ARE YOU CONTINUALLY IMPROVING YOUR BUSINESS?

Is your organization getting better all the time??

Most business owners would like to think that their business is always improving; however, very few people are willing to actually do the heavy lifting to create an enterprise that is systematically improving on a regular basis. In the world of manufacturing, these concepts have been around for awhile.? American consultant Edward Deming was a pioneer in? quality improvement with Japanese industry post World War II. The Japanese term kaizen has become synonymous with continues improvement and this method was popularized by Masaaki Imai in ?Kaizen: The Key to Japan?s Competitive Success.? In his book which was first published in 1986, Imai introduced the ?LEAN? philosophy to the world and shared the secrets behind the success of Toyota and other Japanese companies.

The core principle of continuous improvement is the ?self reflection? process.? This is essentially a feedback loop that requires a willingness to be brutally honest about your organization. The purpose of this process is the identification, reduction, and elimination of poor processes. Using a commonsense approach, minor improvements are continually made in small, incremental ways in the organization with a strong emphasis on the customer.

As a company successfully embraces continuous improvement then it moves from being a best practice to becoming part of the fabric of the organization. While these concepts may have originated in the manufacturing sector, they are rapidly being adopted by service businesses, particularly in health care and technology.? There is a tremendous opportunity to gain a competitive advantage by committing your company to a path of continuous improvement.

Mississippi entrepreneur Jill Beneke formed Pileum Corporation in 2002, and she has successfully built a management consulting firm by relentlessly focusing on improving her organization. Beneke worked for over twenty years in financial services, and she was Senior Vice President of the Capital Management Group for AmSouth prior to forming Pileum.? Her father was an entrepreneur as well as her husband, so it was a natural shift for Beneke to launch her own venture when the timing was right. Pileum acts as a trusted partner to companies in multiple industries to help with their information technology and their most important asset ? their data management.? Because of this critical role the company plays for its customers, Beneke and her team have to stay ahead of the constant evolution of technology and meet the real time needs of their customers.

While Pileum may not use phrases like kaizen or LEAN to describe their internal process, they are very much committed to the path of continuous improvement.? The management team and staff continually ask the question ?How can we do things better?? According to Beneke, ?our management team gets together frequently, and we are open and honest about trying to improve.? This means that we can?t be afraid to be self-critical.?? Pileum also provides a significant amount of in-house training for its employees and pays for its employees? external training and industry certifications.? Their goal as a company is to be getting better all of the time.? For Pileum, this commitment to continuous improvement has helped separate it in the marketplace and establish the company as a leading technology consulting business.? The company now has over 30 employees and services a large number of clients in the Mid-South.

If your company is not embracing the principles of continuous improvement then time is of the essence because your competition probably will be soon.? As a leader, you can demonstrate a commitment to continual improvement and set the direction of the organization.? In order to be successful, you also need buy-in of the members of your team and for them to embrace this kaizen mindset.? While dramatic changes may not occur overnight, your team will daily be embracing a way of thinking conducive for long term success.

 

HOW TO BENCHMARK YOUR PRACTICE FOR SUCCESS

I grew up playing and teaching people how to play tennis.? Some players would practice and practice, but it was not until they actually played in a tournament that they got real feedback on how they were progressing. Similarly, as you work day to day in your medical practice, it is easy to operate in a vacuum.? However, you can solve this problem by benchmarking your practice against others locally and around the country.

Practicing medicine is data driven.? You spend years learning to quickly review and interpret data to improve patients? lives.? This data driven mindset can help you optimize your practice as well.

There are four keys to successful benchmarking:

(i) The ability to produce accurate data in your own practice

(ii) Access to quality data on key metrics for comparable practices

(iii) Proper analysis and interpretation of the data

(iv) The will to execute on your findings.

Producing Your Own Data

How much do you know about your own practice? ?It?s hard to make comparisons to others when you don?t know your own numbers.? This starts with creating sound accounting practices.? What type of accounting software are you using?? Can it track all of the detail you need?? Is the information easily accessible?? Work with your accountant or practice consultant to ensure you are capturing the necessary data.? As bestselling author Stephen Covey taught, ?you want to begin with the end in mind.?? Therefore, think about the data you want to be able to review, and then make sure that you have the systems and data collection to give you what you need.

Comparable Key Metric Data

You want to look both at practice characteristics and productivity measures when analyzing comparable data.? For example, practice characteristics include:? size of patient base, number of exam rooms, hours of operation, number of physicians, number of staff, fees, and payor mix.? Productivity measures include revenue per square foot, annual revenue per active patient, gross revenue growth, patients per day, gross revenue per exam, staff turnover, percentage of gross income and net income for staff, marketing, insurance, etc. ?It is also helpful to compare salaries, rent costs, and insurance premiums.

Where do you get this type of information?? There are associations such as the Medical Group Management Association that have a great deal of this type of information available.? I?ve also found that practice focused associations also generally have good data on practice areas. Finally, some of the medical industry vendors (e.g. pharmaceutical and device manufacturers) have very good data as well.

Analyze the Data

Your job is to practice medicine, not to be a forensic accountant.? Therefore, your practice reports should be clear and easy to understand.? You?re looking for trends and patterns in the data.? It should not make you cross-eyed to interpret the data.? I prefer nice graphs and charts to graphically illustrate the information.? This helps me to spot changes over time.? One additional point is to know the value of your time.? I encourage professionals to do the basic equation (income / hours worked) to know their ?hourly rate.? This is very helpful when you consider how you spend your time and what things need to be delegated or outsourced.

