What are your most ambitious practice goals? Whether you envision your practice meeting Bright Futures guidelines next year, qualifying as a Patient Centered Medical Home, starting up a nutrition or sleep class for parents, or doubling your staff and office space, it’s likely that your most ambitious goals aren’t your only priority. With a busy office and many different tasks on a pediatricians’ plate, it can be easy to let big business decisions stagnate. If your head is spinning with ideas to make your practice and community a better place, here’s how to make sure those changes are both lasting and impactful for your patients.
It’s not uncommon to finish a book, webinar, or conversation with a mentor and return to your office inspired, or to return from a conference with more ideas than you know what to do with. Every pediatrician wants to improve patients’ access to care, ease practice’s workflows, and improve practice culture and community to create a successful practice. But while it’s inspiring and wonderful to have lots of ideas, it’s vital not to take on too much too quickly, or else you risk losing progress.
Your Big Idea: what’s the most important reason your practice needs this change?
Prioritizing lasting changes could be as simple as considering finances and schedules, or as complex as an extended discussion with partners and staff who will present their own ideas. Whatever changes are most important to you, plan them carefully and with the commitment to see them through before taking on another project.
Inspiration doesn’t last, so act quickly. According to The Winner’s Laws, a book by popular German finance expert Bodo Schafer, you must act almost immediately upon new intentions or goals. Schafer states that a concrete action on a goal should be enacted within 72 hours, or your chances of acting upon it at all fade to almost nothing.
Want to combine several smaller ideas? Consider assigning smaller projects to other providers and staff so that multiple projects can be managed with care.
What’s the Big Idea?
If you’re a part of a multi-provider practice and you have big plans for moving your practice forward, your work is cut out for you; to make lasting change, you have to get your partners on board with your ideas. The best way to do this is to find your Big Idea: what’s the most important reason your practice needs this change? Guiding your progress with this motivational idea will help you prioritize, remain focused, and even help you adapt to challenges, making sure your goals are accomplished even if the methods or results turn out differently to what you envisioned.
During your initial pitch, outline to your partners how the change will make theirs or patients’ lives easier. Back up your ideas with evidence of other practices who have successfully made this change already, or even other small businesses who aren’t pediatricians. Address their concerns proactively by talking out possible risks and mitigations.
If you are a solo provider, organization around business changes are no less necessary. In fact, since you are the one person responsible for implementation, it’s even easier not to hold yourself accountable. Find your Big Idea and return to it when things get challenging. Why do your patients or practice need this change?
Like any resolution, business changes are accomplished more easily when they are clearly planned out. You can write a formal report, a detailed checklist, or compile a spreadsheet to organize your ideas. If a vision or Pinterest board helps you carry out your plan with inspiration or staff enthusiasm, utilize them in combination with your other tools. These planning documents will be valuable as you plan for changes as an office staff and make them available to staff and colleagues as you plan and make progress together.
Some things to consider as you plan for change are:
- Time constraints — How long will changes take? Make notes of your limits, e.g. 6 months for construction, or one year for opening a new office.
- Costs — Big or small, every business decision should be an endeavor that keeps or increases revenue, not decreases it. As with all financial business endeavors, seek the advice of your accountant.
- Staff — How long is the staff’s training period for new procedures? Take into account the time added to existing workflows, including implementation time when they are learning. Finally, will they have a say in the new workflows?
- Patient satisfaction — If your business changes affect the way patients experience their time with your practice, how will you explain them? How will you guide patients through new improvements and answer their most common questions?
- Logistics — Leave room in your plans and budget for unexpected expenses, time, and other variables in your plan, such as unforeseen construction blocks or a longer hiring and interviewing period than you hoped for.
As a physician, you know that your practice of medicine depends on evidence that has been proven and tested. As a small business owner, the same standard of evidence applies. Before you take any steps towards your goal, decide what measurable factors will indicate success — an important part of a SMART goal, which should be Specific, Measurable, Attainable, Realistic, and Timely.
If your goal is to gain 12 new Facebook or Yelp reviews, achieving 9 or 10 within your time frame could still be considered a success. Measure for reasonable milestones: for example, if you want to enroll all of your patients in the patient portal, a 50% increase could be success to one practice, while 90% enrollment could be stagnant for others.
As you measure your successes and failures over time, adjust your plan. Be sure to measure successes even after initial goals are accomplished. Consider for example a new policy for staff tardiness that allows a 5 minute window for tardiness. If you let your new methods maintain themselves without tracking them, you could see positive progress slow or even revert to previous tardy behaviors.
Sometimes it helps to have someone else to keep us accountable. Besides giving you practical milestones to mark your progress, reporting back to someone can be rewarding and inspire you to keep moving forward. This person could be one or more of your partners, your staff, or even a colleague at a different practice. Whether you connect on Facebook or meet at a conference, keeping each other accountable can be as simple as keeping up an email exchange to update on your progress, and can be especially inspiring if you share a similar goals.
It’s also important to keep in mind that lasting changes, such as workflow shifts, policy changes, staff changes, or new programs will take time to settle into the community and culture of your practice. As well as keeping yourself accountable to your goal, remain accountable to your patients, staff, and colleagues. How is their experience of the changes different from yours? Do they have suggestions to improve? At what point would you consider going back to a previous approach if the new one remains unsuccessful or unpopular? PCC’s Chip Hart recommends staff surveys and regular meetings to weigh how new workflows and programs are going. Keep constructive conversation going to ensure a smooth transition and a culture of change.
When in Doubt, Seek Advice
In small business world, independent pediatricians must be some of the most supportive colleagues out there. If a project or workflow isn’t going as planned, or you’re not sure where to start on a larger project, reach out to your colleagues, peers, and mentors for advice.
Another fantastic resource is SOAPM — which, if you haven’t joined already, you really should, as most providers say the benefits are well worth the $35 annual dues. It’s likely that another pediatrician has endeavored to do the very thing you’re aspiring to bring to your practice, and on the SOAPM listserv, you can get advice from across the country and troubleshoot problems.
SOAPM members march in a second line in New Orleans during the 2019 AAP National Conference & Exhibition.
If you’re a PCC client, you can also find valuable advice on PCC Community, your space to discuss workflows, forms, state resources, and EHR tips from your colleagues.
As you bring your practice into a new phase of positive change, check out PCC’s Chip Hart’s webinar on “The 5 Mistakes Pediatricians Make,” to make sure that your aspirations aren’t checked by simple business mistakes that are easily remedied.