She lasted only one month as the office manager for a group of psychologists. Sure, it was annoying to cover for a doctor who was habitually late, made scheduled patients wait while he checked e-mail, poured a cup of coffee, and chatted it up with friends on the phone. But the straw that broke her back came at 3 pm one Friday when she received a routine phone call from a new patient seeking an immediate appointment.
When the manager regretfully told him there were no openings, the patient informed her that he had a gun. “My heart started pounding, and I could feel my face go white. I was so scared I’d say something that would make this guy go over the edge and shoot himself while he was talking to me,” she says. She collected herself and calmly told the caller he needed to dial 911, only to be met with hysterical laughter.
It was her boss, playing a practical joke. She cited that incident as unprofessional in her exit interview, but the doctor merely accused her of not being a team player.
Do your employees also post gripes at employeesurveys.com (a real Web site, where anyone can send in a complaint about her boss.) Probably, says Robert Hogan, PhD, the president of Hogan Assessment Systems, an employee consulting service based in Tulsa, Oklahoma. According to Hogan, between 65 and 75 percent of the people in any organization say the single worst aspect of their job is their immediate boss.
When the VHA West Coast, a large managed-care organization in California, dug into nurse-physician relationships throughout its system in 2002, doctors scored worse in the “physician is aware of how important the relationship is to nurse satisfaction” category than in any other question. What’s more, 92.5 percent of the 700 nurse respondents say they witnessed disruptive behavior by physicians. When pressed, they cited yelling or raising the voice, disrespect, condescension, berating colleagues, berating patients, and abusive language. Most respondents claim this happens once or twice a month. More than 30 percent said they knew a nurse who had quit because of it.
Yet when ranking the seriousness of disruptive behavior, VHA West Coast doctors rated it below how the nurses and executives scored this trait.
Meanwhile, researchers at Bucking-hamshire Chilterns University College in England discovered in 2003 that nurses working for overbearing supervisors registered a 15mm Hg difference in their systolic blood pressure and a 7mm Hg difference on the diastolic measurement compared to nurses who didn’t rate their bosses overbearing. Increases of 10mm Hg and 5 mm Hg respectively account for a 16 percent increased risk of coronary heart disease and a 38 percent increased risk of stroke.
Hogan simply cuts to the chase. “The data is quite clear: When physicians are jerks, it costs them money. The guys with low scores on interpersonal sensitivity get sued,” he says.
On the other hand, “the more effective you become as a leader, the more likely you are to make more money,” contends Michael Woods, MD, a full-time surgeon and the founder of Doctors in Touch coaching service in Oak Park, Illinois. “Not necessarily because you’re seeing more patients, but you’re seeing less money lost in terms of employee turnover.”
How low can you go?
Unfortunately, the office manager’s complaint isn’t an isolated incident. Nurses, technicians, and administrators across the country tell the same story in various ways. “When we socialized together outside the office, our husbands and families would say, ‘Is the doctor’s behavior the only thing you have to talk about?’” says Marcy London*, an RN who worked for a private practice in the Midwest. “It always became a major bitch session, which wasn’t healthy, but we were trying to get through.”