The benefits, and limits, of practice task force committee work

Interdisciplinary working groups can be charged with problem solving and researching opportunities.

Issue: July 10, 2016

ByJohn B. Pinto

“A camel is a horse designed by committee.”
– Alec Issigonis

“A committee is a group of people who individually can do nothing, but who, as a group, can meet and decide that nothing can be done.”
– Fred Allen

For years, I have urged clients and audiences to adopt a simple, five-step, one-size-fits-all way to address every practice problem:

1. Gather in one room the facts and statistics associated with the problem or opportunity. For example, if a provider’s schedule consistently runs behind, you might reasonably need:

A brief history of when the problem started and how it has developed.
The provider’s current template.
The results of a time study showing a typical patient’s movement though the clinic.
The provider’s actual recent morning and afternoon arrival times.
Comments from staff in the trenches.
Comments from patients about how they feel when the clinic runs late.
Monthly patient counts for the provider compared with norms for the number of patients an average peer can reasonably transit.

2. In the same room, gather the people who touch the problem or opportunity. In the case of the scheduling problem, this might include:

The affected provider.
The provider’s lead technician.
The department heads of reception and technical services.
The practice administrator (at least in smaller practices).

3. Discuss the problem, considering both the facts on the surface (“Dr. Smith’s clinics run 60 minutes late throughout the day”) and the less obvious, sometimes uncomfortable root causes (“Dr. Smith routinely arrives in the office at 9:15 a.m. for his first 8 a.m. patient”).

4. Unless you have solved the problem on the spot, nominate someone who is going to take charge of a new, brief-lived, problem-focused task force, and ask them, “What’s your deadline for coming up with an actionable solution and solving this problem?”

5. Then let your task force do its work, and hold the leader responsible for nailing the self-imposed deadline.

This approach comes as close to a universal Swiss Army knife solution as anything we have in the business of ophthalmology.

This five-step universal solution is so simple — why isn’t it used more often? First, because committee work is so often mocked, and second, because of the exceptional culture of medicine. Surgeons are trained to think and act more on their own than collaboratively. This ethos seeps through practices and results in a culture of, “Go figure it out for yourself.”

I have dropped into many practices where individuals have puzzled for months over a problem that subsequently yielded quickly to groupthink.

Some practices get halfway to collaboration but fall short. A problem may be brainstormed in the tech department but without the input of other team members from billing or marketing or the call center. Break down the silos in your practice and ask, “Who else contributes to this problem? Who else will be impacted by our solution?”

Advantages of working groups

By creating successive, brief, interdisciplinary working groups, you not only solve problems faster, but you also:

Break down the barriers that commonly result in techs saying, “The front desk goofs off while we’re dying back here” (and vice versa).
Build teamwork by allowing staff who would not ordinarily rub shoulders to work together.
Encourage cross-training and career mobility, as everyone is eventually exposed to every area of the practice.
Achieve greater buy-in with difficult but necessary decisions.
Improve morale by giving a wider voice to staff ideas.
Develop leadership skills by passing the baton to different “problem owners.”
Find out faster if the agreed solution is working because several people will be watching for positive results.
Take pressure off the managing partner and administrator, leaving them to deal with larger problems by delegating to special, focused committees.

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Missteps to avoid

Try to avoid these common missteps in your targeted committee work:

Get your organizational basics in order: A diverse group of problem solvers will better serve their practice if you have hardwired your practice’s culture and general mission.
Do not use task forces as a replacement for leadership: If an obvious course of action is indicated, proceed rather than lose time to committee work. As the old maxim goes (with apologies to my herpetological readers), “If you see a snake, just kill it; don’t appoint a committee on snakes.”
Such focused teams are not the same as standing committees: They should be disbanded as soon as the problem is solved and not linger.
Some of the most effective, creative people do their best thinking alone: Feel free to empower a committee of one in circumstances in which an interdisciplinary approach is not critical.
Try not to call on the same people time after time when problems surface: Mix it up and encourage the involvement of staff “wallflowers.”
Supply adequate resources: If your task force has to meet before or after hours, pay overtime to nonexempt staffers.
Keep your task forces as small as possible to get the job done: Do not draft five members if two or three will do. As quoted in The Economist, Amazon’s founder Jeff Bezos once quipped, “If I see more than two pizzas for lunch, the team is too big.”

Good approach for opportunities

Note that seen positively, this all-in-one solution works as well for opportunities as it does for problems. Perhaps you have seen this common boardroom phenomenon: Someone will mention a new opportunity; it could be an office to open, a doctor to hire or a new piece of capital equipment to buy. Lively discussion ensues and, without disciplined chairmanship, can go on for 20 minutes, until someone changes the topic and off everyone goes in a new direction, with no closure on the opportunity raised. When new ideas surface that deserve company attention, the effective chair delegates to one of his or her colleagues the task of leading a work group to come back to the boardroom with its recommendations.

For more information:
John B. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm established in 1979. John is the country’s most-published author on ophthalmology management topics. He is the author of John Pinto’s Little Green Book of Ophthalmology, Turnaround: 21 Weeks to Ophthalmic Practice Survival and Permanent Improvement, Cashflow: The Practical Art of Earning More From Your Ophthalmology Practice, The Efficient Ophthalmologist, The Women of Ophthalmology, Legal Issues in Ophthalmology, Ophthalmic Leadership: A Practical Guide for Physicians, Administrators and Teams and a new book, Simple: The Inner Game of Ophthalmic Practice Success. He can be reached at 619-223-2233; email: pintoinc@aol.com; website: www.pintoinc.com.