A Path to Equitable Patient Care

When the healer's hand unknowingly carries the weight of bias, the very essence of medicine is at stake. 

Healthcare is a realm where science and compassion ought to be the norm. However, healthcare providers are not immune to the subtle, yet impactful presence of bias. This blogpost will illuminate the hidden facets of implicit bias in medical care and explore potential paths to a more just and equitable patient experience.

The purpose of this blog is to raise awareness, share data, and support providers in finding the right resources to continue the inner work of identifying and dismantling implicit bias. Doing this confronting and sometimes uncomfortable work is hugely rewarding for your patients, team, community, and for your own humanity.

“Of all forms of inequity, injustice in health care is the most shocking and inhuman.”

— Martin Luther King, JR., National Convention of the Medical committee for Human Rights, Chicago, 1966

The National Institutes of Health define implicit biases as, “...unconscious mental processes that lead to associations and reactions that are automatic and without intention; actors have no awareness of the associations with a stimulus maintain that social status is relational and people unconsciously hold more negative attitudes or feelings about membership of an outgroup (people with whom they do not share identities) than about membership of an ingroup (people with whom they share identities).” 

The American Psychological Association describes implicit bias as such, “...people may hold negative unconscious or automatic feelings and beliefs about others that can differ from their conscious attitudes.”

Implicit bias develops early in life from repeated reinforcement of social stereotypes. Implicit pro-white bias occurs among children as young as 3-5 years of age. 

Between 1998 and 2006, more than 4.5 million Implicit Association Tests were completed, and the results showed the following:

• Implicit bias is pervasive

• People are often unaware of their implicit biases

• Implicit biases predict behavior

• People differ in levels of implicit bias

The impact of implicit bias in healthcare is glaring. Non-white patients receive fewer interventions, Black women face higher mortality rates after breast cancer diagnosis, and patients of color are less likely to be prescribed pain medications. This bias even extends to more invasive treatments, such as Black men being less likely to receive chemotherapy and radiation for prostate cancer and more likely to undergo testicle removal. 

Patients of color are often unfairly blamed for being passive about their healthcare. Additionally, patients who perceive bias from their providers have more difficulty remembering what their physicians told them, have less confidence in their treatment plans, and believe it would be more difficult to follow recommended treatments. 

It’s important to note that while many implicit bias studies in healthcare have been conducted with Black patients and non-black providers, other researchers are studying implicit bias in relation to other ethnic groups, people with obesity, sexual and gender minorities, people with mental health and substance use disorders, older adults, and people with various health conditions.

To combat implicit bias, healthcare providers must adopt skills and strategies to break their thought patterns and habits. These include perspective-taking, emotional regulation, and partnership-building. Empathy, in particular, plays a crucial role in patient satisfaction, self-efficacy, and overall health outcomes. When providers view themselves as part of a larger group, it becomes easier to empathize with others, thereby reducing bias.

At the organizational level, healthcare facilities can play a significant role in addressing implicit bias. To create an equitable environment, organizations should evaluate the racial climate, investigate and address discrimination reports, and establish monitoring systems to track disparities in care. Promoting racial diversity at all levels of the organization hierarchy can help reduce bias, and organizations should implement training to equip clinicians with the knowledge and skills to prevent racial biases from affecting patient care.

Additionally, healthcare organizations can implement work policies and clinical procedures that protect clinicians from high cognitive load and promote positive emotions. When clinicians’ cognitive capacity is low or overtaxed, memory is biased toward information that is consistent with stereotypes. High cognitive load can be created by productivity pressures, time pressure, high noise levels, inadequate staffing, poor feedback, inadequate supervision, inadequate training, high communication load, and overcrowding.

Healthcare providers must also take proactive steps to combat implicit bias. This includes gaining an understanding of the various cultures their patients come from, avoiding stereotyping, recognizing the impact of unconscious bias, and following National Standards for Culturally and Linguistically Appropriate Services*. Techniques like "teach-back" and practicing evidence-based medicine can also help reduce bias in patient care.

Studies have shown that implicit bias is deeply ingrained in the healthcare system, causing devastating health inequities. The only intervention found to reduce implicit bias involved a prejudice-habit-breaking approach, which was effective for undergraduate students. 

The learning and training environments for healthcare professionals are crucial in addressing implicit bias. Formal diversity training in medical school has little or no effect on students’ levels of implicit bias over time. Implementing and psychological methods to address psychological problems of bias have proven effective over the longer term. 

