Governance and Infrastructure in a Small Medical Practice

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Background Statement

Midtown Neurology has faced significant issues regarding governance and infrastructure management. Initially, the medical practice was founded by a single physician who had over 20 years of experience helping the community members. As the practice grew further, it has changed from a mom-n-pop operation to a more significant practicum site but faced pain points of growth. The founding physician hired four new neurologists to help to expand the practice. However, as the primary physician insisted on his own decisions, the new professionals forced him to leave the practice. The critical organizational points that a practice faces include issues in organizational leadership, the structure of the practice, and the management of proper behavior from employees and adjustments.

Summary of the scenario and issues in the case

Midtown Neurology, established by a physician with significant experience, gained recognition primarily due to the work of that medical professional. The founding physician had all the powers, responsibilities, and decision-making duties. However, when the large urban hospital associated with the Midtown Neurology gained Level 1 trauma status, the practice had to expand to capture new opportunities for development. However, the major problem was the absence of the structure and governance established defining employees duties, responsibilities, and schedules to present the information and track the processes within the practice.

The secondary issue that, from time to time, became the primary issue is the absence of leadership skills of the founding physician. It is evident that the founding physician was able to schedule his time correctly and was responsible for successfully managing his responsibilities. When new employees came to Midtown Neurology, the physician could not empower others and detach some of his duties. The main difference that comes out when reviewing the problems is the leadership and management of a small and a more significant organization that brings the necessity to establish controlling protocols, medical records, and administrative accountabilities and divide it among all workers.

An analysis of the causes and effects

I will address the cases significant problem from the point of the outside consultant who would advise the practice. I have chosen such a role because it provides an opportunity to present results in a structured manner and present specific solutions that are achievable and applicable for the organizations. The advantage of being an external consultant lies in the ability to be unbiased and make decisions based on gathered information without emotional attachment to the practice (Allen, 2020). The disadvantage of being an external consultant lies in data collection because sometimes, consultants cannot get the full scope of problems and existing relationships within the organization (McKewen, n.d.).

It is clear that the cause and effect system in the organization is primarily connected to the decision-making issues and lack of leadership. When there are no clear responsibilities of employees, they do not want to be accountable for their actions. When there is a lack of a clear strategy for future development and continuous communication, everyone does what is in his or her interests and does not take joint steps to help each other. An outside consultant can define the roles and authority for team members and present a structure that would exclude vague duties.

The strengths and weaknesses of the organization

The lack of governance is one of the central weaknesses of the Midtown Neurology practice. Governance helps to establish a clear direction of the organization, its goals, and objectives. This approach would aim to oversee the managerial activities, make everyone accountable for the organizations success and risk, and satisfy the regulative authorities (Jyoti & Dev, 2015). The second weakness of the organization is the lack of employees managerial skills to supervise the existing infrastructure. It is suggested that managing complex and evolving organizations requires leadership skills, including division of responsibilities, coordination of all stakeholders, participation in the decision-making process (West et al., 2015). The lack of diversity of views can also negatively affect the organization.

One of the significant strengths of Midtown Neurology is its recognition in the medical community and its ability to attract talent. It should be highlighted that the founding physician has built a workplace where other professionals want to work because he was able to hire four new neurologists. This fact suggests that the organization has a good brand image and human resources techniques that allowed it to recruit new employees and retain them. The other strength is the analytical approach and the evidence-based decisions that helped the organization treat patients successfully.

Solutions and alternatives

There can be named several options that might be implemented in the organization to resolve the primary problem. First, it is possible to focus on the transformational leadership approach that helps develop and nurture the leadership skills of employees and personality traits to encourage open communication and employee accountability. The implementation of proper leadership strategies will help to resolve the major problem. It can be suggested that Midtown Neurology will benefit from a transformational leadership style that implies an exchange of information among staff while avoiding hierarchical structure (Xenikou, 2017). The advantage of this approach is the unity of employees that can be achieved when developing the necessary skills together. The disadvantage of this approach is a lack of governance rules that should also be established in the organization.

Another way to approach the significant problem initially is to establish a clear strategy and constructive organizational culture and then deal with leadership issues. It is suggested that a constructive organizational culture brings transparency and open communication about the company processes, employees activities, and duties (Cooke, 2015). Constructive organizational structure assigns the leader as a facilitator accountable for the development of the employees skills and providing essential benefits to adjust according to circumstances (Cooke, 2015). In this case, the leader is the first to improve competencies and then convince workers to follow the changes. The pro of this approach is an opportunity to develop clear governance rules and divide responsibilities. The con is the possibility of employees disobeying and do not follow the example of a leader who adopted the rules and regulations.

Any alternative implies that the adjustments must start from the leaders to show other employees willingness to establish a clear structure, rules, and evaluation methods to encourage others to follow. To assess the success of adjustments, it is essential to develop an evaluation plan based on goals, KPIs, and participation. Firstly, the list of goals will be defined. Duties will be distributed; anonymous surveys will be conducted weekly to check whether the proposed solution works and see if the organization reaches its goals. For all employees and leaders, there will be established a list of duties and an electronic track record system, where they should mark their performance. For instance, checked ten patients in one day, prescribed medicine to 5 patients, gave a presentation on proper communication with colleagues, depending on the role. All the goals should be in the proper time frame; the leader and an employee should define deadlines. The proposed solutions will bring Midtown Neurology to a new stage of development while gaining more and more recognition and expanding its services to get more revenues and help patients.

References

Allen, T. (2020). This is what it takes to become a successful management consultant. Forbes.

Cooke, R. (2015). Create constructive cultures and impact the world. Human Synergistics International.

Jyoti, J., & Dev, M. (2015). The impact of transformational leadership on employee creativity: The role of learning orientation. Journal of Asia Business Studies, 9, 78-98.

McKewen, E. (n.d.). Hiring a consultant: The pros & cons. California Manufacturing Technology Consulting.

West, M., Armit, K., Loewenthal, L., Eckert, R., West T., Lee, A. (2015). Leadership and leadership development in health care: The evidence base. The Faculty of Medical Leadership and Management.

Xenikou A. (2017). Transformational leadership, transactional contingent reward, and organizational identification: The mediating effect of perceived innovation and goal culture orientations. Frontiers in psychology, 8, 1754.

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