Feature Article:

Looking Ahead for Practice Success

By Shelley Simon, RN, DC, MPH, EdD
Founder, Beyond Practice Management

Professional futurists are paid handsomely to look at trends, analyze data, develop scenarios, make forecasts, and advance theories either on behalf of clients or for their own research or scholarly endeavors. Interestingly, even though you?re probably not paid to peer into the future, you are also a futurist. We all are. As ?philosophers of foresight? we?re continually pondering, planning, and plotting strategies for our futures, sometimes based on instinct, intuition, or after having conducted analysis and developing scenarios.

Just as often, however, we make important decisions about the future based on past experiences, false or incomplete data, fear, or denial. Having a clear understanding about how you habitually think about the future can help you plan and make wise choices today that will positively influence tomorrow. Being aware of your own point of view, mindset, and tendencies is critical for processing information and making good decisions in an increasingly complex and turbulent healthcare environment. In this issue of Practice Your Way, we discuss how to use proven planning techniques to achieve sustainable practice success.

When it?s time to look ahead for practice success you could hire your own futurist (pricey), visit your local psychic (fun, but probably not effective), go to another practice management seminar (been there, done that). Or, you could read and apply the four steps I?m about to share with you. They are: (1) increase your awareness, (2) gather pertinent data, (3) learn and apply scenario development, and (4) make an action plan based on 1, 2, and 3.

This step involves understanding how you perceive and approach planning, make decisions, and take action. This is the inner work that determines your outlook, the inner research that shapes how your future unfolds. It?s important to recognize the thought and behavioral patterns that determine how, when, and why you move forward. If you?re encouraged when you imagine how your practice will look a few years from now, you?ll make different choices than if you are habitually discouraged or pessimistic. If you focus positively on the results you desire when you embark on a new program, service, or marketing effort, you?ll have a very different outcome (assuming, of course, that you also take effective action) than if you go in fearing the worst.

See which of the following statements apply to you. When you recognize your usual approach to planning, you can better understand how your attitudes either limit or support your change efforts.

• I make plans based on past experiences. If it worked once, it will work again.
• I just work as hard as possible and hope I?m doing the right things.
• I never make a decision until I have all the data . . . and I mean ALL the data.
• I plan for the absolute worse and occasionally I?m happily surprised.
• I just assume everything will work out. So far I?m okay.
• I am always on the lookout for opportunities. I?ll try anything once.
• I never plan. I believe in living for the moment.
• I don?t want feedback. I make my own decisions.
• I am guided by my intuition and tend to make decisions quickly.
• I make a plan and then stick to it, no matter what.

Consider for a moment how your beliefs and attitudes work either for or against you. It may well be that you?re someone who won?t make a decision without all the data and you?ve discovered over time that operating this way works perfectly for you. Or, you might realize that your assumption that ?everything will work out? doesn?t hold true when you look closely at your outcomes. Keep in mind that attitudes you have about the future have a direct and significant impact on the results you achieve. For example, if you are in the ?I never plan? camp, efforts to grow your practice will probably not be very successful because practice marketing, by its very nature, requires at least a modicum of strategic planning coupled with specific action steps.

Making good decisions about the future requires having access to a broad range of meaningful information sources. Gathering data entails much more than looking at your numbers, although that?s part of it. Consider collecting information using all of the following methods, as you look ahead and plan for the continuing growth and development of your practice.

Read widely. Study clinical journals and industry trade publications, but don?t stop there. Concern yourself with at least the basics in business, economics, demographics, politics, social trends, and technology. Notice what?s on the bestseller lists. Scan the covers of magazines you don?t ordinarily read. Bookmark major newspapers and spend a few minutes reviewing the headlines each day. As you begin to notice trends or when new ideas come to you, make notes for later reference. Pay particular attention to anything that might have an impact on your practice in the near or even the distant future. What are the driving forces influencing your profession? Are there advances in technology on the horizon that could make something you currently do obsolete? What?s the latest in personal health, wellness, and self-care?

Listen to your patients. What are your patients beginning to question or ask you about? What new concerns do they have? What are they telling you about what they?re reading in the lay press about health and healthcare? Are they changing how they make decisions about their care? You have the equivalent of a focus group in your office every day. You don?t have to conduct extensive interviews to get a glimpse into what patients are thinking. Just pay attention and ask good questions. As you listen, try to objectively assess whether the service you provide is being perceived as valuable, or if it?s falling short.

Talk to your colleagues. Particularly in competitive specialties, it?s easy to become isolated, to circle the wagons, to be wary about exchanging ideas. This is not in your best interest. Network with professionals in your field (and from outside your field as well) about the trends they?re noticing and how they?re planning for the future. Be willing to share your own views and insights. Don?t operate in a vacuum.