Transformative Learning Theory (TLT) can help disrupt existing paradigms by challenging assumptions and promoting critical reflection. Increasing interaction with underrepresented groups, faculty, and patients, along with the perceived quality of that contact, can reduce bias and encourage healthcare professionals to actively address their biases.

Prejudice habit-breaking intervention, based on theory developed by Patricia G. Devine, PhD, and William T.L. Cox, PhD, of the University of Wisconsin–Madison adopts the premise that bias, whether implicit or explicit, is a habit that can be overcome with motivation, awareness and effort, includes experiential, educational and training components. Michelle van Ryn’s company, Diversity Science - helps organizations apply the best findings and interventions on implicit bias to creative inclusive cultures. 

Other suggestions include seeing the patient as an individual rather than a stereotyped member of a group and Individualizing patients to encourage medical students to question stereotypes about a patient's ethnic group. This can help patients become more engaged with their treatment and fostering patients' sense of being “on the same team” as their provider. Ultimately, it’s about how to improve your skills as a doctor or nurse. It requires commitment and practice. 

Implicit bias remains a persistent challenge in healthcare, perpetuating disparities in patient care. To create a more equitable healthcare system, raising awareness about implicit bias is vital. Healthcare organizations and providers must actively work to address these biases through training, awareness, and policy changes. By doing so, we can take significant steps towards ensuring that every patient receives the equitable care they deserve.

If you are a practice owner looking for support to lower your stress levels and fall (back) in love with your practice, schedule a strategy call to see how we can help you take back your time, grow your practice and elevate your leadership.

Sources:

Tackling Implicit Bias in Healthcare NEJM 2022 

https://www.nejm.org/doi/full/10.1056/NEJMp2201180

Eliminating explicit and implicit biases in health care: evidence and research needs

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9172268/

Quick Safety 23: Implicit Bias in Healthcare

https://www.jointcommission.org/resources/news-and-multimedia/newsletters/newsletters/quick-safety/quick-safety-issue-23-implicit-bias-in-health-care/implicit-bias-in-health-care/

How does implicit bias affect patients’ healthcare? APA 

https://www.apa.org/monitor/2019/03/ce-corner

Implicit Bias and Racial Disparities in healthcare ABA

https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/racial-disparities-in-health-care/

With implicit bias hurting patients, some states train doctors

https://stateline.org/2022/04/21/with-implicit-bias-hurting-patients-some-states-train-doctors/

Additional Resources:

Anti-Oppression Leadership Academy https://nadifantastic.com/

Black Women’s Maternal Health

https://nationalpartnership.org/report/black-womens-maternal-health/

Mandated Implicit Bias Training for Health Professionals—A Step Toward Equity in Health Care

https://jamanetwork.com/journals/jama-health-forum/fullarticle/2795358

National Institutes of Health Implicit Bias Training

Diversity Science

Teach-Back Method

https://www.ahrq.gov/patient-safety/reports/engage/interventions/teachback.html

Thriving Together: Overcoming Professional Isolation in Physician-Owned Practices

Behind many successful physician-owners lies a silent struggle: a deeply-felt sense of professional isolation.

Physician-owned practices have a profound community impact by fostering personalized patient care, promoting local economic growth, and preserving a sense of familiarity and trust within their community. Unlike a hospital or larger practice where social contact and networking is practically built-in, owning a practice, or any business, can feel quite isolating. As a physician-owner, your team is likely made up of just you, possibly a small handful of other providers, and your clinical support and administrative teams. 

If you’ve been following our blog, listening to our Podcast or have attended our roundtables, you won’t be surprised to learn: isolation and loneliness are major contributors to physician burnout. Over 70% of physicians who attempt suicide are solo providers. We know it’s not healthy to live in isolation. This data seems to support our thesis that there is an urgent need for providers, particularly physician-owners, to actively seek and nurture relationships to help avoid feelings of isolation, and to feel supported professionally.*

It’s important to choose the kinds of social and professional relationships in which you want to invest your most precious resources - your time and energy. This blogpost will explore different ways to expand your professional support network. 

First things first: Get clear about the amount of time and energy that you are willing to invest in building relationships. Also ask yourself what kind of relationships and support you would like. Getting clear about what you want and need most will help you find the right kind of support, and it’ll save you a ton of energy in your search. Once you’ve established what will serve your needs, then you can consider what contribution you’ll make. 

Do you prefer individualized support, or group networking opportunities? Be honest, and do your best not to censor or judge yourself. If you’re currently lacking in “extra” time and energy, make sure you honor that. 

If you’d like to broaden your options and be part of a networking or professional group, how much time and energy are you willing to invest in integrating, building and nurturing those relationships? There’s no wrong answer, and that can change over time.