As you know and understand your own data then you can better compare it to the benchmark data you review.? It?s important to make sure that you are comparing ?apples to apples? in your analysis so be cognizant of distinctions based on urban/rural settings, practice size, and geography.? How does your practice stack up?? Are you managing costs appropriately?? Is your practice being productive with the resources allocated?? It takes time to actually compare this important data.? This is truly thinking ?on your business? versus thinking ?in your business.?? Take the time to set aside good thinking time to review the data.? I would recommend getting out of the office so you?re not interrupted.? You may want to get some of your trusted advisors or staff to review it with you.? Having more than one perspective can be helpful.? What is the story that the data is telling you?? Write down your conclusions and potential action items.

Act on What You Learn

I have spoken with many physicians who are disappointed when their patients don?t act on the valuable medical advice they receive.? As any physician knows, it?s not what you know that counts, but what you do with what you know.? Once you?ve taken the time to create the systems to produce accurate data in your practice, gather quality third party data, and to thoughtfully review and analyze the information, now it is time to act.? Create written goals and action items based on your findings.? Make sure you have action items delegated to those who can get it done.? Most importantly, you want to follow up and make sure your organization is accountable to complete the proposed changes. Finally, it?s important to remember that this process is an ongoing one.? It creates a positive feedback loop in your practice.? I would recommend at least annually making sure that your practice is on the right track!

 

UNDERSTANDING YOUR MOTIVATIONAL DRIVERS

I have made my fair share of mistakes as a manager of people.? In my first business out of college, I co-owned a company that managed private and public tennis complexes.? One of our key staff members was the head tennis professional who was a leading tennis teacher in the area.? He had students lined up to take lessons from him which was great for our business.? In my brilliance, I went out and hired another tennis professional without consulting our long time head pro.? Within a few months, my long employee left and went to work for a competitor taking all of his students with him.? In his exit interview, I learned that he enjoyed being the sole head professional and that he did not get along well with the person I hired.? Ouch! This was a painful lesson in managing people and learning to communicate better.

Later in my career, I was apparently not much wiser.? I personally don?t like much oversight or micro-management when someone is managing me. Just point me in the right direction and let me go.? Therefore, my default is to manage that way as well.? Unfortunately, that style does not work for everyone.? I had a very talented law clerk that I hired to assist me with my law firm.? I would share some big picture ideas with him and turn him loose to work his magic.? Unfortunately, when we would reconvene, I would be very disappointed in the work product.? After several failed attempts, he finally said, ?Could you please just tell me exactly what you are looking for, and I will be glad to do it!?? I needed to hear that as a good reminder that many people need clear direction and want more detail in how to accomplish a project.

I have had my occasional good moments as a manager.? In one work setting, I shared an assistant with another co-worker. ?She was a very nice young lady who worked very hard.? The colleague I was working with had a very different management style than me. My colleague had a very stern approach and would become very upset if the work product was anything less than perfect.?? I watched my assistant leave this person?s office many times in tears.? I personally believe you ?catch more flies with honey than vinegar?, and I tried to be an encourager and challenge my assistant in a positive way to be her best.? What I learned from that experience is that my assistant would expend extra effort to get projects done for me, but would do the bare minimum not to get in trouble with my colleague.? In other words, she cared enough to give me her discretionary effort.? That lesson has stuck with me.

How we lead and inspire others in the workplace matters.? Gallup has some very interesting research on our workforce in the United States and the impact of employee engagement versus disengagement. ?They have been tracking employee engagement since the late 1990?s, and they have administered over 25 million employee surveys to measure employee engagement.? In a?recent report, they found that only 30% of the U.S. workforce is engaged in their work, and the ratio of engaged to actively disengaged employees is roughly 2-to-1.? For work groups with engaged employees, the results are phenomenal ? ?higher productivity, profitability, and customer ratings, less turnover and absenteeism, and fewer safety incidents than those in the bottom 25%.? ?In addition Gallup found that, ?Organizations with an average of 9.3 engaged employees for every actively disengaged employee in 2010-2011 experienced 147% higher earnings per share (EPS) compared with their competition in 2011-2012.?

However, in contrast those with an average of only 2.6 engaged employees for every actively disengaged employee experienced 2% lower EPS compared with their competition during that same time period. ?Gallup also estimates that active disengagement costs the U.S. $450 billion to $550 billion per year.? These disengaged employees are more likely to steal from their companies, negatively influence their coworkers, miss workdays, and drive customers away.

What I have realized in my journey is that most businesses today are PEOPLE businesses.? We either win or lose based on how well we have engaged employees working together to accomplish organizational goals. That is how you build a great brand and create loyal customers.? As we continue to distance ourselves from the industrial age into the knowledge economy, it is paramount that we as leaders understand that our employees are not cogs in a machine but living, breathing people who have hopes, desires, dreams, and NEEDS.? If we are going to unleash the greatness in our organizations then we have to unleash the greatness of our people.??

In my work with organizations, I frequently use personality tests like DISC? or Myers Briggs?; however, my favorite tool is the Birkman? assessment because it helps you understand your ?needs? as well.? If a person?s needs are not being met then they are unlikely to be a productive employee in an organization. The challenge is that people don?t walk around with their ?needs? spelled out on their resumes.? They may not even be clearly known by the individual.? As a leader, we can learn how to inspire and motivate our team members by understanding what truly motivates them.

In my search for an efficient way to practically apply these principles, I discovered a tool to help streamline this process.? Dr. Carl Hicks, a native Mississippian, co-developed with Birkman International a new tool called Understanding My Motivational Drivers.? This assessment combines the objective statistical input from millions of people who have taken the Birkman with Dr. Hicks? practical experience in working as a business consultant for several decades.

The assessment produces a short report which addresses five key topics for individuals:

(1) How to work with me

(2) How to talk to me.

