Your Practice Is Falling Apart Every Day. What Are You Going To Do About It? – Practice Perfect Podcast Episode #12

Nick Dumitru

"So you can create the most elegant and beautiful solution to a problem that you've got in your business, but if your staff can't sustain it and be consistent with it, then there's no point to doing it."

Speaker 2: 00:13 Practice Perfect.

Speaker 3: 00:14 Actionable business information to take your medical practice to the next level.

Speaker 2: 00:19 Now your host, Nick Dumitru.

Nick Dumitru: 00:27 Welcome to another episode of Practice Perfect. The title of today's show is, your practice is falling apart every day, what are you going to do about it? Now medical professionals tend to like order and a state of healing, but unfortunately, businesses and medicine, the state of business isn't one where it is constantly getting better by itself. If you create an incision in a body, generally in a healthy person, that incision will heal. The correction that you've made will get better and in time that patient will fully recover and continue to be robust and make improvements. But I want you to start thinking of your business a little bit differently.

Nick Dumitru: 01:06 The first concept we're going to talk about is entropy. Now entropy, I'm sure you've studied science. You are probably familiar with the term. I'm going to define it in a way that's easy for everybody else to sort of understand so that we have some common ground. And the definition of entropy that we're going to use is the tendency of all things in the universe to fall apart or more accurately to fall into disorder from order.

Nick Dumitru: 01:31 Now, business systems are no different. They're in a constant state of entropy. I'm talking about things like your customer service, your web content, your website structure, your technology infrastructure and your marketing. Examining each one of those little bit by little bit, look at your customer service if you're not on top of your customer service. The market can change, employees can change, and then you start to decay. Basically your customer service starts to get worse and worse and worse without you attending to it. Your web content can be the same way. It can become out of date. It can be subject to maybe not looking the way it should be. Styles change. The structure of your website may be different. Maybe a user interface element is introduced, for example, a mobile device versus a desktop, and now the way that you've got your site structured is no longer efficient to be navigated. That can sort of fall apart. Just because the world is changing, times are changing.

Nick Dumitru: 02:27 Your technology infrastructure. If you don't update your technology, your backbone, the backbone of your business, it can start to fall apart because security holes are discovered. Things start to no longer work with maybe new equipment or old equipment stops functioning. All that stuff isn't a constant state of decay. Your marketing is no different. Your ads can get stale, your messaging can get stale, the market's sentiment can change. So all things in business are in a constant state of entropy. They are put into order by yourself, by your staff, by your consultants, and then they tend to revert back into a state of disorder.

Nick Dumitru: 03:06 So the question I have for you is, what is your organizational half-life? Not to define half-life is the time required for a quantity to reduce to half of its initial value. Now I want to use that analogy here because I want you to start thinking of it that way. How much time do you have until what you've put into place is half as effective as it was today? And I want you to start looking at the different components of your business that way because procedures are not enough. The blame ultimately lies with management and making sure that these systems are robust and in place and functioning properly over time without you. Now, there are two things that you need to ensure for this to happen.

Nick Dumitru: 03:47 In order to have a robust infrastructure, you need to ensure consistency and sustainability. If something isn't being done consistently, then your half-life is short. In some practices, that's as soon as you walk out the door. So let's say you're asking your staff to call people right away. While you're standing over them, they pick up the phone immediately. They get a lead. Something comes in by email. Someone filled in an application on your ad. They'll pick up the phone immediately as soon as you turn your back and you walk out of the room, that's no longer happening. So the half-life of that process is extremely short. It's literally minutes. It's as soon as you turn your back. And you have to start thinking about every system in your company that way. What infrastructure is in place to ensure a longer half-life, to give that process a better chance to work over time. Because if it's not being done consistently, then your half-life is very short. So consistency is the first element that you need to pay attention to.

