Why Your Practice Needs "Troubleshooter" Employees

A few columns ago, I mentioned a leaking radiator in my home which resulted in a moderate renovation project. The guy replacing that unit - along with several others after him to deal with insulation, drywall, electrics, painting, etc. - was hardworking and efficient. Just about everything that needed doing was done in a single week, leaving only carpet installation before the affair would be settled and the disruption of my home-life could end.

In stark contrast, the carpeting has been a frustrating disaster, with errors and delays piling atop one another. No single player in the drama has taken charge to prevent future mishaps, let alone claim responsibility for previous mistakes. The errors have self-propagated; one begat another, which begat two more, creating a positive-feedback loop whose cycle of dysfunction got harder and harder to break.

Two facets of this situation have stood out, both of which have parallels in health care and business in general. One: Despite the skilled, hard work of the pre-carpeting team, my satisfaction with them is overshadowed by the aggravations caused by their successors. Even if I make a conscious effort to tell friends and family how good the first 90 percent of the renovation was, they come away from our conversation focused on the rottenness of the last 10 percent. Customers, and those around them, are most likely to remember the weakest link of a business’ chain.

The second theme: Once one is off a well-trodden path, it can be difficult or impossible to return to it. Many of our society’s processes are meant to swiftly and efficiently handle as many people, products, or tasks as possible; the subject goes from point A to B to C and so on. If one gets derailed between A and B, the same mechanisms that would ordinarily facilitate one’s progress from B to C now become obstacles, as they ensure that C only receives those who have gone through B. This is particularly problematic if nobody realizes that B failed to occur; the most crucial step can be figuring out where things went awry. Meanwhile, each subsequent roadblock piles on those prior to it, and those involved soon have not one but half a dozen mishaps to tax their time and patience.

Remedying such snafus is often beyond the abilities of the workers who initially discover (or create) them. Their increasingly desperate efforts to find a fix without reporting to a superior can add layers of complexity to a problem. Sometimes, they can create an illusory solution, but sooner or later the underlying issue resurfaces. The customer, often the first to learn that his nightmare is recurring, will immediately rediscover all of his aggravation from prior to the false solution…and may subsequently have less faith when told “this time, we’ve found and fixed the real problem.”

An office manager can sometimes handle these issues, but what about when the manager is out for the day? What if two crises occur at once, or the manager is so unfamiliar with the nuts and bolts of an issue that he’s just as lost as everyone else?

Consider appointing some troubleshooters, employees who have demonstrated not just competence at their daily responsibilities but also an ability to think on their feet and adapt to situations as they arise. Each major section of the office deserves its own troubleshooter - one for appointments, for instance, and perhaps another for billing and the front desk. A troubleshooter, while doing the same job as others in his area of the office, is always on the lookout for problems before they snowball out of control, is ready to pinch-hit for coworkers who see trouble brewing, and follows through on issues to make sure they were really settled. Troubleshooters should be among the most trusted employees, and compensated accordingly.

Some corporations have entire divisions for this purpose, with titles like “executive escalations.” They recognize that, even with the most well-oiled business machine running like clockwork, mistakes will happen. The customers slipping though those cracks are the ones who can be retained by your safety-net…if you have one.