Addressing management issues

Sept. 1, 2009
Big company bought our lab

Q As the manager of a physician-owned laboratory (POL)
for more than 10 years, what changes should I expect now that the lab
has been sold to a large independent commercial lab? What suggestions
can you offer that will help me work well in this new environment? How
can I help the other employees adjust to the changes?

A Your expectations should flow from an understanding
of what you were doing and what your function was as a POL compared to
your role as part of the commercial lab. A lot will depend on your
proximity to your new owner’s other facilities. If you are in a place
that is not convenient for couriers, there may be little change in your
test menu. In that case, the largest operational change will probably be
in tying into the new lab’s computer system.

If the services your lab provides replicate those of
other nearby branches that can provide adequate turnaround time, it will
make sense to consolidate those overlapping services. Do not overlook
the possible upside, as this could mean that some services could be
consolidated into your lab. It is more likely, however, that some
testing you have been doing for years will now go to another facility.

As the manager, the best thing you can do is to
accept that there has been a change in your circumstances, and
understand the underlying reasons for the changes that will be made.
Then convey that information to the employees whose lives are being
affected. Be empathetic, but be clear. Then look for ways that you can
be helpful in meeting the new mission of your laboratory.

—Wendell O’Neal, PhD, D(ABCC)

The WHISK Group

Clinical Laboratory Consultants

Cincinnati, OH

A The first change that you may see is an increased
focus on the financial benchmarks for your laboratory, especially if the
large independent commercial laboratory is a publicly traded company.
Understanding the new owner’s management philosophy is paramount to
being successful in the new environment. If there appears to be a more
stringent focus on benchmarks, that is not a bad thing if the employees
are familiar with the metrics. The best approach to helping the
employees adjust to the changes is to have open, honest, and consistent
communication. Have scheduled team meetings so employees know they have
a venue to receive information and ask questions. You may want to
schedule more frequent meetings initially until everyone is comfortable
with the new management. It is also likely that your lab will experience
an increase in test volumes. Be sure your lab and your lab staff are
flexible and ready for that change.

—Christine Diehl, BS, MT(ASCP)

Director, Laboratory Practice

Wellspring Partners

Chicago, IL

A Expect that there will be changes in the way that the
laboratory operates following an acquisition. Typical changes relate to
the tests that are performed onsite. The physicians have elected to sell
their laboratory and will no longer be gaining revenue by tests being
performed within the lab. This may cause them to rethink which tests
need to be performed when the profit motive is withdrawn from their
equation. Routine tests will usually remain on the in-house menu, and
the volume may increase or decrease based on patient care needs.
Low-volume testing and non-routine testing will typically be sent to the
commercial laboratory for testing due to economies of scale. If a STAT
test result is needed, most commercial labs work out a testing agreement
with a local hospital.

The new lab will have standardized testing equipment,
procedures, and vendors, and they will provide written procedures,
purchasing decisions, ordering systems, and changes in equipment when
needed. Do not expect the lab to come in and change all of your
equipment unless the sale was precipitated as a result in the need for
capital to equip the lab. Acquired labs often continue using the same
equipment for years afterward.

Challenges you will face personally relate to
interactions you will have with management, in addition to concerns and
apprehensions by your employees, and will involve your learning new
personnel policies and procedures, purchasing systems, as well as
oversight relating to all aspects of the lab. You may feel as if you are
dealing with an unworkable bureaucratic process, but learn patience and
find a way to get things done in a positive manner.

Here are some important reminders for you and your

  • Do not become defensive over any question or
    challenge posed to you.
  • Ask for help when you need it.
  • Learn how to interact within a larger
  • Maintain a good attitude.
  • Embrace the change.
  • Communicating well is critical.

As manager, you are a key element in making the
acquisition work smoothly for your personnel and your physician-office
staff. Help your team by anticipating concerns and addressing these
concerns with facts in a positive light. Learn the new systems that
relate to the personnel as well as you can to ensure their needs are
met. Arrange interactions between your personnel and your new management
group as often as needed to help your team feel they are a part of the
larger company. Continue to interact with the physician staff and clinic
personnel to foster a continued feeling of “team” with the clinic and
encourage good communication among all concerned. Being a part of a
larger organization usually brings about better benefits and
opportunities for all involved. Remember, the company deals with many
labs and situations like yours — and it wants to make your lab work.