(3) The biggest mistakes you can make with me.

(4) How to incentivize me.

(5) What motivates me.

I asked Dr. Hicks about this tool and he shared, ?I believe that being your best requires that others treat you as you want to be treated. This report can serve as the vehicle that permits you to review, confirm, share and discuss your expectations in an objective manner.?

I believe that tools like the ones that Dr. Hicks created are extremely important because they help individuals increase their self-awareness and leaders better understand how to unlock the greatness in their employees.? I encouraged leaders to follow the Platinum Rule which means that we treat people in the way that they want and deserve to be treated. The harsh reality in life is that the only person you can truly change is yourself.? Therefore, one of the ways that YOU can change is to make sure that you are seeking to understand what motivates your teammates and seeking to be a positive example of how to lead by helping people meet their needs. You may just be the catalyst for helping to take your organization to the next level!

THE GAMIFICATION OF WORK

Picture for a moment yourself on a sunny and cool fall afternoon getting ready to watch your favorite college football team playing their biggest rival.? The stands are packed, and the crowd is ready to cheer their team on victory.? However, right before the game begins the announcer comes over the loudspeaker and says that the teams won?t be keeping score and are just going to play for fun.? How would you feel?? Would you still be as interested?? Do you think the players would give it their all or simply go through the motions?? Have you ever watched a professional All-Star game ? not exactly the highest level of intensity and effort.

It reminds me of when my kids were very young playing youth sports.? I remember coaching baseball and soccer, and I could not get my head around the fact that we were not keeping score.? I know, I know ? five year olds don?t necessarily have to be competitive warriors out there, but still, it is just not very interesting if you don?t keep score.?? You may be asking where I am going with this line of thought.? Good question!? In my 25+ years in the marketplace, I have found that most businesses operate just like my five year old soccer team ? they don?t keep score!

Sure, ultimately, all businesses get down to the bottom line.? However, in most organizations employees go through their day as if they are in the Bill Murray classic, Groundhog Day.? It is easy to fall into a rut where you feel like you are on a treadmill with no end point.? There is a recent effort to try and ?gamify? work to make it more meaningful.? While this gamification of work has become a growing trend, you don?t need high tech gadgetry to tap into the power of making work more interesting and meaningful.

Over 40 years ago, business consultant Charles Coonradt had an epiphany that led him to commit his life?s work to helping people make their work more like their recreation. He was watching a group of young men building a house that seemed to be slow and arduous work.? However, he noticed that on their lunch break these same young men engaged in heated competitions of 4 on 4 pickup basketball games.? For him, this was a paradox. ?How could they put that much energy into their recreation but not their work?? He became fascinated with the phenomena that people will work harder and expend more energy in sports and other athletic pursuits than they will at their daily jobs.?? Coonradt has several books out on this topic, but I want to highlight a few key ideas that may revolutionize how you think about your work.

KEEPING SCORE

In my teens and early twenties, I taught a great number of people how to play tennis.? I enjoyed the game and learned how to teach others at a young age.? As I would teach beginners the basics of how to hit the ball and keep a rally going, they all eventually wanted to play.? In order to do that they needed to learn how to keep score.? It was always interesting to watch how people pushed themselves harder and the competitive spirit would come out when we would keep score.? In organizations, we want to find simple and clear ways to keep score of what is important both as an organization and for the individual team members.? I have found over the years that some positions are easier to come up with the 2-3 areas to keep score. Scorekeeping should be objective and the individual employee should ideally know how to track and keep their score.? If you have not defined winning and losing for your team members then you are at risk of mediocrity.

ESTABLISHING GOALS

When a golfer goes out to play a round of golf, they usually have a score in mind they are trying to beat.? While I am a novice runner, I have come to understand a little of the lingo of competitive racers who talk about their PB (Personal Best). ?When the coach gets the basketball team together to discuss the goals for the season they focus on specific goals.? For many programs, the goal is to make it into the ?Big Dance? ? the NCAA basketball championship tournament.? I have experimented with all kinds of goals for organizations and individuals.? I have found that the best are shorter term in nature.? I find that if they are too long term then people wait until the last minute to work on them like cramming for an exam. I like clear and specific goals that ideally can be accomplished in three to six months.

PROVIDE FEEDBACK

I went to a St. Louis Cardinals exhibition game recently against the hometown Memphis Redbirds.? As I looked at the new scoreboard in the stadium, I noted how much data was readily available: the score, balls, strikes, outs, and even the speed of the last pitch.? The players get real time feedback on how they are doing and can adjust their strategy.? Unfortunately, that is often not the case in business.? I have visited with many employees who never get any feedback or maybe only once a year in a perfunctory review.? How can people improve if they don?t get constructive feedback on their performance? As leaders, we should give helpful feedback early and often if we want our team members to develop.

KNOW THE RULES

Along with teaching my tennis students how to keep score, I also taught them the rules of the game.? Without rules, it would be chaos out on the court and constant controversy.? What if you started a game and then halfway through the rules changed midway? ?How frustrating would that be?? Unfortunately, many workplaces feel that way.? The rules are not clear and may change in an instant.? Sure, there may be policies and guidelines in an employee handbook, but I am talking the day to day rules of operation.? What is expected?? What is off limits?? Too many handbooks are more driven by legal than practical considerations.? Employees want clarity and fairness.? As a leader, you have the opportunity to stomp out the ambiguity and create clear a set of rules that you expect everyone to follow.? I promise it will reduce the drama in your organization.

I hope these concepts give you some inspiration and ideas to ?gamify? your organization. ?We don?t have to watch the clock until 5:00 or wait until the weekend to enjoy a little competitive activity in our lives.? Our work can be just as invigorating and challenging if we put our minds to it.? Enjoy!