Nick Dumitru: 04:49 Now let's talk about sustainability. If something isn't sustainable, it's just as bad as being inconsistent. For example, grinding your workers to the point that they won't be able to sustain the procedure isn't the answer. You can create the most elegant and beautiful solution to a problem that you've got in your business, but if your staff can't sustain it and be consistent with it, then there's no point to doing it. So by this point, you're probably asking yourself how to do these things. And if you're a longer time listener, you understand that I like to try to give you some practical, usable advice in these podcasts, in these talks that we have together so that you can go back to your company and start implementing them. I deal with this situation in two ways. The first way is to create a feedback loop. The second way is to schedule regular monthly meetings. So let's go over each of them in turn.

Nick Dumitru: 05:43 Getting feedback from your staff is extremely valuable. So you need to give your staff a 360-degree feedback mechanism. Because there's no way that you or your managers can know if they're doing a good job without anonymous feedback and the culture of candor. So you want to solicit this feedback from them. You also want to make sure that your staff understands that it's anonymous and safe. Creative mechanism technologies in place, you can do anonymous forums, whatever it might be. If you're a very small organization, it'll be a little bit tougher. But if you've got four, or five, six, 10 people working under you and you start to solicit this feedback on a regular basis, you can expect a certain level of anonymity there. And what's also important is that they feel safe.

Nick Dumitru: 06:28 In a paternalistic organization, people try to avoid blame. They do try to shy away from the gaze of the business owner or the manager because they know that they're just going to get dumped on. They know they're going to get attacked. They know that rather than looking for a solution, the culture is one of placing blame and that's not what you want to have in your company. What you want to have is valued candor. You want them to understand that their feedback is there to make the company better, and the way that you solicit that feedback is in such a way that they're safe and they're not going to be attacked. There will be no repercussions to them giving you that feedback.

Nick Dumitru: 07:06 Because if you operate in a paternalistic style, you're just shooting yourself in the foot because you're taking all of the collective brain power that you have in your business, and you're basically just compartmentalizing it and putting it away in a closet that'll never be accessed by anyone else in the organization, and you're going to do yourself a huge disservice like that. You want to access that brain pool. You want to have them tell you what's wrong so that you can improve. Because without that feedback, you don't know if what you're doing is right or wrong.

Nick Dumitru: 07:35 You may have the best intentions, but that intention can be perceived very negatively. And then what happens is the employee then takes it as a slight and they're seeing you doing harm to them. And then it just becomes this festering open wound that gets infected, and then nothing ever gets resolved, and you're think you're doing good, they think you're doing bad. And then you think that they're being ungrateful, and then they think that you're not understanding what they're going through. It almost sounds like like parenting to some degree, but it's very important to get that feedback because what's you're after is solutions. You're after a successful practice, you're after moving it forward. You're not after placing blame, you're not after inefficiencies. So that's the first thing, the 360-degree feedback mechanism.

Nick Dumitru: 08:19 The next thing that I always implement and practice is a regularly scheduled monthly group meeting. And I also recommend that you take smaller teams and have them do daily huddles at least once a day, preferably two to three times a day. Usually first thing in the morning, maybe at lunch to check in and make sure that everybody's got what they need to do their job. There are no problems. Or if there are problems, how they're going to be dealt with and that they've got the tools to deal with them.

Nick Dumitru: 08:46 Now these monthly meetings, when you involve the whole organizations, they're really magical. You'll be amazed at how steadily your business starts to forward when you have this kind of feedback and collaboration each month. I look at them as sprints. You've got people coming together every 30 days. That means that they've got 30 days to implement what was decided on 30 days ago. And what you'll find is that in preparation for these meetings, even people that tend not to do things, they may leave it till the last moment. So maybe a three-day job will take them 30 days to do, but on those last couple of days, they want to make sure that they get it done because they don't want to be the ones that let the team down.

Nick Dumitru: 09:28 And these sprints really move things forward over time because if you've got them monthly, then you've got a monthly sprint. That means that 12 times a year, your business will have taken forward progress. It would have made forward progress, it would have moved towards its goal, and it's sustained and consistent. And that's important here because you're doing this every month. So that's one of the best things that you can do for your practice. When you can come together and let everyone contribute.

