There are as many styles of management as there are varieties of beans, and as many approaches to managing a practice as there are practices. When we read of Alex Ferguson’s ‘hairdryer’ treatment of players, or view Lord Sugar’s autocratic demeanour in The Apprentice, we know we inhabit a world where personality and cunning are as important management tools as planning and organisation.
Managing a small- to medium-sized business such as a general practice may not require such extreme behaviour, but it does involve personality and creativity and is as much an art as a science. The art of good practice management is being able to marry the application of sound principles, processes and procedures – the scientific tools – with good timing, good sense and to good effect. That takes skill and experience.
Take the management of sickness absence, where there is always a fine line between managing the interests of the individual and those of the organisation. Most practices will have developed sickness-absence procedures, which describe how the practice will deal with absence issues and set out the responsibilities of the employee and the employer. There may be an intent and tone to the policy and procedures, which indicate that the practice is applying downward pressure on sickness absence due to high levels of sick leave.
When applied to someone whose attitude to work is questionable and who has a consistently bad sickness record, the clarity of these procedures can seem like very useful management tool. As everyone is aware of them and how they will be applied, there is no ambiguity and the application can seem straightforward. However, as we know, few things are straightforward in management. An unintended consequence could be that a respected and highly valued member of staff gets drawn into the process, because they experience an unfortunate period of ill health; perhaps someone you cannot afford to lose and who will react adversely to a formal process.
These are fine lines indeed. The procedures, with their unambiguous clarity, are there to protect the manager, the employee and the organisation yet they can seem harsh and uncompromising in certain circumstances. If they are not applied consistently the manager is open to accusations of unfairness, preferential treatment and discrimination. But this is a line the practice manager has to walk and they have to find a way of implementing the procedure without alienating the valued employee.
It’s how you approach a dozen situations like this every day that defines you as a manager. The practice manager’s role is broad and complex. You’re expected to be an expert in everything – employment law, accounting, IT, health and safety, etc – and therefore a generalist by definition. You’re responsible for handling complaints, communication within the practice, effective teamworking, planning and organisation. You have to be a leader, a team player, a diplomat and a shoulder to cry on.
The science of management will provide you with essential tools. It will give you the theory, the principles and examples of good practice. But the application is the essential bit and often requires imagination and common sense. The art of practice management is doing this to a consistently high standard.
Sean Quinn is Management Partner of Ballyclare Group Practice. It is the largest medical practice in Northern Ireland and the first to hold the Quality Practice Award and the Charter Mark simultaneously. Sean has 16 years’ experience of practice management, having previously worked on one of Northern Ireland’s Health and Social Services Boards.