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Mastery is key to practice management success
Applying ancient wisdom to daily issues can lead to better service, a stronger bottom line and greater personal satisfaction.
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I’ve just returned from watching a local children’s karate class. Twenty-six Ninjas-in-training, ranging in age from 4 to 8 years old, all going “Ayyyyaaahhh” at the top of their lungs for about an hour under the watchful eyes of Sensei Kikuchi and Sensei Clauson. Unbelievable. Any two of these little guys could easily take down your average urban mugger. How? Mastery. And focus. And enthusiasm.
Taoists in China have written about mastery for a thousand years. Their wisdom is a useful index for managing your practice:
“The average butcher sharpens his knife every hour. The excellent butcher sharpens his knife every day. But the master butcher never sharpens his knife, because he finds the space between the bone and sinew and muscle where there is no resistance. And the knife stays sharp forever.”
How often do you hit “bone” as you manage the day-to-day affairs of your practice? How often must you sharpen your knife? As you read this, settle back and think about what level of mastery each person in your practice has achieved. If you’re a surgeon reading this, start with yourself. Continue with your most senior staff. One person at a time, how are the rest of your support staff: serenely competent or barely hanging on? Is your organization made up of alert “Karate Kids” or a legion of slump-shouldered workers who long ago stopped well shy of even trying for an ophthalmic black belt?
Envision the potential
You should always see “better” as a potential that lies in front of you. Don’t be satisfied with simply maintaining standards — raise them. No practice ever achieves a perfect way of attracting new patients. Or seeing a larger clinical volume. Or collecting fees. Even the most adroit practice misses out on polishing steps that could mean another ramp up in reputation and profits. Here are the most common gaps — errors and omissions that continue day after day in practices that have not only not yet mastered the art of management, they’ve stopped even trying.
Practices hire new staff who are convenient, rather than excellent. And they hang onto weak links far too long. You likely have one or more staff who should be removed from your practice today. Why are they still hanging around?
Doctors and staff don’t pay sufficient attention to their appointment book, which can be thought of as a kind of “gas gauge” for your practice. Are you failing to keep tomorrow’s appointment book 100% full? If so, you should know that just five extra patients a day can bring $100,000 or more to the bottom line each year.
In faltering practices, patients are treated like a number. Instead, make it a point this week to treat every customer as though they were your only patient for the day. What would you do differently if you were just starting your practice? What’s stopping you from acting that way today?
The most common performance gap is in the area of continuity of care. Existing patients aren’t use to develop the practice. You should be giving such great service that you’re comfortable asking every patient to refer a friend. This can be embarrassing for established surgeons, especially if the quality of their service has slackened. Start over, and begin handing out your cards and shaking hands at the end of each visit like it was your first year of practice. Every moment you forget about marketing is a moment that your practice begins to grind to a halt; if you listen carefully, perhaps you can almost hear it happen in the hallway outside your office as you’re reading this article.
Doctors who don’t know their practice numbers are begging for disaster. You wouldn’t drive a high performance car without adequate gauges. The smallest practice is far more complex than a Porsche, yet many still ignore the warning signs even when their practice is sputtering to a halt. If you own your practice and you can’t recite your financial and volume performance numbers from memory, you haven’t mastered your responsibility as a business person.
Most doctors pay excessive attention to counting their surgical volumes or patient visits, forgetting that success is better measured in profit per doctor-hour instead of cases per month.
Here’s a shock for most Americans. Europe, the “old country”, is way ahead of us when it comes to mastering service standards. The best haircut — and fastest — I’ve every had was in a small Paris salon. Five minutes of blazing scissors and I was shorn. European medical practices will eventually have to adopt ISO 9000 series service standards (once reserved for manufacturers only) to receive third-party payments.
Core of happiness
Lest you think this whole topic dry, I’d assert that mastery is at the core of career happiness. Maybe even life happiness. Two years ago, engineer Milton Garland, who had worked for the same employer for 78 years, was honored as the oldest employee in America. At 102 years young, Garland told a news conference at the National Press Club, “I love the work I’m doing. My advice is to go into something and stay with it until you like it. You can’t like it until you obtain expertise in that work. And once you are an expert, it’s a pleasure. And once you like what you do, you won’t want to quit doing it.” Asked where he would be if he had retired with his peers 37 years earlier, Garland didn’t hesitate. “I’d be in my grave,” he said.
I think those junior Karate Kids are absorbing the same wisdom. Amazingly, they’ve just got it about 100 years earlier than most of us.