Business Development | Martin Willoughby

29 Feb 2016

Sticky Post By overseer Posted in Business Development, Decision Making, Entrepreneurship, Managing Your Business, Uncategorized Permalink

HOW TO VETT A BUSINESS OPPORTUNITY

Sticky Post By overseer On February 29, 2016

Like other high-income earners, physicians are often sought after sources of angel investment funds for start-up or growing businesses. I am often asked to review and analyze these business opportunities for physician clients.? In this article, I am summarizing the key considerations for evaluating potential investment business opportunities in startups or growth companies.

Vision, Values, and Strategy

Can the company?s management articulate a clear vision and strategy for the company? In other words, do they know what they stand for, and do they have a plan for where they are going?? Many companies suffer from a lack of focus.? Research supports that companies with a narrowly focused strategy will generally outperform the competition.? I am wary of any company that can?t clearly articulate their value proposition in the marketplace in 30 seconds or less.? I also look for whether management and employees are all in sync on the company?s vision and strategy.? Many companies overlook the creation of a value statement.? I prefer companies that know what they stand for.? Difficult times will face every organization.? Value statements that have real meaning and adoption provide anchors during turbulent times.

Execution

This is one of the hardest things to actually find out in due diligence, but probably the most important.? Here, I am trying to determine whether the management team can actually execute the company?s strategy.? Many people confuse effort and activity with execution.? Successful companies have high functioning teams that execute with purpose and passion to get things done.? I ask questions about how management creates accountability in the organization or look for examples of past execution to try and determine whether the management is execution-oriented.? Other clues to whether a management team can execute is the level of organization, timeliness, and if they are goal oriented.? I like to see clear written goals and action plans.

Products/Markets

People raising money for a company should have a clear command of the marketplace they are competing in and how their products and services stack up against the competition.? Is the company swimming in the ?red ocean? of a very competitive market or the ?blue ocean? of new and untapped markets??? If they are in a very competitive market, then can they clearly articulate why their product/service is differentiated from the competition?? In a new market, how are they pricing their products and gauging the overall market opportunity?? Many companies venture out and find that their market is actually much smaller than they thought. It is helpful if the company?s industry has solid data on size and growth.? High growth companies need large and growing markets to thrive.? I look closely at the price sensitivity of the products/services and the barrier to entry of other people to compete.?? I also prefer recurring revenue companies versus companies that only have one-time sales.? Is the company a one trick pony or is there a pipeline of other products/services?

Management

No matter how good the products and services a company may offer, ultimately the success of a business depends on the quality of the people. ??When you invest in a company, you are really investing in the management team.? Most companies in early funding stages lack a complete management team. I try to determine the strengths and weaknesses of the management group, and I want to understand how they will shore up the deficiencies in the short term and what their long-term plans are for fully staffing the management team. ??Does the management group complement each other or is there too much overlap?? Are any of the founders part of the management that may soon have to be replaced?? Replacing a management team member can be a time consuming distraction for a company.? I prefer managers who have experienced both success and failure.? We all know we learn more from our mistakes than our successes.? I would prefer that a management team not learn their failure lessons with my investment.? Great managers are great leaders.?? They are high performers and can attract top talent.? I have found that the best leaders are great coaches and know how to get the most from their employees.?? You want to avoid know-it-all?s and micro-managers because they will ultimately prove to be poor leaders and will run off talented employees.

What is the Exit?

Most investors eventually want their money back out of the company in a reasonable amount of time.? A typical time horizon is 5-7 years.? What are the long terms plans of the company?? Are the founders creating a lifestyle business or a high growth company??? Typically, lifestyle companies will have slower growth but greater profitability.? High growth companies, often referred to as gazelles, usually focus on top line revenue growth.? These companies will typically lose money at first.? I look carefully at the ?burn rate? of these type companies and want to understand when profitability will occur.? It is critically important that the owners and management all be in sync on the trajectory of the company and the goals for exit.

The Deal

Ultimately, the opportunity to own part of the company must be for the right price tag. ?All pro-formas tend to look alike with slow growth in the early years and then the proverbial ?hockey-stick?? high growth in the later years.? The investment and corresponding ownership should be reasonable based on very conservative financial projections. There are also a number of ways to creatively structure a deal to provide additional risk mitigation for investors.? In addition, the legal terms and conditions of the corporate documents you will be signing are a major factor to consider.? Structuring the financial deal and key terms and conditions will be explored in more detail in a future column.