—Alton B. Sturtevant, PhD

Laboratory Director


Birmingham, AL

Bottom line: Set
up a meeting with the new owner to answer questions relating to the new
owner’s philosophy and expectations for your laboratory. Meet regularly with
your staff to provide guidance and assurance. Open communication with both
the new owner and the staff is key to being an effective liaison. Know your
current statistics related to management (i.e., employees, schedules),
finances (i.e., cost per test, net testing operation costs), and equipment
(i.e., test volume capacity vs. actual volumes, current contractual
obligations). Be prepared to negotiate appropriate expectations for your
laboratory. You are the “champion” to foster this transition; being positive
and following Dr. Sturtevant’s reminders will serve you and your staff well.

Wanted: happy applicants

Q During the interview process with prospective employees,
what is the best way to determine a new hire’s “happiness level”? We want to
create a positive atmosphere, and maybe we can do this by avoiding hiring
someone who has a “glass is half empty” view. We have a great interview
process, but do you have any suggestions to help us get a glimpse the true
personality traits of potential employees?

A Interviewing for a positive attitude or happiness cannot
be related directly to answers to questions, since answers can be crafted to
cast a positive light on the interviewee. Attitude can be seen by studying
the entire person, including responses to questions, posture, facial
expressions, how the individual looks at you, the pride he shows in himself
— as exhibited by his dress and the respect he shows the interviewer.

Ask some questions that relate to attitude: What do you
do to help fellow employees feel motivated? How do you handle a negative
person? What do you think are your positive traits? Do you like working with
others in a team atmosphere and why?

Ask about previous jobs they held to help with attitude
assessment: What did you enjoy about your last job? Did the attitude of your
fellow employees affect how well the team worked together? How? Did the job
encourage teamwork? Did you like what your supervisor did to motivate
teamwork? What motivated the team the most?

As you conduct the interview, use follow-up questions
that relate to the response the prospective employee gave to gain insight
into his attitude. Ask questions that will allow you to judge whether the
person is a team player or a loner. It may be useful to determine if he
participates in team activities such as sports, group studies, or
organizations. If he participates in organized activities on a regular
basis, this may indicate that he is likely to have good interactions with

—Alton B. Sturtevant, PhD

A Your question raises two key issues. First, if we take a
fundamentally happy, optimistic person and put her in a job that is
frustrating with vague expectations, over time her attitude will begin to
change. Unfortunately in job interviews, the “grunt work” may be downplayed;
and when the employee comes to work, her job expectations are different from
what she is experiencing. It is critical in the interview to be clear,
concise, and specific about the job.

The second issue, I believe gets more to the essence of
your question. Viktor Frankl, a Holocaust survivor, reflected on his
experiences in the concentration camps when he wrote Man’s Search for
. In the book, Frankl explores the most extreme circumstances of
human suffering to understand why life has meaning. According to Frankl,
happiness comes as byproducts when we surrender ourselves to others. When
our life has meaning, it gives us a core sense of purpose, depth of passion,
and contentment. During the job interview, candidates can be asked about
their community involvement and what they do in their spare time outside of
work. Candidates who are actively involved in sharing their gifts with
others and are pursuing activities to grow as a person will probably have
the “happiness level” you are seeking.

—Francee Preston

Patient Relations Specialist

Medical Practice Services

State Volunteer Mutual Insurance Company

Brentwood, TN

A Many supervisors could probably have saved themselves
much grief if they had been able to establish the “happiness level” of
prospective employees to avoid hiring a basically unhappy person.

Search the Internet for free and commercially
available personality tests that are applicable to the work situation.
Choosing one of these or developing your own will allow you to test all
candidates in a standardized fashion.

If you do not want to go with something that formal,
incorporate several questions designed to reflect “happiness” into your
interview process. Questions could focus on such things as how
candidates feel about themselves and their lives, how they feel about
learning new things, how they give back to society, how well they take
care of themselves, and what makes them happy or sad.

—Marti Bailey, MT(ASCP), CPC

Work Unit Leader, Pathology

Penn State Milton S. Hershey Medical Center

Hershey, PA

Bottom line:
It sounds as if you currently do not have a positive work atmosphere,
and you believe that environment exists because of the personalities of
your staff. As Ms. Preston points out, you can take a happy person and
put him in a less than desirable atmosphere and the “happy camper” will
not necessary remain happy. Consider performing a staff satisfaction
survey, and use it to help create a positive work environment; the
“happy” people will come.

Anne Pontius is a senior medical practice
consultant with State Volunteer Mutual Insurance Company in Brentwood,
TN, and president-elect of CLMA 2007-2009. Send questions to Ms. Pontius
[email protected]