There seems to be something in the air that's causing a lot of people to idle quietly in a "let's just wait and see" mode. Maybe they were waiting for the outcome of the midterm elections (as if much will change), and now they're waiting to see what portions of health care reform may or may not be repealed, what the stock market will do in the coming months, or what their accountant tells them to expect come April 15.
Many people I speak with say that they are also working twice as hard now as they did just a few years ago in order to achieve the same level of practice profitability, or that they have to do three times as much marketing just to keep patient volume steady. When efforts begin to feel futile, when working harder doesn't seem to be paying off, and when the business journey feels like it's all uphill, the risk for career burnout and simply giving up or "shifting into neutral" increases.
If you're speeding along in high gear day in and day out, and at the same time feel like you're stuck in a ditch or snow bank with your wheels spinning, it may be time to downshift long enough to evaluate your situation and make a new plan. This isn't the time to slip into neutral; but perhaps taking it down to first or second gear to take time for planning will help you gain the traction needed to get you back on the road to practice success and satisfaction.
The Challenge: Defining Priorities
I have a challenge for you, and it's not about encouraging you to come up with some new practice marketing or business success tactic that will be "the answer" for success in 2011. You've most likely done that, year after year. Some tactics probably did produce results, but my guess is those results were not as lasting as you'd hoped they would be, and may have even resulted in more frustration and disappointment than success. Genuinely sustainable success requires moving beyond tactics. It requires setting priorities that are based on closely held values and a well-thought-out strategy that is meaningful enough to see you through the journey; one that won't allow you to shift back into neutral when drive is what's needed.
What overarching priorities could you embrace this year that would move your practice in the direction you want it to go? That direction might include increasing volume and profitability, but it's entirely possible that those goals will only be achieved if you focus on more encompassing priorities such as embracing change, becoming a more effective leader, developing your staff into a team of true professionals, rethinking your practice brand, catching up with recent changes in technology, developing functional systems and infrastructure, increasing your emotional intelligence, or letting go of things that are no longer of value.
Six Steps to Clarity
Not sure what your priorities should be for 2011? Set aside a couple of hours, pen and paper in hand, to work through these six steps. If, at the end of this exercise, your priorities are not clear, set the project aside and work on it again in a few days. Ready?
Step #1: Get honest with yourself. How do you feel about your career? Is what you're doing aligned with your values? Does the way you've measured success in the past no longer feel relevant? Are you contributing in ways that are meaningful to you, and for others? What's your unrealized vision? What project would you take on if you knew it would be successful? What do you need to let go of? In what ways are you spinning your wheels? Where are you sabotaging your own success, and why?
Step #2: Assess your current situation. Make a list of everything you can think of that has been working well in your practice over the past year or two. What have you been doing that's contributed to outstanding patient satisfaction, excellent clinical outcomes and value for your services? What have you become known for in your community that is making your practice more successful? Which of your recent marketing activities have been the most effective?
Make a second list of obstacles, challenges, and concerns that you have about your business. Where have you fallen behind in technology or allowed your skills to get rusty? What recurring problems are showing up in your practice related to staff, procedures or systems? In what ways do you need to develop yourself personally or as a leader in order to sustainably grow your practice in the coming years?
Step #3: Identify the gaps. Think about where you are now versus where you want to be. Author and management expert Peter Senge says," Truly creative people use the gap between vision and reality to generate energy for change." What would your practice look like a year from now if you could close (or at least narrow) some of the gaps you're facing?
Step #4: Look beyond the symptoms. Is revenue down? Are you having staffing problems? Patients not following through with recommended courses of treatment? The problem underlying these symptoms may be that you are practicing in a way that is incongruent with your values or personality, that your leadership or communication skills need work, that patients are not experiencing outcomes they perceived as having been promised via your branding or marketing, or that they don't fully understand the value of the services you provide. Think about your most pressing challenges and drill down as deeply as you can - looking for root causes.
Step #5: Make a plan that will keep you in drive. Draft a one-, two- or three-year plan based on what you'd like your practice to look like at the end of the designated time frame. If your number-one priority is, for example, to turn your staff into a highly engaged team, what are action steps that you can take this week, next month, during the second quarter and throughout the year that are motivating enough to keep you from slipping back into neutral? Get creative. Become willing to do things differently. Take some interesting side roads on the way to your final destination.
Step #6: Evaluate your readiness to change. An individual's readiness for change - the inclination to shift out of neutral - is often tied to their level of frustration, angst or pain. And yet some people stay in untenable situations for years and years, wishing and hoping for change but doing little to make it happen. If your priorities for 2011 require change - within yourself or within your practice - how ready are you to do the work that the change demands? What kind of support do you need to make the changes you know are needed? When will you begin the change process?
Step on the Gas
Now, here's the real challenge: Stop waiting, stop standing around hoping that things will "sort themselves out," stop running for cover. Remove the blinders, deal with reality as it is as opposed to how you'd prefer it to be, and step out of the holding pattern you've been in. It's time to shift out of neutral and get moving again. It's time to get clear about what's important and make extraordinary things happen, in your practice and in your life.
Depending on your stage of practice, your opinion about the economy and the health care system, and how stalled versus energized you feel related to planning and change, reading this might make you nod vigorously and say, "Yeah, let's go!" Or it might make you want to lie down for a nap. Unless you're planning to retire within the next 24 months, I challenge you to muster up enthusiasm - rather than dread or ambivalence - about the future and join the "let's go" team.
Doctors with drive and momentum will have banner years in 2011. As the economy continues to slowly thaw, patients and potential patients who have been "in hiding" will wake up, realize how fatigued they are from not taking care of themselves, and seek out the care and support of professionals who can help them shift out of neutral in terms of their health and wellness.
Business management icon Peter Drucker says, "The problem in my life and other people's lives is not the absence of knowing what to do, but the absence of doing it." So, are you ready to take your foot off the brake and step on the gas? Are you prepared to engage in courageous optimism? Are you ready to define and design the practice of your dreams? I hope so. And I wish you an exciting, profitable, happy, and healthy new year.
Click here for previous articles by Shelley Simon, RN, DC, MPH, EdD.