Look at your practice. Look at the numbers, review patient satisfaction and retention, calculate staff turnover, and assess your finances. What do you see? What are the trends? What does the data really reveal? What is your return on investment for recent practice management or marketing efforts? How has your practice model changed or stayed static over time? Where do you need to update or reinvent? What kind of outcomes data should you be collecting and acting upon?

One of the most difficult aspects of data gathering is looking at ?what is? instead of seeing only what you?d like to see. It?s very easy to magnify data that supports our current point of view, makes us feel good, or allows us to avoid doing anything new. At the same time, we seem to have an uncanny ability to minimize or ignore data that suggests we need to make serious changes. As you gather and assimilate information that you think might be useful for planning the future success of your practice, try to keep an open mind. By doing so, you?ll be able to do effective scenario planning and achieve more of the outcomes you desire.

This is a tool used by futurists, strategic planners, financial analysts, and others who try to predict and prepare for the future. Scenario development does not have to be complicated. Scenarios are essentially stories about how the future could potentially unfold. To weave these stories effectively, you must be willing to suspend certain beliefs as you spin several versions of the future and try to imagine the implications of each one. By inventing and considering a variety of possibilities — ideally rich with detail — you bring forth previously unimagined plots as well as pitfalls and obstacles you might not otherwise have considered. Done at a practice retreat and/or with staff members, scenario development is both enlightening and empowering.

Here?s an example of how to do scenario development. Let?s say you?ve heard a rumor that a major employer in your area is about to switch to a health plan that pays so little you can?t afford to be a participating provider. You stand to lose 20% of your patient volume. What do you do?

• Gather the facts. Can you find out if the rumor is true? If it is, what?s the timeline? Exactly how many patients would this impact? Are these patients you?d like to retain if you could? What would your numbers look like if you lost all of those patients?
• Make up stories. In your mind, on paper, or brainstorming aloud with your staff or partners, make up all of the stories you can about the situation. Good stories have protagonists and antagonists, complications, plots and sub-plots, more complications, twists and turns, and surprise endings. Have some fun creating all of the possible ways the story could unfold and eventually conclude.
• Create contingency plans for each story ending. For each of your story endings (rumor is false = happy ending; rumor is true = dramatic ending causing you to swing into action; something altogether different than what you?d heard happens = surprise ending) develop contingency plans, including initial action steps. For example, if the rumor is true and one possible course of action is to launch a new marketing effort, you?d want to do research, draft a plan, create a budget and timeline, and get staff and other resources in place to support the endeavor.

The goal of scenario development is to map out alternative action plans based on all plausible futures so that you can effectively manage, regardless of how things play out. The process also helps you shape the future because it gives you more insight into possibilities that promotes good decision-making along the way.

Whatever your motivation is to change — a decline in numbers, failed marketing efforts, high staff turnover, career dissatisfaction — when it?s time to take action toward a more positive future there are a few key points to remember.

First, be sure you?re taking actions that will have a positive impact on your future in the long run, rather than just taking actions that offer immediate gratification. Identify long-term objectives and create a plan you can realistically implement over time to achieve those objectives. Second, get a clear picture of exactly where you are now versus where you want to be in the future. This way, you can measure your progress as you implement your plans. Third, factor in your own (and your staff?s) work style, skill sets, and strengths so that you don?t inadvertently create a plan you?ll never be able to execute. Fourth, be flexible. Don?t give up at the first sign of struggle, but be willing to change course if conditions change. And, finally, challenge yourself. Hold yourself accountable (or hire a coach who will hold you accountable) to do what you say you want to do. Actions that result in a positive future require sustained effort and commitment.

You can?t know what will happen tomorrow, next month, or a year from now. Maintaining balance between living in the present and planning for an uncertain future isn?t always easy, but it?s a worthy goal. If you focus too much attention on ?the now? and neglect long-term planning, you?re likely to find yourself struggling. If you put all of your attention on how your practice could or should look at some point in the future, you diminish your daily satisfaction and may fail to recognize opportunities that are right in front of you.

As you plan for a successful future in your practice, keep the four steps in mind. Become more aware of how you think, plan, and make decisions. Base decisions on having looked objectively at trends and data. Imagine different scenarios and take actions that are most likely to result in the success you?re striving for. Stay accountable to your goals and remain flexible and willing to change strategies as conditions change. And as you plan for your future, don?t forget to enjoy today.

Read Online:

Dr. Shelley Simon?s Article Published in DC

In case you missed Team EQ: Your Edge in Practice Development in the July 2 issue of Dynamic Chiropractic, you can now read it online. Click here.

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