Learning the Art of Delegation: A SMART Tool for Physicians

An earlier version of this article appeared on this website in July 2023.

Delegating can be a challenging skill for many physicians to master, but it’s often an integral part of safe and efficient patient care. The need to maintain control over every detail—especially when you bear ultimate responsibility—can make letting go feel risky. That’s why the most effective delegation is not just about offloading tasks; it’s about empowering your team to work at their best.

In this article, we’ll explore which tasks are most suitable for delegation, how this practice can strengthen teamwork, and strategies to make the process efficient and effective. Plus, I’ll share a practical template to help you overcome common barriers, enabling you to maximize your team’s potential.

Of course, you can’t (and won’t) simply assign a task and hope it all works out. Instead, when you delegate, the goal is to get the same or better result than if you did the task yourself.

As a physician, there can be a blurry line between what you need to do to assure the optimal care for your patients and what others must do in order for you to accomplish your best work. Creating a cohesive team mentality will help you to reach these goals with greater confidence.

Begin with creating clarity around responsibilities and purpose. You are the team leader. The goal is to provide the best and most timely care for your patients, and to administer that care with compassion and professionalism. By establishing clear and well documented instructions and expectations, you’ll set your team members up for success.

You may already know about SMART goal setting, but the SMART Delegation mnemonic is a distinct tool designed to help you manage your workload more effectively and make the most of your time. By following its steps, you can delegate tasks successfully while empowering and motivating your team to perform at their best.

 SMART Delegation

(Based on the work of Kate Christie of Time Stylers)

SELECT: Choose the best person for the task. This may be someone with little experience but a willingness to learn, or it could be someone with years of practice in the same or related field. Be choosy, but consider thinking outside the box.

MOTIVATE: Motivate your team by explaining why the task is important. This will create buy-in and a sense of importance and pride. This step is important to revisit periodically, especially at first.

ACTIVATE: Explain the details of the task in detail. Be sure to include a checklist if appropriate, and a written guideline that can easily be referred to and updated as needed. Once you put in the work to create the guideline, this bit of heavy lifting is done. This is a crucial part of time management.

RESULTS: Describe and explain clearly what a good result looks like. Be sure your delegated team member understands the purpose of their work, and how to recognize common complications.

TIME FRAME: Set realistic but firm deadlines when implementing new protocols. Consider setting up a mid-point check in if appropriate.

What to Keep in Mind When Delegating

Trust but Verify

Delegation requires trust in your team, but it’s also essential to check in periodically to ensure the task is on track. Verifying progress not only helps catch potential issues early but also reinforces accountability and builds confidence in your team’s ability to meet expectations.

Acknowledge the Learning Curve

Remember, your team or individual members may be learning a new skill. Take time at the outset to be available, approachable, and patient—especially in the early stages. The time you spend now will be paid back in multiples once the process is clear. Ensure the person taking on the task fully understands their role and the expectation that they will eventually handle it independently in most cases.

Keep Communication Open

Maintain open lines of communication so your team feels comfortable seeking help with complications or unexpected situations. Whenever possible, turn their questions into teaching opportunities instead of simply providing answers. Foster a spirit of teamwork by encouraging them to brainstorm solutions and come to their own conclusions, while also offering a safety net of support.

Utilize Supervisors as Needed

If appropriate, involve a supervisor to provide additional support. This allows your team members to seek guidance on minor issues or questions without always relying on you. It also brings the supervisor into the process, building camaraderie by acknowledging their role and creating stronger team cohesion.

Provide Constructive Feedback

Be generous with your praise and constructive criticism. Patience is essential, but if someone consistently struggles to meet expectations, consider delegating the task to someone better suited for it. Avoid slipping back into the time-consuming habit of doing everything yourself.

Embrace Discomfort

Delegating can feel like relinquishing control, so it’s normal to experience some discomfort at first. Be patient with yourself and your team while setting clear and achievable expectations.

The Ripple Effect of Effective Delegation

When you commit to the principles of SMART delegation, you’re not just easing your workload—you’re fostering a culture of trust, accountability, and growth. With the right people and processes in place, delegation can make you more productive, improve safety, strengthen teamwork, and enhance patient satisfaction.

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From Conflict to Collaboration: Overcoming Challenges with Your Staff

As a cardiologist in practice for nearly 30 years, I was fortunate to work with a fantastic team of nurses, medical assistants, and office staff. I give much of the credit to our no-nonsense in-house nurse manager. But not all physicians are so lucky. And even one bad apple can make going to work a miserable experience.

Although medical training involves teamwork, it’s uncommon for physicians to learn managerial or business skills during medical school or residency. If you’re learning on the job, getting off on the right foot can impact your experience at work for years to come.

Until my practice was acquired by a larger organization, I served as chairman of our Human Resources (HR) committee for a number of years. So if you’re a physician dealing with challenging staff members, I’ve got some expert tips and insight to help you get to the other side of this common problem.

