Most health care managers spend a good portion of their day dealing with patients both directly and indirectly. If there's one thing I've noticed it's the comfort that consistency brings to their medical experience. By that I don't just mean having a doctor they can trust, but also nurses and office staff they know and can depend upon.

I was reminded of this as I read a recent Medical Group Management Association article about rewarding a good staff as a means of keeping them in your employment:

''One way leaders minimize turnover is by rewarding employees for helping the practice succeed. The clinic also gives staff members a voice in the practice's operations...Employees can have a direct effect on practice operations in several ways. Because they serve as liaisons between patients and clinic leaders, employees use a feedback box to capture comments they hear from patients. Those submissions are reviewed monthly at staff meetings so all employees and providers are aware of issues and can help provide solutions."

Of course, this requires that everyone put their egos aside for the benefit of the overall practice, and in places where there is an established hierarchy it can be difficult to share information so freely. However, giving every employee a voice and rewarding their effort increases their commitment to the work they do, and patients intuitively know when the people who care for them are truly involved.

At our office, we offer year-end bonuses and increased vacation time for ideas that save money and time. In a small work environment where advancement opportunities are limited, it is our way of keeping people in the fold. It helps make it a place that I look forward to going into every morning, and props up morale.

I'm lucky. The office I manage is able to pay a competitive wage, which is invaluable in both attracting and keeping a high quality staff. However, it's been my experience that while a satisfactory paycheck is vital, it's not the only way to keep office morale high.

One of the main things I do is recognize achievement. When someone does something noteworthy or makes a valuable suggestion, I make note of it and during the next office meeting, I take the time to mention publicly just how grateful I am to that particular person. Praise, when legitimately given, is a terrific way to make an employee strive for excellence.

I also will send out the occasional complimentary email for the whole office to read, or even something as personal as a post-it on someone's computer. I'm careful not to go overboard or say too much, but I've found that people really appreciate the fact that their deed was remembered. Granted, we're all professionals, and should routinely be doing outstanding work, but that doesn't mean we don't like getting complimented for it on occasion.

Another thing I do with everyone in the office is plan small events like a dinner out together or even something informal like a bowling party. Nothing reinforces the sense of working in unison like bonding outside of the workplace. It also helps break down the barrier between doctors and office staff, keeping everyone approachable and on good working terms.

Sometimes I jokingly refer to our office as a lifeboat. We sink or swim together. It isn't necessary that we like or care about everybody on board, but it sure does help.