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If complaints are piling up, talk to staff directly
Don't terminate anyone before you do
Considering the amount of turnover in the average patient access department, the last thing you probably want is to lose a staff member. However, there are times when a staff person has to be terminated never a pleasant task, but at times, a necessary one.
"It has been my experience that health care managers will sometimes subscribe to the 'warm body' theory, which is that having someone is better than taxing your good staff with extra hours," says Michael S. Friedberg, FACHE, CHAM, associate vice president of patient access services at Apollo Health Street and author of Staff Competency in Patient Access.
Both sides of this discussion have their advantages and disadvantages. "But I would lean toward not keeping ineffective or incompetent staff members employed due to the fear of not being able to easily replace them," says Friedberg. "This sends the wrong message to your hardworking and dedicated staff."
On the other hand, you may get a pleasant surprise if you ask an employee for his or her side of the facts. On one occasion, Friedberg got a complaint about a financial counselor from a manager who said, "I'm at the end of my rope; this person's got to go."
"So as I always do when I terminate somebody, I went to talk to them. I asked her if she could tell me why she was rude to a particular patient and she said, 'I didn't mean to be rude, but I take care of as many patients as I can in a day, because these people really need charity care, and I don't want to hear their life story about when they were a little boy. I want to get the facts from them because I don't want somebody to have to come back tomorrow because we couldn't process them today.'"
"I said, 'I'm not firing this woman, that's a really good answer,'" says Friedberg.
While the employee's manager moved on, the employee is still to this day the supervisor of the financial counseling area.
"What I was able to do was cut through the office politics and the 'I don't like this person' dynamic that was going on. I was able to recognize that this was the kind of person I wanted on my team," says Friedberg.
Friedberg says that by bringing the employee in to talk, "that was the right opportunity for her to come out of her shell. She was given the chance to show what she could do. At the end of the day, she got it. Initially, I thought she was rude, she needs to go. But that was not the case."
As a patient access professional, sometimes you have to take a step back and ask "What are the skills that this person needs? And what have we instructed or asked them to do?" says Friedberg. He says that perception is not always reality. "The perception of this employee was that she was rude, but she thought that she was doing her job."
Another thing that the woman said which surprised Friedberg was "please don't fire me. I love my job and I want to work hard for these patients."
Just because somebody is complaining, doesn't mean that their complaints are factual. "Sometimes those are the people you want to spend a bit of time with," says Friedberg. "Sometimes you get a gem."
Replacing people is costly, both financially and in terms of staff morale, says Friedberg. "I have always been at peace with terminations because I am honestly able to tell myself that, 'There isn't anyone I terminated that didn't earn it.'
"To be honest, I give people too many chances sometimes. I have stuck my neck out for people who ended up disappointing me. But those are the minority, and I'd rather take the chance," says Friedberg.
It's also possible that a fired employee will learn from his or her mistakes even if it's after they leave your department. Friedberg recalls an occasion where a registrar said to him, "I'm here because you're going to fire me, right?"
"I said, 'Look at the evidence," and she cried and said to me, 'You know what, you're right. I'm sorry I let you down and I really learned something from this experience.' Last I heard, she was doing something else really great."
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