Next, identify what is missing and what you’d like most from a professional network. 

Do you crave the guidance of an experienced mentor who can share their experience so you can learn faster than on your own? 

Are you looking to expand your network and connect with other providers in your speciality? 

Do you prefer the convenience of an online community that provides flexibility and direct access to peers?

Are you interested in serving on an advisory board or committee?

Whatever you choose, make sure you’re crystal clear about what would serve you best, and if you’re joining a community or a board, make note of what you bring to the table. The key here is to be clear about your needs first. Yes, I’m recommending that you take the “WIFM” (What’s In It For Me?) approach to expanding your network. 

Building relationships is like constructing a bridge to professional fulfillment. Without bridges, vast chasms stand between us and our goals, leaving us stranded on one side, longing for progress. Similarly, by actively seeking and nurturing relationships, we build bridges that connect us to opportunities, resources, and a supportive community. These bridges enable us to cross over from isolation to fulfillment, ultimately reaching our professional aspirations.

There are various avenues to network with other physician-owners. Networking can offer opportunities for collaboration, sharing best practices, and building professional relationships. 

Below are some ways you can network with your peers:

• Medical conferences and seminars: Attend medical conferences, seminars, and workshops focused on your speciality or healthcare management. These events provide opportunities to meet other physician-owners, participate in panel discussions, and engage in networking sessions.

• Professional organizations and associations: Join professional organizations and associations that cater to physician-owners. 

• Online communities and forums: Participate in online communities and forums designed for physician-owners. 

• Local networking events: Attend local networking events, such as medical meetups, physician roundtables, or business networking groups. These gatherings may be organized by medical societies, healthcare institutions, or physician-led organizations.

• Referrals and introductions: Leverage your existing network to seek referrals and introductions to other physician-owners. Reach out to colleagues, mentors, or medical school alumni who may be aware of potential networking opportunities.

• Physician-led organizations: Explore joining or collaborating with physician-led organizations or groups that focus on healthcare management, practice ownership, or business development. These organizations often provide platforms for physician-owners to connect and collaborate on various initiatives.

• Social media and online platforms: Engage in social media platforms like Twitter, Facebook, and LinkedIn to connect with other physician-owners. Participate in relevant discussions, follow influential individuals or organizations, and share insights to establish connections.

• Mentorship programs: Seek out mentorship programs tailored for physician-owners. These programs pair experienced physician-owners with those seeking guidance, providing an opportunity for networking and exchange of knowledge.

• Advisory boards and committees: Serve on advisory boards or committees related to healthcare organizations, medical startups, or industry initiatives. These roles can connect you with other physician-owners who are passionate about shaping the future of healthcare.

Building meaningful relationships takes time and effort, but the benefits of a strong physician-owner network can be invaluable for minimizing isolation and maximizing your professional growth and success.

No matter what route you choose, it’s important to be very clear about the resources you’re willing to invest in building your professional network. Get clear about what you need most, then decide whether you’re looking for individualized support or an opportunity to expand your network in a group setting. From there, determine your best fit, and ultimately grow your professional network in a way that provides the right kind of support you need as a provider-owner.

Practice ownership and solo-provider practices are an incredible resource for our communities, and your patients and community need you to be at your best. Make sure you prioritize and support your wellbeing in a robust way by building your bridges and nurturing your professional relationships. 

We support provider-owners in decreasing overwhelm, taking back their time and growing their practices without sacrificing. If you would like support from a trusted professional and access to an international community of peers, schedule a strategy call with us to see if working together is a fit for you.

*If you are experiencing suicidal thoughts, contact your local emergency medical facility, or call or text your local suicide prevention number (US and Canada: Call/SMS 9-8-8). 

Charting the Course: Innovations Shaping the Future of Healthcare

The transition from college to the "real world" comes with a whirlwind of challenges, and one that often goes overlooked is the struggle to find trustworthy doctors and manage one's healthcare independently. For many young adults, this can be a daunting task, filled with uncertainties and questions. 

In a prior blog post entitled "Navigating Healthcare Challenges for Post-College Individuals: Insights and Solutions," I explored the countless difficulties that young adults face as they transition into the "Real World." Regardless of whether one is employed full-time, part-time, on contract, or freelancing, securing healthcare in the United States is challenging. The task of locating a dependable and suitable provider can often be more daunting than obtaining a healthcare plan itself.

However, companies, such as One Medical, are stepping up to make this transition smoother for the post-college generation.

Need a little background from the previous blog post before we go forth? 