 

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ORGANIZATIONAL HEALTH

Rich Roll is one of the fittest men on the planet. He has been interviewed by CNN and featured in numerous fitness magazines. Roll has been a top finisher in the Ultraman World Championships which is a three-day/320-mile double ironman distance triathlon. The event is invitation only for 35 select participants from around the world.? The first day is a 6.2 mile ocean swim followed by a 90-mile cross country cycling race.? The second day is a 170-mile cycling race, and the third day finishes up with a 52-mile double marathon. I am exhausted just thinking about that type of incredible endurance feat.? While he had been a competitive swimmer in college, this attorney and father of four had hung up his ?Speedo?s? after college and was almost fifty pounds overweight by his 40th birthday.? Roll overhauled his diet and got back on track with his fitness program, and within two years, he was competing at an international level for endurance athletes.? What he has done through intentional planning and hard work is to achieve a level of optimum health that is allowing him to compete internationally well into his 40?s.

Similarly, organizations of different types and sizes can achieve a level of optimum health. This does not mean that we need organizations full of ultra-athletes.? Rather, we want organizations that operate in a healthy, complete, and consistent way. Best-selling author Patrick Lencioni emphatically stated in his book The Advantage, ?The single greatest advantage any company can achieve is organizational health. Yet it is ignored by most leaders even though it is simple, free, and available to anyone who wants it.?? Most organizations fail to embrace organizational health, and the typical reasons include that it is too ?touchy feely,? the concepts are too simple, or the tyranny of the urgent feeds our adrenaline addiction. Lencioni describes a healthy organization as one with minimum ?politics? and confusion, employees with high morale and productivity, and low employee turnover.? Wouldn?t that be a great place to work?? As obvious and important as that is, we tend to spend all of our time and energy on the technical aspects of the organization (e.g. strategy, marketing, etc.) and very little time in making sure that we have a healthy company.? I have summarized below a few of the ways to help make the transformation from being a ?couch potato? organization to one that has optimum organizational health.

Establish Trust

You don?t need to go to the ropes courses to build trust (although team building exercises can be helpful); instead, there are some simple things you can do to increase the trust in your organization.? One of the major symptoms of unhealthy organizations is that the management group does not feel free to share their opinions.? When managers are simply ?yes men and women,? the organization is not benefitting from the collective wisdom of the group. Teams that always have complete consensus are potentially toxic because people are certainly withholding their true opinions.? The intelligence of the organization is hindered as employees all try to CYA (cover their assets) instead of contributing their best thoughts and ideas. The leader of the organization sets the tone here and should insist on candid discussion and promote vigorous debate. Remember healthy conflict is to be encouraged, not discouraged.? Team members need to understand the boundaries for conflict and be willing to commit to the path ultimately decided by the leader.?? Another way to help strengthen the trust in the team is to utilize personality tests like DISC?, Myers Briggs Type Indicator? or The Birkman?.? These allow team members to better understand both themselves and their colleagues.? Many misunderstandings can be avoided once communication and personality styles are better understood.

Create Clarity

Healthy organizations have clarity and alignment around the main things and know how to ?keep the main things the main thing.?? This is easier said than done and requires asking some simple but challenging questions. I recommend having the organization?s management team periodically independently respond to the following questions:? (1) What is our reason for being as an organization ? why do we exist? (2) What are our true core values that guide our behavior? (3) What business are we in? (4) Where are we going as a company ? what is our strategy for success? (5) What are the most important things that need to be done in the organization in the next 30-90 days?? (6) Who needs to do what to accomplish the most important things? (7) What are the key metrics for measuring the success of the organization?? Answering these questions independently will ensure that ?group think? does not set in and that everyone does original thinking about the answers. The team can then gather and debate their answers and synergize their responses.? I am an advocate for having a concise 1-2 page summary of the results of this process which serves as the guide for the organization and an accountability tool for team meetings.? Answering these types of questions requires time and a change of perspective from ?thinking in the business to thinking on the business.? In our world of constant emailing and texting, it is important to unplug and get away to periodically think on our organizations to create clarity.

Communicate, Communicate, Communicate!

Healthy organizations know how to communicate well. Their leaders repeatedly communicate key themes. They know that repetition counts and that they need to communicate with clarity what is really important.? I have found that whether coaching sports, raising kids, or leading in an organization, the key is to keep the messages simple and repeat them often.? Effective leaders use different mediums and tools to constantly reinforce messages.? Ambiguity and confusion are the hallmarks of dysfunctional organizations.? The anti-dote is communication!? Too often leaders fail to communicate enough because they are too busy or incorrectly believe that they are being too repetitive. Healthy organizations not only have effective top down communication that cascades through the organization, but they also have effective lateral and bottom up communication.? Smart organizations know that the information gathered by front line employees is invaluable and needs to circulate within the company.? Innovative companies will create regular opportunities to make sure upper management is spending time with front line employees to foster open communication.? Leaders can also promote good communication by being accessible and utilize techniques like ?management by walking around.?? There is nothing worse for leaders than to get stuck behind their computer all day.? Focus and alignment occur when organizations have clarity on what matters most and communicate effectively throughout the organization.

Conclusion

While being an Ultra athlete is not in the cards for me, I do know that I can be a part of making sure that organizations I am part of achieve optimal health. There is no reason to settle for working in dysfunctional situations. By recognizing the important of being ?healthy? in our business and utilizing some of the simple ways to become healthier, we are on our way to building healthy organizations!