Nick Dumitru: 09:56 Now, the key to this is to make it a collaborative effort where everyone has a say. Don't run this like a dictatorship where it becomes a blame game, or a bitching session, or they all just come to you for answers all the time and they weren't given the opportunity to come up with solutions on their own. You really want to solicit this kind of contribution from the team. And if you find that you've got team members that can't contribute, then you have to start thinking about making a change. So this is also a great way for you to evaluate your staff and their ability to contribute to the business and move the business forward. And keep in mind that not everybody is an ideas person. So it could be that some people are just doers and not thinkers and which is okay, a business needs both of those people. Just keep that in mind, but you can really gauge the value of each employee at these meetings and see what they've done to contribute, what they've done to move your business forward.

Nick Dumitru: 10:52 Now, what I want you to also understand is that you should not expect your business to run smoothly. No successful growing business runs smoothly. Businesses that are in a stable state, everything's smooth, they're usually in the processes of dying. At the start, we discussed entropy a little bit. Energy in the system means higher entropy. If your business is experiencing a lot of change and a lot of problems that are not a result of incompetence, that's good. That's a good thing. It means that your business has a lot of energy and momentum and that's what you want. If you have something that's just stable and it's just slowly decaying, it's still technically in a state of entropy, but it's also in a state of the decay, that's not what you want.

Nick Dumitru: 11:36 If you're adding energy into a system, again, things will fall out of order. Like do you think that Apple computer, or Microsoft, or any other large company, Amazon, do you think that they're running smoothly? They're not. They're innovative. They're moving forward. They're in a constant state of entropy. They're constantly evolving, but it's controlled chaos. So your job is to accept and manage the chaos. You have to accept change. You have to accept problems. You can't look at problems and let them defeat you. You can let them make it be a sign that something's wrong in your practice. It's not necessarily the case. If it's entropy as a result of innovation and progress and growth, it's fantastic. You want to have those problems. You want to tackle them. You want to have a challenge for your team to handle when they come together every month.

Nick Dumitru: 12:26 Now your job as a leader is going to be to organize these systems so that they are robust and repeatable without your constant involvement. And that's really your job as a leader in your organization. It's not to denounce problems, it's not to place blame. It's to design your practice in such a way that it is robust and resistant and actually thrives on this change. So that when a problem comes up, as opposed to it crippling your organization, you have the mechanisms in place to tackle that problem and innovate on the back of it.

Nick Dumitru: 13:00 For example, if patients are constantly complaining about the wait time, that's a problem in your practice. So you can either sit there complaining about it, blame the doctor for being late, blame the staff for not getting them in on time or mismanaging or double booking. Or you can look at ways to innovate and you put a mechanism in place that identifies that. So something as simple as those monthly meetings where maybe your operations manager tells you, "Hey, we've got a long wait time. We've got complaints. How can we fix this? What can we put in the waiting room? How can we adjust our systems? How can we innovate to be the best practice in the city on the back of this problem that we've identified?" So the problem's not crippling you, it's now spurning innovation. It's now giving your team a challenge to move your practice forward.

Nick Dumitru: 13:47 And that's what I mean when I say that you can accept the change and use it as a jumping board, a platform for you to move your practice forward. Because entropy, change, chaos problems, those are nothing more than veiled opportunities for you to become better and set yourself apart from your competitors and really take the lead in your city.

Nick Dumitru: 14:08 All right, I'm going to get off my soapbox here. I think I've made the point. I want you to go out there and start taking action. I also want to ask you to subscribe if you're listening to this on iTunes. And do me a favor, if you go to where we host the podcast, go on there and fill out our form and give me some feedback on topics that you'd like to hear about. I'd love to get feedback on new topics that you want to hear about. It helps me understand how to move the podcast forward and what to do for additional topics for you guys, and I'd love to answer any questions that you've got. All right. Having said that, get out there, get your practice going and go up and hug some problems.

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