While this is an abbreviated list of due diligence considerations when vetting investment opportunities, hopefully it will provide you a framework to begin to consider future investment deals.? For an easy checklist summarizing these points and others, feel free to email me, and I will send you a copy.?? Good luck in your investment future!

15 Feb 2016

Sticky Post By overseer Posted in Attitude Permalink

HOW TO GROW YOUR WILLPOWER

Sticky Post By overseer On February 15, 2016

At the 2009 U.S. Open, Serena Williams lashed out at a lineswoman in a profanity laced tirade that not only cost her the match, but also $82,500 in fines. Serena, a former No.1 ranked tennis player in the world and holder of 27 grand slam titles, had a lapse in self-control.? Our ability to self-regulate has tremendous impact on our lives.? The lack of self-control by many politicians and celebrities has led to public displays of the disastrous results (e.g. Rep. Anthony Wiener, Gov. Mark Sanford, Charlie Sheen, etc.).? A study published in 2010, tracked one thousand children from birth to age thirty two and found that the greatest predictor of ?success? in life was the trait of self-control.? Interestingly, in a study with over one million survey responses, participants were asked to list their personal strengths, and self-control was dead last. We seem to know our own limitations when it comes to our willpower. ??Unfortunately, the challenge of self-control has led to alarming rates for crime, divorce and sexually transmitted diseases in our modern times.? In fact, social psychologist Dr. Roy Baumeister in his 1994 book ?Losing Control? argued that, ?Self-regulation failure is the major social pathology of our time.?

For entrepreneurs and business leaders, the ability to exercise self-control is extremely important.

In today?s business environment, we have constant distractions competing for our focus and energy.? We have the vast array of information of the internet readily available ? just tempting us to explore.? We can watch our favorite movies and television shows any time on portable devices we carry around with us.? Even going to the grocery store presents us with a dizzying array of choices as local groceries have now grown into megastores.? Author and performance coach Tony Schwartz noted, ?Self-control is the ability to say no, in the face of temptation, and to take sustained action, despite the difficulty of a given challenge.?? I have the good fortune to interview leaders on a regular basis. One of the common themes I hear is that it is critical for leaders to separate ?the great from the good? by learning to say no.? By saying ?no? to very good things, we are able to ?yes? to the truly great opportunities. Leaders have to make difficult decisions and lead by example.? Nobody wants to follow people who routinely exhibit poor self-control.

Schwartz also emphasized, ?Over the years, we?ve learned that nearly everything people tend to believe about self-control is wrong. Most of us assume the only way to resist our impulses, or persevere under pressure, is to grit our teeth, furrow our brows, steel our nerves, and tough it out. Precisely the opposite is true.?? In his recently published book entitled ?Willpower,? Baumeister shares the results of over two decades of rigorous scientific study on this topic which I believe will reframe how think about self-control.? Baumeister and his co-author John Tierney share that ?willpower is a form of energy in the brain. It?s like a muscle that can be strengthened with use, but that it also gets fatigued.?

What the authors found was that our energy is the key to our self-control.? We all have a pool of energy to complete our physical and mental tasks each day.? Each time we exercise self-control in an important or even trivial matter, we draw down on this available energy.? The energy source in our bodies is glucose, the simple sugar produced in our body from the foods we eat.? Researchers found that there was a direct correlation between glucose levels and self-control.? In fact, they found that, ?As the body uses glucose during self-control, it starts to crave sweet things to eat . . .?? I know when I skip a meal that I become ravenous and my own willpower to eat healthy tends to go out the door ? just give me a piece of pizza!

As we learn more about how our brains and bodies work, we can put this information to use in our daily lives. By learning to improve our willpower, we can create a huge competitive advantage in work and life.? To have more self-regulated lives, we have to learn how to manage our energy.? Below are some of the core concepts from this emerging of field of research that we can start to apply today.

