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Behind every great medical practice is a motivated staff. And behind every motivated staff is a great supervisor. "Staff motivation begins with the supervisor and trickles uphill to the administrator and to the physicians and so on . . . to the owner," says Jacqueline Coates, MA, practice administrator at Apple Hill Eye Center in York, PA. A practice's weak or solid foundation is built upon the supervisor's direct leadership, she adds. Following are six key elements that make up the framework for employee motivation and performance