Young adults might have relied on the same family doctor they've known for years. I am guilty of going to the same practice for multiple years–even when I went to college out of state. Finding a reputable doctor nearby can be a significant challenge. Additionally, factors like long wait times, rushed appointments, and a lack of personalized care can lead to a disillusioned view of the healthcare system. Especially when your schedule is now confined to a 9-5 with minimal flexibility.

However, read the full blogpost here to catch up. 

This is where companies like One Medical enter the scene, reshaping the way young adults approach their healthcare. One Medical, founded in 2007, has gained popularity for its innovative approach to primary care, making it particularly appealing to the post-college generation.

Convenience: One Medical prioritizes convenience. With their user-friendly app, it allows patients to easily schedule appointments, renew prescriptions, and access their medical records. This aligns perfectly with the tech-savvy nature of young adults–definitely beats a phone call that may result in being on hold for over 10 minutes.

Accessible Locations: One Medical has strategically placed its clinics in urban areas, making them accessible to many young adults who often reside in cities post-college. This eliminates the hassle of traveling long distances for medical care.

Mental Health Support: The post-college age can be emotionally challenging, and One Medical recognizes this. They offer comprehensive mental health support, acknowledging the importance of mental well-being. Not into the whole office visit thing? One Medical also provides Live Video Chat (24/7!). 

Transparent Pricing: Navigating insurance and healthcare costs can puzzle young adults. One Medical offers transparent pricing, helping patients understand the financial aspect of their healthcare. They also accept (most) insurance plans, which can save you the headache of finding a provider in your area.

The Future of Healthcare for Young Adults

One Medical's approach is not just about providing medical services; it's about making healthcare more manageable for the younger generation. This approach is gaining traction and could potentially set a precedent for the future of healthcare. It’s also important to acknowledge that One Medical is not the only player on the field. Many startups and healthcare providers are recognizing the unique needs of young adults and are tailoring their services to be more accessible. 

The transition to independent healthcare management after college can be intimidating, but it doesn't have to be. Companies like One Medical are redefining the healthcare experience for young adults, emphasizing convenience, personalization, and accessibility. As the healthcare landscape continues to evolve, it's crucial for the younger generation to explore these options and take charge of their health with confidence. 

If you’re a provider who would like to grow your practice and are passionate about supporting your patients, schedule a complimentary strategy call. We can help you grow your practice, recapture your time, and bring your focus back to providing the highest level of care for your patients. 

In this ever-evolving field, it's crucial to prioritize the needs of your patients in order to deliver a high standard of care. This approach not only fosters the growth of your practice but also cultivates meaningful connections.

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We are not affiliated or sponsored by One Medical or practices associated with One Medical.

In a world where healthcare can be complex, many people are drawn to simplicity and ease. One Medical is a great example of a healthcare provider that's changing the game. They focus on making things easy for patients and skip the usual insurance hassles. If more healthcare providers follow their lead, we might see a shift towards simpler, patient-friendly healthcare. This approach challenges the old way of doing things and could make healthcare better for all of us.

Navigating Healthcare Challenges for Post-College Individuals: Insights and Solutions

Transitioning from college to the professional world brings a range of new responsibilities for young adults, including managing their healthcare. Many individuals encounter difficulties accessing appropriate healthcare services, particularly in finding OB/GYNs, primary care doctors, and affordable care options. 

In a perfect world, national healthcare plans would not be dependent upon employment or income; however, in America that is not the case. By sharing the challenges young adults/post-graduates face once stepping out of the cocoon of schooling, we hope to share the importance of affordable and accessible healthcare. 

By discussing issues such as pap smears, cost, finding an appropriate healthcare provider for individual needs, and how to navigate health insurance in the ever-growing freelance age, we aim to shed light on only a few challenges faced by post-college individuals and offer insights and solutions to navigate these obstacles effectively. 

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The Pap Smear Conundrum: Breaking the Silence

Young women often find themselves at a loss when it comes to pap smears, a vital screening for cervical cancer detection.

Inadequate knowledge about pap smears and the appropriate age to start getting them leads many young females to overlook this crucial test. The silence surrounding this topic in health courses and the lack of discussion by primary care providers leave them in the dark, unaware of the importance of early detection. 

A lot of females, like myself, find themselves sitting in the physician's room at twenty-two or twenty-three years old being told they are late with getting their first Pap smear. How could any of us be “late” when we didn’t know twenty-one was the age to begin getting routine Pap smears every few years? 

Moreover, primary care providers have a responsibility to proactively discuss pap smears with their young female patients. By initiating these conversations and providing clear guidance on when to start screenings, healthcare professionals can ensure that no woman falls through the cracks and misses out on necessary preventive care.