MOTIVATING TODAY'S EMPLOYEE

Have you ever stopped to really consider what motivates you or your employees?? This is a critical question for today?s companies. When I do one-on-one coaching with employers, this topic comes up a lot. For decades, most businesses have utilized extrinsic methods of motivation with the ?carrot? and the ?stick.?? This typically takes the form of bonus plans or negative reviews and firing for poor performance. The question to be asked is whether or not we are getting the desired results from these extrinsic efforts to motivate our teams.

Interestingly, recent scientific studies are challenging the way business leaders have traditionally thought about getting results. Researchers at the London School of Economics conducted an analysis of 51 separate studies on financial incentives in employment relations and found overwhelming evidence that the incentives may ?reduce an employee?s natural inclination to complete a task and derive pleasure from doing so.? According to Dr. Irlenbusch of the LSE, ?we find that financial incentives may indeed reduce intrinsic motivation and diminish ethical or other reasons for complying with workplace norms such as fairness.? As a consequence, the provision of incentives can result in a negative impact on overall performance.?

Author and speaker Dan Pink helps us make sense of this counterintuitive point by arguing that extrinsic rewards are only effective for left brain activities that involve rules and routine tasks such as certain types of accounting, financial analysis, or computer programming. However, there has been a major shift in many organizations to outsource as much of this routine work as possible. Therefore, many jobs today require more right brain creative problem solving skills than ever before.? The problem, as noted above, is that studies have shown that traditional incentives do not work well to motive employees tasked with right brain responsibilities.

When you look at the way most firms attempt to motivate their employees, it becomes apparent that most businesses have not caught up with these scientific discoveries.? So, what do we do to motivate today?s employees?? Leading thinkers point to the value of intrinsic rewards for work.? Pink notes three key elements for the new paradigm of employee motivation:? Autonomy, Mastery, and Purpose.

Autonomy

It is particularly apparent with the younger generations that they will be demanding more autonomy in their work life.? They will not be content to be blindly directed by management without some level of self-direction.? Employees empowered with autonomy usually have a sense ?ownership? and are more engaged.? A practical example of this is Google?s practice of allowing its engineers to spend 20% of their paid time on their own projects.? Of note is that about half of Google?s products and services have been created by employees during this autonomous work time including Gmail. In the extreme, some companies have completely gone away from schedules and allow everyone to work their own hours.? The bottom line is that autonomous workers have greater productivity and job satisfaction.? The problem is that the ?manager? mindset has been so ingrained in our business psyche that this can be a difficult shift.

Mastery

For centuries, most people either worked in agriculture or in a trade with their hands.? This usually involved years of training and experience to master a craft.? In the industrial age, we were challenged because our labor became repetitive and disconnected from the final product or service. This led to inevitable job dissatisfaction problems and poor productivity. Today is no different. We want to provide the opportunity for our employees to learn and become better at their skills and abilities.? We all tend to feel better about ourselves when we improve.? A focus on mastery allows people to once again become experts at their craft and to continually improve.? It is no wonder that most successful organizations today place a high value on the training and development of their people.

Purpose

When your work seems pointless, it is hard to become motivated to give it your best.? An effective leader knows how to bridge this gap and let each employee know how his or her contribution directly impacts the success of the organization.? I believe that as human beings we all desire to find our purpose in life.? Since work takes such a huge part of our time, it is only natural to seek meaning and purpose in our work. I strongly advocate that businesses also benefit when they have clearly stated visions and values that define who they are.? This allows employees to connect with the larger purpose of the company.

In sum, it will be imperative for businesses to embrace these scientific findings that intrinsic motivators can achieve the best organizational results.? I believe in the very near term, U.S. companies will face increased competition globally even in the right-brain work prevalent in our economy today.? Incentivizing management and workers with outdated ?carrot? and ?stick? models will lead to being left behind.? Companies that unleash the potential of their employees through intrinsic motivators such as autonomy, mastery, and purpose will lead the pack in the future.

LEADING THROUGH CHANGE

In 1804, Napol?on Bonaparte?was crowned emperor by the people of France.? Five years before, he had seized control of the French government and named himself First Consul.? Until his ultimate defeat in 1815, he led the French military through almost two decades of war where he seized control over much of Europe.? As a part of Napoleon?s thirst for conquest, he set his sights on destroying the British Royal Navy and invading England.? The Royal Navy had established its dominance of the seas in the 18th Century, and during the Napoleonic Wars, the British had blockaded France?s ports.? Napoleon was determined to break the Royal Navy?s supremacy, so he assembled a fleet of barges and over 100,000 soldiers on the English Channel ready to invade once they could subdue the mighty British Naval fleet.

Napoleon tapped Vice-Admiral?Pierre-Charles Villeneuve?to lead the French Mediterranean Fleet.? On September 16, 1805, Napoleon gave the order for the French fleet to put to sea and engage the British Royal fleet if the French had superior numbers.? The British Royal Navy was led by Admiral Lord Horatio Nelson, and in the Atlantic Ocean off the Cape of Trafalgar, the British fleet of 27 ships faced the French with 33 ships on October 21, 1805.? Back in these days of sail ships, the cannons were on the sides and the traditional form of battle was to sail line to line against the enemy, and the British preferred to sail into battle with the wind at their backs. This military approach had its limitations, particularly from a communication standpoint.

Admiral Lord Nelson was a gifted leader and saw an opportunity to break from traditional thinking and pursue a different strategy.? Instead of the normal line to line attack formation, he sailed straight at the French military and used a new communication method.? This unorthodox approach achieved a dramatic result as the British lost no ships and the French fleet lost 23 of their 33 ships.? While the Battle of Trafalgar was a major military victory for the British and thwarted Napoleon?s plans for invasion, they lost their hero as Lord Nelson was killed in battle by an enemy sniper.? As he was leading his men into battle, he signaled from the flag ship, ?England expects that every man will do his duty.?? This phrase went down in history as probably the most famous military signal in British military history.

