Friday, July 26, 2013

5 Ways to Manage Up for Best Practice

Being new to the rehab director position, I felt that this topic would be particularly interesting and useful for #DPTStudents and those looking into understanding the clinical manager's perspective. While this post circulates upon managing up the clinical practice, the principles can certainly be utilized for any type of business model. Also, these 5 ways are simply ways I've found useful when I've needed to manage up - AND - these are way I personally like being managed up. Enjoy!

5 Ways to Manage Up for Best Practice

1. Respect the Office
Respecting the chain of command is an essential part of managing up - in fact, without this, there is no managing up. Everyone knows what it means to be, think, speak, and act (passively/actively) insubordinate. Management does not welcome this. No matter how passive aggressive, sneaky, or subtle - we get it - we know what you're up to - we're not dumb! What is sad is this: as management, I'm not out to "get you"; I am trying to protect your job. The disrespect of the office only threatened staff job security. In this vein, so often managerial positions are seen as this adversarial anti-floor/frontline-worker. That's REALLY not what management is about. Management is (minimally) about a big picture, operational standpoint of how to maintain a business model so that it will continue to run for the next day, week, month, quarter, year, decade, etc. In the end, this is precisely what we're concerned about. So! You don't have to like me; but, I do ask you respect the office for which I serve.

2. Know the Business & Be Proactive
If you need equipment, continuing education, have marketing needs, etc. - I am all ears! The condition is that you understand how your requests affect business and that you are proactive about it. Asking for an *insert terribly expensive amount of money costing* machine for *insert non-evidenced-based benefit here* is a great way to turn me off to the request. Again, my job is to protect your job. Many times, it means I'm not going to be terribly popular. Other times, I means I'm Santa Claus. Regardless, I most deeply appreciate when my staff keep the business in mind - are aware of how their requests, decision, and actions will affect the operational and financial facets of the clinic. Additionally, I as most appreciative when they are proactive in their steps to save money, make more money, nip problems in the bud, etc. Seeing a train about crash without helping the engineering pull the brakes is just as bad as someone causing it themselves. Be proactive!

3. Complain WITH Solutions
Complaints are ALWAYS welcome WITH SOLUTIONS! Nothing is more annoying to management than a laundry list of complaints, needs, wishes, etc. with no viable way of achieving the resolution points. If you are to complain, be sure you bring to the table viable action steps to reach the goal. Repeated complaints without any participation on a staff member's part to fix the issue is a red flag for which management starts to wonder what/who the root problem really is. Oh, and one more thing: not to be rude, but, what's the bottom line? I don't have all day... really. If you, as my staff, are able to punch out 1, 2, 3 and the suggested solution - I will be far more agreeable to any future approaches.

4. I'm no longer clinical... I trust you!
Most managements staff become less clinical the higher up you get on the command tree. To be honest, we rely on you, as the front line clinicians to be up-to-date, with the times, and heavily evidenced based for excellent outcomes. In fact, we expect it. When you approach us with ideas, suggestions, requests, etc. - we trust you've done your due diligence in properly researching the literature behind it. We trust you. The best thing to do is to print out a few abstracts or email some links with a short paragraph description on how the literature supports your idea for a clinical approach. Sold!

Caveat - DON'T BLOW THE TRUST! If every I discover you're blowing smoke, abusing my trust, and are up to something, you'll never regain that trust again. In fact, it'll probably place you in the hot seat - for not just myself as your director, you'll probably be seen quite unfavorable by the entire rehab team.

5. Remind me again?
Management staff typically has a thousand and one tiny little things to attend to... All. The. Time. It's actually quite annoying, but hey, we signed up for it! Be very welcome to remind me as often as you'd like; emails, sticky notes, text messages, etc. are all tremendously appreciated. If you do wish to discuss something face to face, make sure you spend that time wisely. Again, its kind of back to #3 - "I don't have all day." Be clear. Be concise. Be convincing. And, I will continue to listen, every single time! In fact, I'll probably start seeking you out for your thoughts & input on a great many topics! HOWEVER... Start to ramble. Start to waver. Start to make no sense.... yeah, you are totally going to lose your audience. Writing is always the best because it is trackable - especially via email. Also, many managers utilize their work emails as a secondary calendar/reminder tool; these types of reminders is a great help to the department. Every good manager will appreciate this method of managing up.


Managing up is a delicate art, a must have in professional relationship dynamics, and a critical part of making clinical practice the best it can be. Clinical managers are responsible for making sure that the departmental operations are firing on all cylinders and to support best practice. Typically, it is up to the clinical educators/specialists to bring forth, promote, train, and reinforce best practice. Regardless of how you feel about your manager (because, you know, there is ALWAYS someone above you), knowing how to respectfully interact and do business above & below the chain of command is critical in developing a strong & cohesive team dynamic. This is also essential in you keeping your job secure and your upward mobility options wide open.

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