Building Consensus To Build Practice Profits

Building Consensus To Enhance Practice Profits

[Part of this material has been taken from Business Basics for Veterinarians and Management Basics for Veterinarians, and may not be reproduced without written consent of author]

Veterinarians, by the very nature of possessing the title “doctor”, are expected to be leaders. While veterinary schools teach all the basics of medicine and surgery and turn out competent practitioners, where are veterinarians expected to develop their leadership and team-building skills? While some believe that leadership is an innate attribute that can’t be taught, there is compelling evidence that given the right individual, leadership can in fact be taught, or at least enhanced.

Trying to understand leadership causes us to also explore the origins of power within an organization. As students at veterinary school, soon-to-be veterinarians would seem to be almost devoid of power. Virtually everything that they do is under someone else’s authority. Interestingly, upon graduation, leadership is supposedly conferred upon individuals with some pomp and circumstance and a diploma. The peons of yesterday somehow miraculously evolve into leaders of the profession and join the ranks of their mentors as respected colleagues. The terrified student who prays for a passing grade in surgery is now the “seasoned” professional that will be practicing on owners’ animals with their full confidence. By the same token, after a few years of practice, the relative neophyte may elect to own a practice and become an administrator and manager. This time there is no ceremony and no diploma – just a bank loan and a desire to succeed. The ultimate success has a little to do with quality medicine and a lot to do with leadership, teamwork, and understanding the benefits of performance measurement.

BARK (Business Assessment Report Kard) is an excellent way to empower practice teams and make practices more profitable. The basic premise of such a program is to unite staff to common strategic goals, while not focusing specifically on profit.

Running a successful veterinary organization is much more like driving a bus, piloting an aircraft, or being captain of a ship than it is a military chain of command or government bureaucracy, yet many practices operate on this latter command-and-control philosophy. Being the boss stifles creative solutions by staff and makes dramatic profitability enhancements more difficult to achieve.

On the other hand, BARK focuses on vision and strategy and keeping an eye on the big picture, while allowing practice teams to come up with creative solutions to achieve desired outcomes. For example, practice owners (preferably with the assistance of a properly-trained consultant) will create strategic goals for a practice. BARK serves as the monitoring device for determining whether the practice remains on course and whether objectives are being achieved. If the practice owner is considered the pilot of the practice aircraft, then BARK serves as the instrumentation, providing immediate feedback, similar to the gauges in the cockpit.

Where does financial assessment fit into the BARK system? The financial analysis is an important component of BARK, but it serves more like a rear-view mirror than a front-looking gauge of speed, course, and performance. Financial analysis tells us the results of our previous decisions, and is only a very loose predictor of future performance. If we look at our past average transaction charges, this tells us what we have being doing to date, but doesn’t tell us how to increase that amount by 20%. For that we need to look forwards, not backwards.

To put the concept in medical terms, imagine that the practice is a patient, and the owner is the doctor in charge. The doctor has a variety of assistants and myriad monitoring devices that can be used to assess the patient, and make changes as the situation warrants. The morbidity and mortality data from previous such operations play the role of financial data. They are indicators of past such operations but only relate indirectly to the outcome for the current operation. The assistants are there to perform critical support functions, but if they can’t act and react spontaneously to the patient’s needs without direct instruction from the doctor, the patient becomes at risk. If the individual monitoring anesthesia is not free to respond to the needs of the patient without waiting for the doctor to notice and provide directions, the outcome is likely to be compromised and the ultimate success of the operation impeded. The doctor must concentrate on the big picture (successful outcome for the entire operation) and allow support staff to perform their own autonomous roles in the process.

If financial analysis is the part of BARK that reports on our past performance, what measures are used to direct our future trajectory? The three forward-looking aspects of the balanced BARK are the three main drivers of future profitability: customer value; innovation, and supportive business processes.

The BARK system turns from qualitative to quantitative by utilizing continuous performance measurement, just as using the odometer and speedometer help keep a journey on track, or measuring heart rate, tissue oxygenation, and blood pressure help assure a successful outcome to a surgical procedure.

BARK is also a form of internal marketing, reaching out to the staff to accomplish the strategic goals of the practice. Many practices fail miserably at this task when the goal is to motivate staff to bring in more revenue. This tactic often falls flat when employees perceive that their relatively low-paying positions are being leveraged to separate more money from clients, solely for the purposes of profit.

The BARK method takes a balanced approach to achieving strategic outcomes. While management usually determines the strategic vision and mission of the organization, all other aspects of BARK are planned and achieved by the involvement of all staff members. In many veterinary organizations, a command-and-control style of management is employed, with orders coming down from the owner(s)/managers, and tasks being carried out by employees, most with little or no opportunity to advance in their positions. In many cases, this top-down approach gives the veterinarian/owner/manager a feeling of power, but little real progress can typically be made with this regimented approach.

Power is not domination, supremacy, or control. Ultimately, power arises from many sources and is the ability to get things done and to effectively mobilize and utilize resources needed to meet goals. Interestingly, power is not diminished when it is shared. Empowering others to have control over their actions allows more to get done. The despot with complete control is ineffectual as a true leader. Having power over those who are powerless allows nothing meaningful to be accomplished.

Power is the ability to do and the powerful are those who have access to the tools to get things done. This includes the support of empowered individuals who themselves can make things happen. Leadership is about having willing followers, not domination of those followers. Taking responsibility for the care of your followers is what makes them happy and keeps them motivated.

As mentioned previously, empowering subordinates does not strip power from the leader, but is a valuable tool for getting things done in an organization. The more independently people can work to complete their tasks, the less “politics” are necessary within that organization. When individuals are dependent on others giving approval for every step in a process, these supervisors can be considered as roadblocks and hindrances rather than worthy teammates.

It is also important to embrace change, because there are no ways to avoid it. There will always be new technological advances, new procedures, new expectations, and if you remain in the organization long enough, new generations of employees with their new values, communication styles and motivators. Just take a deep breath and “go with the flow”. BARK can help.

Recommended Reading:

Ackerman, L: In, Business Basics for Veterinarians. ASJA Press, 2002

Ackerman, L: Management Basics for Veterinarians. ASJA Press, 2003

Kaplan, RS; Norton, DP: The Balanced Scorecard. HBS Press, 1996, 322pp.

Badaracco Jr., JL: Leading quietly. Harvard Business School Press, 2002, 224pp.

Belasco, JA; Stayer, RC: Flight of the Buffalo: Soaring to Excellence, Learning to let employees lead. Warner Books, 1994, 355pp.

Goleman, D; McKee, A; Boyatzis, RE: Primal Leadership: Realizing the Power of

Emotional Intelligence. Harvard Business School Press, 2002, 352pp.

Kennedy, Marilyn Moats; Mitchell, L: Office Politics for Dummies. Hungry Minds, Inc., 2002, 360pp.