So why take this stroll through some two hundred year old military history? What relevance does this story have in our fast paced modern world?? I believe a great deal.? As a history major in college, I was intrigued when reminded of this story by a friend.? As a student of leadership and a business consultant, I was particularly intrigued by the leadership lessons that Lord Nelson had to offer.? I believe that true leadership principles are timeless, and we can glean insights from throughout history from men and women of true courage and vision.

Consider for a moment, if you were one of the officers or soldiers in the British Royal Navy.? For over a century, there was a conventional way of doing battle.? Your leader has asked you to try a very unorthodox approach which has you sailing straight at the enemy who happens to outnumber you!? As a leader in any organization, you will face times of change.? There will be times of fear and uncertainty.? To be effective, you will need the trust and loyalty of the team.? You will need people to follow you into uncertain situations and believe that you have a vision for success.?? Just because you have a title, it does not mean that you will have that level of trust.

Reward Success/Take the Blame for Failure

According to one Lord Nelson?s biographer, he had a history of taking initiative and being aggressive. His men also knew from experience that if things went wrong Lord Nelson would take the blame.? If the outcome was a success, Lord Nelson ensured that his leaders were rewarded and acknowledged for the victory.? Leaders are not glory seekers.? They don?t hog the limelight.? They are quick to praise and reluctant to ever criticize in public.? Leaders today should consider the need to utilize every opportunity to encourage others by acknowledging their successes, and they should avoid pointing the finger.? As the sign on President Harry Truman?s desk said, ?The buck stops here.?? Leaders are called upon to make decisions and accept responsibility for the outcome.

Lead From the Front

Lord Nelson had the trust and loyalty of his soldiers because they knew he led from the front.? He shared in the danger they faced.? In the Battle of Trafalgar, he sailed on the flagship Victory which was the deadliest spot in the battle.? Similarly, George Washington told his Continental Army in 1777 when he came upon some British troops in New Jersey, ?Parade with me, my brave fellows,??and led the charge into enemy lines. ?Great leaders don?t ask others to do what they would not do themselves.? They lead with a moral authority that inspires others.? Consider in your own organization whether you are truly leading from the front.

Empower Others

As he led his fleet into battle, Lord Nelson would not be micro-managing his other leaders.? As they sailed into the heat of combat, he had to trust that others would act on their training and experience and be responsible for carrying out the plan.? When he signaled, ?England expects that every man will do his duty,? Lord Nelson was unleashing his leaders to greatness.? He expected them to be courageous and to do their job.? While he expected a great deal from his soldiers, he expected even more from himself.? Legendary basketball coach John Wooden would share at the beginning of his pre-game locker room speech, ?Men, I’ve done my job, the rest is up to you.”? Coach Wooden?s team had done the preparation.? On game day, he released them to go get the job done on the court.? In your organization, have you empowered your team?? Do they know you have their backs?? Have your prepared your employees for success?

While we don?t face the heat of military battle every day, we are competing in a challenging global marketplace.? We encounter traditional ways of doing things every day.? If you are not in a period of change then you are probably just coming out of one or about to head into another.? If you are in a leadership position, perhaps the lessons of Admiral Lord Nelson might provide some encouragement and insights into navigating your next challenging season.

ELEVATE: HELPING OTHERS BE THEIR BEST

Paul Simon, one of my favorite musical artists, penned a song, I Am A Rock in 1965.? The song about a recluse repeats the chorus, ?I am a rock, I am an island.?? I think about this song a lot because we tend to forget that achievement in life is rarely a solo act.? We aren?t islands.? We all stand on the shoulders of those of who preceded us and helped us along the way.

Are We Independent or Interdependent?

Herbert Hoover, the United States? 31st President, emphasized our country?s ?rugged individualism.?? He believed that the U.S. faced a decision between ?the American system of ?rugged individualism? or the choice of a European system of diametrically opposed doctrines ? doctrines of paternalism and state socialism.? He said, ?The acceptance of these ideas meant the destruction of self-government through centralization of government; it meant the undermining of initiative and enterprise upon which our people have grown to unparalleled greatness.?? It is interesting that over 85 years later, the U.S. still debates this choice.

Regardless of your political views on this point, there is no denying that the emphasis on individualism and a ?frontier mentality? runs deep in our culture.?? These concepts are related to the ?American Dream? – the idea that each of us can have upward mobility through hard work.? James Truslow Adams coined the term ?American Dream? in his 1931 book Epic of America. He stated, ?The American Dream is that dream of a land in which life should be better and richer and fuller for every man, with opportunity for each according to ability or achievement.?

I describe these cultural patterns because it is easy to take them for granted and not realize the impact on our thinking and our lives.? While there are many positive aspects of these ideas, we sometimes fail to understand their limitations. We can?t lose sight that the greatest successes in life are made with and through people.? Great achievements in life are never solo endeavors.? Sometimes we forget that.? We can be like the turtle on the fencepost.? As the story goes, when you find a turtle on top of a fencepost, “You know he didn’t get there by himself, he doesn’t belong there, he doesn’t know what to do while he’s up there, and you just want to help get him down.”

In reality, our success in life is linked to the lives of other people (whether we recognize it or not). There is a great expression that we are standing on the shoulders of giants.? This quote was first attributed to 12th century scholar Bernard of Chartres, who used to say ?we are like dwarfs on the shoulders of giants, so that we can see more than them, and things at a greater distance, not by virtue of any sharpness of sight on our part, or any physical distinction, but because we are carried high and raised up by their giant size.?

