions, and write down the answers. Sincerity is essential. A forced concern or compliment is easy to see through, with the rest of the conversation possibly received with a grain of salt.


Hire the best. And keep them! Your best employees will look for progress. If they don’t find it with you, they will go elsewhere.

Performance Evaluations

In a performance evaluation, achievements as well as goals should be documented by both you and the employee. Use system reporting and other benchmarking to assist with future goals, and note successes accomplished in the last year. It’s always good to affirm each staff member’s role and value as well as holding the carrot out in front to entice the employee to improve! This is the employee’s moment with you; there must be no disruptions so that this becomes an opportunity to truly communicate. This is also an opportunity to identify redundancies in job duties and to further define the employee’s role.

Conversations That Count

 One of my model recommendations with every office is a slated time, at least twice a month and more often if possible, for the lead physician(s) and the administrator to review revenue cycle, cash flow activity, staffing, and patient issues. It is imperative that leaders learn how to communicate with each other frequently and with ease. When the hard conversations come up, we must be able to speak with respect and understanding. Watch communication improve as patterns and issues are identified sooner for a more proactive approach. “If it’s important to them then it’s important to you.” Determining the priority from that point is up to you. I know it is hard to find the time. Please offer the “welcome mat”—a must for managers. If you are not available at that exact moment, but employees feel you are available to at least designate a time to meet, you are still present in their minds. You can determine the urgency. The point is that they feel you are accessible and supportive. That is big, and carries far with employee engagement, loyalty, and communication. When you meet, consider comparing the attention you are giving to your employee to that you would give the patient—the approach should be the same when an employee needs you to hear something. We all need to know exactly where we stand. What better place to have a conversation than where someone is the most comfortable and confident? Go to them and spend time in their space. Listen and look for nonverbal cues. Let them show you what they do. Pride goes a long way! And as each one asks you questions regarding his or her role, be clear regarding the practice’s expectations and protocols. Clear and respectful communication relays a professional trust that will only enhance the employee’s loyalty toward you as a leader and the organization.

Exit Interviews

Conduct an exit interview whenever you can. It is an opportunity for the employee to say what he or she may have been hesitant to say in the past. Employees often feel freer to speak as they are walking out the door, offering information that can be truly enlightening.


The employee manual offers ethical parameters that are appropriate for your practice and culture. Beginning with the mission statement, all the way through to professional attire and behavior, this is your opportunity to define how the staff interrelates in providing patient care.  Spell it out! Have a professional review your manual for most current workplace topics and protections. Although often disregarded, the manual is one of your most important communicators within your practice. Everything in the following list should be included:

  • Your organization’s mission statement;
  • Professional attire and behavior;
  • Policy regarding concealed weapons on the premises;
  • Gender identification rights;
  • A clearly defined hierarchy to follow when reporting any issues and concerns;
  • An anonymous way to report fraud and embezzlement; and
  • Grounds for termination and how it may affect vacation and sick time accrued.

Employees read the manual, then sign and return a statement acknowledging they understand their responsibilities and the rewards and repercussions of performance. 

Susan Fink Childs, FACMPE
Evolution Healthcare Consulting

This article appeared in The Journal of Medical Practice Management, Sept/Oct, 2018

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