Maximize Your Energy

Based on the research, we could draw the wrong conclusion that we need to have Snickers? bars with us all the time to fuel our glucose so we can exhibit better self-control.? This is obviously not the way to go. However, the key is to maintain healthy glucose levels throughout the day.? Nutritionists would tell us to accomplish that by eating more frequently throughout the day (5-6 times a day).? My own research on this topic has convinced me to be a ?grazer? throughout the day and avoid large meals.? This research also validates the advice your mother gave you to ?eat a healthy breakfast!?? Starting your work day without having a good breakfast puts you at a competitive disadvantage from the beginning of the day.? We also know that we should eat low-glycemic foods which provide sustainable sources of energy throughout the day.? When our bodies crave the afternoon snack, we need to refuel with good sources of glucose and not the cookie or Coke.? ?In addition, the research is clear that regular exercise and sleep all help us maintain the right levels of energy.? The average American only gets six hours of sleep, but performance expert Dr. Anders Ericcson has shown peak performers sleep eight or more hours a night on average. ?The bottom line is that we can be intentional about improving our willpower by better managing our energy levels.

Make Your To Do List

Baumeister and Tierney also found that one the keys to improving our willpower is have a good ?to do? list.? However, this does not mean creating pages of things that we need to get done.? Instead, they noted, ?an executive?s daily to-do list for Monday often contains more work than could be done the entire week.? We tend to have too many goals and to-do?s which diffuses our focus and energy.? Baumeister and Tierney shared a best practice for team members to weekly share up to three goals that they plan to focus on for the following week and to create a weekly accountability loop on those goals.? It is also important to pre-plan your reward for achieving your goal. ?I enjoy the great feeling of scratching an item off my to-do list. It is a simple act but brings me joy!

Clean Your Room

Research has also found that having a messy workspace leads to less self-control.? Unfortunately, those stacks of paper piled up on our desks actually are hurting our ability to exhibit willpower and achieve our goals. By ordering our workspace, we create positive momentum and don?t deplete our willpower resources. ?In fact, a clean workspace is an integral part of the Japanese 5S system of workplace organization used by many companies.

Conclusion

One of the interesting findings from research on willpower is that people with more self-control are more altruistic.? They give more to charity, volunteer more, and are more likely to be concerned about others in society.? ?It is also encouraging to me to learn that I am not a slave to my weaknesses, but that I can actually learn to have better willpower to accomplish positive things in my life.? Through implementing some of the findings described in this article and others from this emerging field of research, we have the ability to improve not only our own lives, but also those around us.? For entrepreneurs and business leaders, reclaiming this character trait of willpower and learning how to grow it could be the most important element of future success.

27 Jan 2016

Sticky Post By overseer Posted in Business Development, Leadership, Managing Your Business Permalink

ARE YOU CONTINUALLY IMPROVING YOUR BUSINESS?

Sticky Post By overseer On January 27, 2016

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.

25 Jan 2016

Sticky Post By overseer Posted in Uncategorized Permalink

THE VALUE OF CULTURE

Sticky Post By overseer On January 25, 2016

I must have looked lost as I was meandering down the food aisle at a Publix Super Market.? As I was unsuccessfully trying to pick up a few items off my ?honey do? list from the grocery store, I heard the words from a friendly Publix employee, ?Can I help you find something??? I was a little caught off guard because I couldn?t remember the last time I was asked in a grocery store if I needed some help with my shopping.? I was prepared for some directions on where I could find the missing item; but instead, the employee insisted on retrieving the product for me while I continued my shopping.? WOW!? I was blown away.? As a business coach and consultant, I take note of great service.?? I was also intrigued.? What kind of organization was this with employees who were so passionate about customer service?? As I was in the checkout line, I shared my positive experience with the checkout clerk (who was also very friendly).? I asked to speak to the manager of the store so I could report this excellent customer service.

I learned a lot in my brief exchange with the store manager.? This young man shared with me that this was normal behavior for their employees.? I learned that he had been with the company for over twenty years and started as a part time employee in high school bagging groceries.? As I pressed in for the secret sauce to the great service, he pointed my attention to their secret – THE CULTURE!? He shared with me how important the company?s culture is and how much attention they pay to cultivating and reinforcing it throughout the organization.? The focus on culture has paid off for Lakeland, Florida based Publix. It is the largest and fastest growing employee owned super market in the country.? With over $27 billion in sales, 1,056 stores, and 157,000 employees, Publix is ranked 106 on the Fortune 500.? What caught my attention though was that the company had been on FORTUNE magazine?s ?100 Best Companies to Work For” for over 16 years.