First, a little perspective. In years past, most physicians owned their practices. So in these situations, the physician or a trusted administrator typically did the hiring and firing. And the staff understood that keeping up good relations with their physician-employers was vital to maintaining happy employment. Now that most physicians are themselves employees, the relationships have become more muddied. And the truth is that depending on your organization, you may or may not have much say in the way the practice is run.

Be that as it may, as a physician, your leadership is crucial to maintaining a good working environment. Whether it is implicitly stated or not, your staff should understand that their job is to support the work that you do. And ultimately, that means providing optimal care and a supportive experience for your patients.

Whether you’re employed or not, your patients depend on you for your expertise and your care. Your employment status is irrelevant to them, and they view your staff as an extension and a reflection of you. That means that if the practice feels chaotic and uncomfortable, your patients are likely to feel unsafe and unwelcome.

It’s likely that most of your staff will appreciate a physician who is kind, principled, and clear. Most people who work in healthcare take pride in their jobs and care about the people they serve. But unfortunately, you can also expect to encounter some difficult folks along the way.

To maintain your sanity, your ability to provide care for your patients, and your role as a team leader, it’s important to have a clear plan for dealing with troublemakers.

Some people may be negative or disruptive, others may be passive-aggressive, and some may simply be incompetent. You may even encounter employees who delight in getting you upset. Regardless of the type of difficult staff member you are dealing with, rule number one is this: do your best to remain calm, cool, and professional at all times.

When dealing with the inevitable conflicts and other tough situations at work, here are some important things to keep in mind.

• Don’t make it personal

Although it can be tempting to let your emotions take over, the minute you make it personal, the problem becomes about you. This can be very difficult if not impossible to turn around. By keeping it professional, you have a much better chance of remaining above the fray.

• Consider involving HR:

If you have access to an HR staff member or administrator, and you feel reasonably confident that they will support you, it’s best to involve them early on in a difficult situation. This can help to protect you from accusations of harassment or favoritism.

When you try to go it alone, especially as a new physician, there’s a good chance you will end up making some important missteps. Never underestimate the power of a passive-aggressive or disgruntled employee to undermine your reputation. In the worst cases, this could mean the loss of your own job.

• Document everything

Documentation is not necessarily to get the employee in trouble. You’re documenting in order to protect yourself.

Be sure to include the specific behavior that is causing the problem, the date and time of the incident, and any steps that you have taken to address the problem. It’s a good idea to make a note of any witnesses as well.

• Try to understand the root cause of the behavior

Although your practice’s administration is likely responsible for managing the employee and their disruptive behavior, getting a handle on the behavior and its root cause may be helpful. Once you understand this, you may start to develop a plan to turn things around.

For example, if a staff member is negative and disruptive, it may be because they are feeling overwhelmed or undervalued. That doesn’t mean that you need to acquiesce to their demands or accept the behavior. But understanding what might be contributing will make it feel less personal. It may also give you insight into the path forward. And armed with this information, you may be able to work more collaboratively with your administration.

• Be direct and honest. 

If your administration takes a hands-off approach, it may be left up to you to manage the issues. This is often the case for minor procedural problems, lack of education, and misunderstandings.

When you address the problem with the staff member, be clear, calm, and truthful. Avoid being confrontational or accusatory. Instead, focus on the specific behavior or issue that is causing the problem and how it is impacting the workplace.

Consider having a trusted colleague or nurse present for the discussion. That will help to protect you from any undue accusations.

• Be prepared to offer a solution

It may be necessary to work directly with the staff member to resolve the problem. For example, if a staff member is struggling with a particular task, it may be up to you to provide them with additional training or support.

Set clear expectations and provide regular feedback. Sometimes these individuals become the most loyal employees, if they understand that you are on their side.

• Be supportive and encouraging

The process works both ways. By contributing to a work environment where your staff members feel valued and supported, you are more likely to be listened to and treated with respect.

• Be fair and consistent

Treat each of your staff members fairly and consistently. Avoid favoritism and keep your personal life separate. When you spend most of your life at work, it may be tempting to see your staff as friends. This is a pitfall that many early career physicians fall into. Over time this can create divisions and expectations that will only make things more difficult for you.

As a physician, you have the right to expect a positive and productive working environment. If a staff member is making it challenging for you and others to do your jobs, it’s critical to take the necessary steps to address the problem. Whether that means involving administration, providing additional training opportunities, or even terminating the employee, embodying a calm and professional leadership style will help to ensure a safe and supportive environment for you, your staff, and your patients.

If you’ve enjoyed this article and would like to stay in the loop for more insights on creating a sustainable, fulfilling, and happy life as a physician, sign up for my newsletter or reach out on my website. I’d love to hear from you.

And if you’d like to schedule a complimentary introductory meeting with me, click the link below.