A Message:

From Dr. Shelley Simon

There is never a good time for a major transition to occur in a practice. But, whether it’s hiring or letting go an associate or key staff person, upgrading documentation software or installing an electronic health record, moving to a new location, adding a new service line, or shifting to a cash practice during a down economy, transitions need not be stressful and practice volume need not dip during these times — if you take a proactive, thoughtful approach.

Healthcare practitioners — and everyone else for that matter — resist change and transition because they fear that there may not actually be a “better” way, they don’t trust that the outcome will be positive, or they worry that even a carefully planned change will become a distraction and negatively impact patient volume and the bottom line. I’ve known practitioners who kept on associates they couldn’t get along with, refused to fire under-performing staff members, and stayed with procedures and systems that were no longer effective or necessary all because they didn’t want to do what they imagined would cause upheaval and stress. Their concerns frequently arose from an aversion to loss rather than an aversion to risk. All too often, we’d rather hang on to what is no longer working to avoid losing more of what we don’t want rather than to risk a new opportunity that might offer potential gain or welcome change.

One key to thriving during a transition is to engage in the change process on your own terms. Be proactive rather than reactive. Deal with issues in a timely manner, but whenever possible, on your own schedule. Take advantage of temporary downturns in patient volume to embark on planned changes such as staff training, policy updates, new marketing activities, computer system upgrades, and so forth.

Below is a case study of a chiropractor who successfully navigated several transitions and actually increased patient volume during the process. His practice also had the added challenge of being staffed largely with family members — not necessarily a good or bad thing in and of itself, but if you’ve ever worked with a spouse, sibling, child, or other family member you know that it can be an interesting dynamic. I hope you’ll enjoy reading about how this doctor and his staff thrived during times of transition.

Case Study:

Practice Growth During Times of Transition

Dr. Jones* has been a chiropractor since 1977. His East Coast office is a high-volume (300+ patients per week), wellness-oriented family practice. Dr. Jones’ daughter, Sarah*, has worked in his office for 22 years, starting out as a teenager doing clerical work. She is now the office manager and wears many hats, among them front desk, insurance, billing, and practice marketing. Dr. Jones’ son, Alex*, also works in the office as a chiropractic assistant.

The issue: Dr. Jones had been with three different chiropractic management companies, starting in 1987. He was attracted to Beyond Practice Management for the “beyond” element of Dr. Simon’s approach. “I didn’t need management anymore,” says Dr. Jones. “I’d learned formulas that worked and helped, but how much of those formulas were authentically me versus learned behavior?”

What Dr. Jones and Sarah needed when they began working with Dr. Simon in 2007 was support in managing their relationships and in effectively hiring and training a new employee who was not a family member to take over some of Sarah’s duties upon the arrival of a new baby. “It was a real challenge to allow other people to come into our family setting,” says Sarah. “We needed to expand our experience in this area.”

The practice also needed to stay at full volume in the face of not only the staffing transition, but also as an associate chiropractor left the office, a new electronic health record system was put into place, and documentation and compliance efforts were enhanced. And, they needed to do all of this while simultaneously working on improving communication and interpersonal skills.

The process: Via telephone coaching sessions with both Dr. Jones and with Sarah, transition issues were addressed as they arose over the course of approximately 18 months. Shelley worked closely with Sarah to help her get a handle on everything her job actually entailed in preparation for hiring the new employee. “I got a realistic view of what I do and made a written plan,” says Sarah, who also appreciated Dr. Simon’s ability to hone in on critical issues. “She can identify five or six things that are happening, look at obvious things that are wrong, and prioritize.” The practice’s hiring process was examined and a training schedule was developed. In order for Dr. Jones to trust the new employee, it was critical that he be involved in the process, a task he embraced.

Dr. Jones is no stranger to transformation and growth. He places a strong value on personal and professional development. Coaching Dr. Jones involved identifying and working on his growth edges so that he could make changes in his practice with less stress, greater empathy, and with improved conflict resolution skills. We worked together to clarify Dr. Jones’ vision and direction for the practice through achieving consensus, developing new scenarios for the future, generating short-term and long-term strategic plans, and creating detailed actions plans for change.

The outcome: Not only did Dr. Jones’ practice not suffer in terms of a downtick in volume or revenue during multiple transitions, the business actually grew. Dr. Jones appreciated Dr. Simon’s ability to help him move away from learned behaviors that were no longer relevant and begin to lead his practice more authentically. “I’m responding to what’s real,” says Dr. Jones. “We talk about relational systems, not just business systems . . . and how these systems relate to me as a doctor, a dad, a husband.”

For Sarah, the process of hiring and training a non-family member to work in the office was a growth experience. It also helped her fine tune many office procedures that were more or less on “autopilot” until recently. “We transitioned from the ‘what’ to the ‘how’ and broke things down to make positive changes. Not just to-do lists, but creating real change,” says Sarah. Training the new staff person also presented opportunities to improve policies and communication.

“I’m finding that a lot of issues are about effective managing. Now I manage myself first, people second, and then time,” says Sarah. “We’re thinking beyond day-to-day, thinking about longer term goals, and putting systems in place that are based on measurable progress.” The new employee has taken on a special project that involves creating outcomes-based case studies so that both she and patients can see how chiropractic is helping them to fully express the innate intelligence of the body.

Communication between Dr. Jones and Sarah improved as a result of working through these transitions with the support of coaching. “Familiar emotions are sometimes hard to separate out,” says Sarah. “Coaching forced us as a family to communicate better and be more direct . . . loving, but direct.” Dr. Jones approaches his family member staff differently now. “It’s about allowing them an opportunity to express themselves and find out what they want to do. It’s producing different results. The atmosphere has changed. . . it’s lightened up, it’s more fun,” says Dr. Jones.

*All names in this case study have been changed at the request of the client.

An Opportunity:

Are You Ready for Coaching?

Interested in achieving a new level of practice success and enjoying going to work again? Are you ready to set aside magical thinking and playing “follow the leader” and tap into your own best ideas instead? Would you like to have more authentic relationships with your patients and staff? All of this is possible with focused one-on-one coaching. The first step in deciding whether coaching would be effective for you is to request a complimentary, introductory consultation. When you schedule this session online you’ll be asked to answer several through provoking questions as a way for you to: (a) become clear on what your most pressing issues are; (b) think about what you would like to get out of our conversation; and, (c) convey to me how I can best help you. To request your consultation, please click here.

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