Publix?s emphasis on its culture dates back to 1930 and the company?s founder George Jenkins. Jenkins held himself to the high standards he expected of others and created a culture of service ?not only to the customer who came into the store to shop, but to every associate as a customer of another associate.? Jenkins and other leaders believed that ?people want to help, and, if given the resources to do so will provide extraordinary service.??? One of the ways they create such loyalty is by promoting from within.? The current CEO and President each started out in Publix as front-service clerks over 25 years ago.? I also took note that, the average tenure at Publix for store managers is 25.1 years, retail hourly workers average about 5.1 years, and hourly support workers average about 9.1 years.

As I have studied companies like Publix, I have become convinced that building a great culture is absolutely one of the keys to building a great company.? It is particularly important for any company that wants to grow and expand with people.? For some, talk about culture may sound ?soft? or of secondary importance.? These type naysayers may believe that having a great culture is a ?nice to have? versus a ?must have.?? Very few companies can afford to ignore their company culture.? If your company involves people interacting with people, then you should be paying attention to your culture.

?For definitional purposes, I describe a company?s culture as the shared values and practices of the people in the organization.? These are the common beliefs and habits of the organization.? Here is the critical part ? your employees represent YOUR BRAND.? They are the living, breathing implementers day to day of what your company stands for.? In other words, they are the front line in creating your brand in the marketplace.? Companies can spend millions on positive advertising but one bad interaction with a representative can destroy the customer?s feelings about the company.

I was attending a conference at the Ritz Carlton in New Orleans recently, and as I was leaving a member of the housekeeping staff stopped me on my way to the elevator and wanted to make sure I had enjoyed a great stay at the hotel and wished me safe travels on my journey home.? She did not have to do that.? It was probably not part of her job description.?? However, with a smile and genuine sincerity she made a point to wish me well on my way.? I have shared with dozens of people about this simple exchange and how that positively reflects on the brand of The Ritz Carlton.

Gregg Lederman, founder of Brand!ntegrity and author of the book entitled Engaged! Outbehave Your Competition to Create Customers for Life, travels the country helping companies realize the value of culture and how important it is in developing their brands.? He notes, ?Branding is not part of the business, it is the business. Every interaction with an employee, with a coworker or a customer has the power to strengthen or hinder the brand image of your company.?? Lederman emphasizes that branding is about experiences and not logos and taglines. ?He teaches companies that the little things that they do daily are more important than the big things they may say about themselves.? I believe and share with my clients that every day their doors are open is ?Game Day,? and they should treat it with the opportunity for greatness.? Unfortunately, for too many companies it becomes like ?Groundhog Day,? and mediocrity can creep in.

I recently discovered Lederman?s company and work, and I have been impressed.? In addition to his thought leadership on this subject, his company has come up with something truly unique in my opinion.? They have created a proprietary software system that actually allows companies to better manage their brand by tracking and measuring customer satisfaction, employee engagement, and financial results. What they have accomplished is the linking together of these critical aspects of the business in a quantifiable way that encourages the right behaviors.? This use of metrics and creative ways to reinforce positive behaviors strengthens and builds the culture, and it is all tied back to the company?s profitability.?? I believe in the future we will see more and more organizations focused on building powerful brands, and I think we should all start to consider what is our R.O.C. ? Return on Culture. ?

11 Jan 2016

Sticky Post By overseer Posted in Business Development, Leadership, Operational Excellence Permalink

ORGANIZATIONAL HEALTH

Sticky Post By overseer On January 11, 2016

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!