The late Zig Ziglar had a wonderful quote he often repeated that ?If you help enough people get what they want in life, you will get what you want.?? This was not a manipulative idea; instead, it is one that recognizes that, by serving others, we truly are helping ourselves.? When we can walk in humility and realize that our success in life is not just the result of our own hard work, but the help of many others along the way, then we are on our way to being a true leader.

Elevating Others

Once we recognize that success in life is not a solo act, then we can begin to consider the importance of building up others to create a great team.? An organization with high performance teams will go further, faster.?? Teams are built on a foundation of trust.? One of the ways to build trust is to invest yourself in the lives of others.? What does this mean?? It means that you help other people elevate and achieve their goals and objectives.?? Unfortunately, this is rare.? We are typically so caught up in the tyranny of the urgent of our own matters that we don?t stop and consider the hopes, dreams, and aspirations of others.?? Think about it ? do you really know what your colleagues are seeking out of life?? Do you know what motivates them to get out of bed in the morning?? What would be the difference if you did?? By taking the time to understand your colleagues hopes and dreams, you are investing yourself in their lives.

I have experienced the benefits of others investing in my life first hand. After earning my law degree, I launched into the practice of law which I enjoyed; however, I felt like my true calling was to use my business and legal training to be a strategic advisor to companies.? I knew for several years that I wanted to make this transition, but I was stuck.? I could not seem to make the switch and clung to my law career like a child holds onto a favorite blanket. I would not let it go.? Two people helped me better understand my motivations, clarify my path, and make this next step in my career.? One was Dr. Carl Hicks.? Carl helped me gain a much deeper understanding of myself.? Carl is an expert with the Birkman? assessment tools and used them to help me clearly see my deepest motivators as an individual.? Through his example and encouragement, I realized that I could make this transition.? He coached and encouraged me along the way.? For that, I am forever grateful.

I also was encouraged by my friend and colleague Andy Wimberly. Andy made a successful transition from being a well-established financial advisor to an executive coach.? As he says, ?it took me 15 years to become an overnight success as a coach,? but his example and encouragement reinforced my confidence.? Both Andy and Carl reached out and helped me help myself.? They challenged me and created accountability.? They would not let me just ?talk the talk? about change, I had to ?walk the walk.? They shared and continue to share their wisdom and life experiences with me. I use the examples of Carl and Andy to illustrate the point that there is a significant impact of helping others be their best.

The Rewards

There are both intrinsic and extrinsic rewards for investing yourself in helping people to be their best.? You will find that when you help others elevate that you feel better about yourself.? I write a weekly column on leadership.? I have interviewed hundreds of leaders for this column and one of the standard questions I ask is ?What is your proudest moment as a leader??? By far, the most frequent response I get is the satisfaction that comes from seeing others develop and move on to achieving great things.? There is typically no direct financial reward for these leaders for that kind of success.? However, by watching others succeed that they had invested in, they were able to know that their investment paid off.? They could see the fruit of their efforts.

Ralph Waldo Emerson noted, ?The purpose of life is not to be happy. It is to be useful, to be honorable, to be compassionate, and to have it make some difference that you have lived and lived well.? I also like Benjamin Disraeli?s statement, ?The greatest good you can do for another is not just share your riches, but to reveal to him, his own.? ?I hope that you will consider whether you are being the kind of leader who is elevating others to help them reach full potential.

THE POWER OF AFTER-ACTION REVIEWS

A training document for the Department of the Army begins with the statements, ?Modern combat is complex and demanding.? We must use every training opportunity to improve soldier, leader, and unit task performance. To improve their individual and collective-task performances to meet or exceed the Army standard, soldiers and leaders must know and understand what happened or did not happen during every training event.?? The document I am referencing is a training manual on how to conduct After-action reviews (AARs).? AARs are widely used in the military.? These reviews ?identify how to correct deficiencies, sustain strengths, and focus on performance of specific mission essential tasks list training objectives.?? These AARs help everyone understand what did and did not occur and why.

AARs create a feedback loop that compares the actual output of a process with the intended outcome. It takes honesty and candor to actually make this a meaningful exercise.? Soldiers learn and remember more by participating in the AAR process than just getting a critique of their performance.? In the military, AARs are conducted either formally or more spontaneously as informal reviews.? The purpose of the AAR is not to punish or be hypercritical.? It is a powerful learning tool to improve performance.

I spend a lot of time interviewing employees of organizations.? I am shocked at how often employees tell me that they never get feedback on their performance.? To grow and learn as an organization, you have to create feedback loops.? Every organization has key events, projects, and performances that warrant taking the time to do an after-action review. Business consultant and best-selling author Peter Senge has stated, ?The Army’s After Action Review is arguably one of the most successful organizational learning methods yet devised.? ?I encourage organizations to adopt this ?habit? that has been so successful for the military.

Organizational After-Action Reviews

Organizations that seek continuous improvement can utilize AARs to engage and equip their workforce. Again, AARs are intended to focus on tasks and goals to discover why things happen.? They are not intended to judge success or failure. ?Examples of when formal AARs can be used in the workplace include after major presentations, technology changes, or launching a new service or product.? Informal AARs can also be used routinely.? For example, they can be used after a patient or customer encounter. The leader uses these opportunities to ask open ended questions and to understand why certain actions were taken. Participants are challenged to explore alternative courses of actions that would have been more effective.? Participants should also compare the results and actions with the expected standards and outcomes.

The biggest challenge to utilizing AARs in our organizations is time.? In our hectic and fast paced schedule, we rarely take time to purposely have these type learning sessions.? However, failure to do so slows our learning and can cause us to continually make the same mistakes over and over.? It is also easier to bark a reprimand at an employee than to take the time to probe his or her actions and find a better way to do things.?? Don?t let the tyranny of the urgent keep you from benefitting from this powerful tool in your organization.