08 Jan 2016

Sticky Post By overseer Posted in Health Care Permalink

THE CRITICAL NEED FOR TEAMWORK

Sticky Post By overseer On January 8, 2016

Teamwork has been a buzzword around the business culture for some time.? Leading businesses know that well performing teams are the key to profits in a business.? However, teamwork takes on a whole new level of importance in life or death situations such as military combat, airline travel, and healthcare. In 1999, the Institute of Medicine (IOM) published To Err Is Human: Building a Safer Health System, which was a revealing review of the U.S. medical care system and the inadequacy of safety practices used in the treatment of patients. The IOM report estimated that medical errors result in 44,000 to 98,000 deaths annually?more than automobile accidents (43,458), breast cancer (42,297), or AIDS (16,516). Since then, there have been a number of initiatives and task forces to address this problem, including the development and research of team based training to improve patient safety.

While the focus on teamwork in healthcare has brought improvement, there is still work to be done. The study, “Medical Errors Involving Trainees: A Study of Closed Malpractice Claims from 5 Insurers,” appeared in the October 22, 2007, issue of the Archives of Internal Medicine. The lead author, Hardeep Singh, M.D., M.P.H., noted, “Our study confirms the relationship of poor teamwork to preventable errors and quality of care.”? The Agency for Health Research and Quality (AHRQ) Director Carolyn M. Clancy, M.D. stated about this study, “This study reminds us that we have a lot to do to ensure that hospitals are providing appropriate supervision to trainees and implementing team-training programs, both in the inpatient and outpatient setting.”

In addition to the obvious importance of teamwork for patient safety, there is also a critical need for effective teamwork to create the efficiencies needed to deal with increased patient volumes and decreasing reimbursements. Physicians today need to make sure they have expert teams, not just teams of experts.? Expert teams aren?t created overnight.? It?s a process and takes purposefulness and commitment.? Teams typically begin in the formation stage where people are learning, leaders are directing, and people are getting to know one another. Unfortunately, this is usually followed by the storming stage where clicks can development, a great deal of supervision is required, and disagreements can ensue.? While many teams get permanently bogged down in the storming stage, better performing teams will enter a norming stage.? In this stage, the team starts to actually work together as a team, goals and directions become clear, and the overall performance improves. Truly high performing teams will enter a performing stage where team members all exhibit leadership, self-motivation is high, and the team members all have strong skills and knowledge.? The reality is that most teams will move up and down this spectrum as they progress and decline in their teamwork.

For some, discussions about teamwork and team building conjures up images of warm and fuzzy games and retreats.? Working on teamwork can be seen as a waste of time and money and not ?real work.?? The reality is quite different.? From 1955-2008 there were over 300 empirical articles on teamwork studying over 10,000 teams. For example, a study by Eduardo Salas, Diana R. Nichols and James E. Driskell Small Group Research 2007; 38; 471 entitled ?Testing Three Team Training Strategies in Intact Teams: A Meta-Analysis? found unequivocally that team training improved performance.

There are a number of training methods that can be used to deliver results including: cross-training, event-based approach to training, scenario-based training, self-correction training, stress exposure training, team adaptation training, and team leader training.?? The reality is that physician team settings vary dramatically from emergency room, to general surgery, to primary care physicians.? The key is adapting your training to your specific environment. For those considering team training, it can be a waste of time and money unless the design and delivery of the training is based on scientific principles, the physicians take ownership, teamwork is rewarded and encouraged, and there is feedback loop to debrief and measure success.? True team development should focus on building the knowledge, skills, and attitudes of your team members and should be an ongoing process.

The handwriting is on the wall.? There is no doubt that quality of care will continue to be scrutinized with greater intensity, particularly with the shift to electronic medical records.? The link between pay and quality of care is only going to get stronger.? Physicians will have to continue to do more with less.? There will be increase pressure to see more patients and be highly efficient. At EMHC, we are continuously striving to stay up-to-date on the quality of our patient care. While more studies need to be done, we have enough data from the commercial airline industry and the military to show us that we need to strive for better teamwork in healthcare to improve safety.? Since many physicians are also entrepreneurs, they must keep an eye on the bottom line and the work of business has shown us undoubtedly that it?s hard to be profitable with a poorly performing team. In the near future developing your healthcare team won?t be a luxury, but a necessity.

04 Dec 2015

Sticky Post By overseer Posted in Entrepreneurship, Health Care, Healthcare, Leadership Permalink

ARE YOU A MEDICAL ENTREPRENEUR?

Sticky Post By overseer On December 4, 2015

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