Personal After-Action Reviews

John Maxwell is one of my favorite authors.? He is a prolific writer and effective speaker.?? In his book Today Matters he states, ?People create success in their lives by focusing on today. ?He emphasizes that, ?It may sound trite, but today is the only time you have.? It?s too late for yesterday and you can?t depend on tomorrow. That?s why today matters.?? I learned from reading his books about a habit he has of reviewing each day.? He has list of questions that he asks himself as he reflects on his day.? What he is really doing is having a personal AAR for each day of his life.? When you take time to reflect and learn from your daily experiences, you create a powerful virtuous loop of improvement.? I believe we create so many of our own ?potholes? in life by needlessly repeating poor habits and behaviors.? When you have a daily AAR you see these ?potholes? clearly and can learn to avoid them.

I took his concept and created my own daily list of questions to focus my reflection on my day.? I write out the answers to force myself to think through my responses.? It never takes more than five to ten minutes, but it is one of the most important things I do each day.? You can use this type of personal AAR to reflect on how you are doing on your goals and how you are living as compared to your values.? This time allows you to see your progress in developing good habits and eradicating bad ones.? Having a daily AAR is an investment of time, but one that pays large dividends.

While we might not be preparing for military battle, life and business do have significant challenges.? In order to thrive and not just survive, we need to be constantly improving individually and organizationally.? I encourage you to borrow the After-action review concept form the military and apply it in your own organization and personal life.? You won?t regret it.

 

Originally Published in Mississippi Medical News

ARE YOU A MEDICAL ENTREPRENEUR?

Successful Medical Practices

All doctors are medical entrepreneurs to some degree. Since the pioneer days in America when they hung a shingle outside their practice door, doctors have been the original medical entrepreneurs.

A simple definition of an entrepreneur is ?a person who has possession of a enterprise, venture or idea and assumes significant accountability for the inherent risks and the outcome.?

Sound familiar? Physicians, like other professionals, often practice in solo or group settings where they are the boss and certainly experience the intrinsic risks and rewards of their medical practice. You may not necessarily feel like an entrepreneur and that?s certainly understandable. A physician?s first and foremost responsibility is obviously patient care. In fact, almost all of medical training prepares physicians just for that task. However, most professionals, including physicians, rarely are trained on how to run their own practices.

I have spent more than 25 years operating and working with entrepreneurial business ventures, and I?am now the CEO of an emergency health care company in Memphis, TN, Emergency Mobile Health Care. I have had the good fortune to study with and learn from some great mentors in this arena, and I?m passionate about seeing people fulfill their entrepreneurial potential. I?m excited to share with you in this column some of the key principles I?ve learned about entrepreneurial success, and specifically, how those can be implemented in a physician practice setting. In addition, I?ll highlight some notable medical entrepreneurs and offer tips on how to evaluate business opportunities outside of your core medical practice.

I begin with the simple premise that your medical practice is an entrepreneurial business, and that your practice shares many common features of any entrepreneurial organization. Common characteristics include people management, implementing systems and processes, taking care of your customers, and financial risks and rewards.

People Management (or Cat Herding)

Rarely do I find an entrepreneur or a physician who operates as a solo act. To run your practice, it takes nurses and staff to operate effectively. Therefore, your success becomes interwoven with your ability to get the most out of the people you work with. Anyone who has every managed an employee knows that hiring and developing talent is no easy task. Therefore, the questions become: what kind of leader are you? Are you getting 100 percent from your team or are they giving you the bare minimum to get by? Building a great team around you is a key step in your path to success.

Systems Management

Every medical office, like every business, also has systems for doing things. The question is whether you know what those systems are and how are they working.? Are you streamlined and efficient, or are you daily enduring broken systems?? Exemplary practices have written ways to do things that people understand and follow. The way Chic-fil-A can serve up a great chicken sandwich no matter what store you visit in the country is based on one simple thing: a great system!

Customer Management

Your patients and referral partners are your ?customers.? Every time one interacts with you, they have a customer experience. Do you know what that customer experience is? Have you thought through your interaction from first contact to final communication? Is there consistency and predictability in what your customers experience with you? Great practices have a well thought out customer experience cycle that is clear and repeatable.

Financial Management

What about the bottom line? While we all hopefully work to pursue a calling and seek personal fulfillment, we also are trading our time and effort for money.? Today?s medical practices are complicated and can be difficult to manage financially. There are lots of expenses, and reimbursements tend to go down and not up. Therefore, keeping a careful eye on the bottom line is critical. Physicians, like many busy entrepreneurs, tend to entrust financial responsibilities to others in the organization. However, I believe it?s also critical for physicians to know and have clear visibility into the key economic drivers of their businesses.

Thinking Strategically

Finally, as entrepreneurs, I encourage physicians to take time to work ?on their practice? and not just ?in their practice.? Most people are so thankful for a day off that they rarely want to turn around and think more about work. However, most of us stay in the trees and rarely plan and dedicate time thinking about the forest.? The end result is that we often feel like we?re on a treadmill we just can?t seem to get off.

I spoke with Robert Harris, MD, a urogynecologist with Women?s Specialty Center in Jackson, MS, who is a well known entrepreneur physician. He shared:

?I try to purposefully take time away from my day-to-day practice each week and work on improving both my practice and my life.?

For Dr. Harris, this has allowed him to not only strategically improve his medical practice, but also to create the time to pursue medical start-up businesses outside of his bread-and-butter practice.

In sum, we give a great deal of ourselves to our work and professions. By becoming entrepreneurially minded, you help not only gain better control over your practice, but also your life.

(c) Martin E. Willoughby, Jr.

 

Originally published in Medical News

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