Breaking the silence surrounding the pap smear conundrum is essential for empowering young women and protecting their health. By raising awareness, promoting ongoing education, and fostering open discussions, we can ensure that every woman receives the necessary information and support to prioritize her reproductive health. 

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Understanding Abnormal Pap Smear Results

Abnormal Pap smear results can leave women feeling anxious due to unclear explanations from healthcare providers. It is imperative to seek follow-up care and further medical advice to address any potential complications. Only some providers will share that it is completely normal to receive abnormal results the first go-round. What do abnormal results even mean exactly? Abnormal results from a Pap smear mean cell changes were found in your Cervix; however, it does not necessarily mean you have cervical cancer. These changes can be minor or low-grade, and in most cases go back to normal on their own. Though, routine checks are essential for familiarizing females with their bodies and feeling confident to know when something feels off. 

The Search for Healthcare Providers

Post-college individuals frequently encounter challenges when searching for suitable primary care doctors, resulting in gaps in their healthcare management. The transition from student health services to independent care can be daunting, and navigating the healthcare landscape can be overwhelming.

The struggle to find a primary care doctor who meets their needs often leaves post-college individuals without a consistent healthcare provider. Post-college and young adult needs vary from finances, racial connection with providers, telehealth options for lack of transportation, and specialty care needs. This can lead to missed preventive care opportunities, delayed diagnoses, and fragmented healthcare experiences.

Closing these gaps in healthcare management requires proactive steps. Exploring online directories, seeking recommendations from trusted sources, and reaching out to local community health centers can help in finding suitable primary care doctors. 

In the newfound digital age, our generation relies on healthcare and insurance providers to have an online presence beyond generic search pages. Having accessible information that is easily digestible instills confidence in those who are weary about making appointments. Beyond that, more practices offering telehealth allows the younger and older generations to take appointments in the comfort of their own home. 

Building a strong patient-provider relationship is crucial for receiving comprehensive and personalized care, as well as establishing a trusted source for healthcare guidance.

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Affordable Healthcare and Birth Control Options

Access to affordable healthcare and birth control remains a significant challenge for many young women and adults, particularly those with unstable employment or inadequate insurance coverage. The cost barrier often prevents them from accessing necessary healthcare services.

It's essential to go beyond traditional birth control options like the Pill and raise awareness about alternative methods that are equally effective, available, and more affordable. From long-acting reversible contraceptives like IUDs and implants to barrier methods like condoms, there are various options to consider based on individual needs and preferences.

Addressing the affordability issue requires a comprehensive approach. Advocacy for accessible healthcare services, including reproductive health, can help ensure that young individuals can access affordable care and necessary birth control methods. Public education campaigns, insurance coverage expansion, and increased availability of low-cost or free clinics are key steps toward bridging the affordability gap.

No person should be denied access to essential, high-quality healthcare due to financial constraints. By acknowledging the cost barrier and promoting awareness about affordable birth control options, we can work toward a more inclusive healthcare system that provides equitable access to reproductive healthcare for all.

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Insurance Challenges in the Freelance Economy

In the growing freelance and contract work landscape, obtaining affordable and comprehensive health insurance coverage has become a luxury for many individuals. The absence of employer-provided benefits poses unique challenges, leaving freelancers to navigate the complex world of insurance on their own.

Fortunately, there are alternative options available for freelancers to explore. Professional organizations may offer group health insurance plans or resources to help freelancers find more affordable coverage. 

By sharing information about these alternative options, freelancers and others can gain a better understanding of the resources available to them. Accessing affordable healthcare should not be a privilege limited to those with traditional employment. It is important to advocate for policies and initiatives that address the insurance challenges faced by those who lack full-time positions and ensure they have access to the coverage they deserve.

In the freelance economy, insurance challenges are real, but solutions exist. A few places to begin are with the Affordable Care Act, also known as Obama Care, HealthCare.Gov which offers a lot of options for those who are self-employed, and COBRA offers affordable healthcare options to those as well. The majority of self-employed, government-assisted plans are accepted by providers.

Post-college individuals face a multitude of challenges when it comes to accessing general healthcare, understanding their options, and managing their reproductive health. By empowering individuals to advocate for their healthcare needs, we can work towards a more inclusive and supportive healthcare system. 

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In the grand scheme of everything, healthcare providers are pivotal in advancing accessible care by advocating for policies and practices promoting inclusivity and affordable options. Providers can become allies to help ensure accessible healthcare for all. 

For providers looking to engage in advocacy, there are resources available to support their efforts. One example is the "Healthcare Advocacy and Policy" program offered by the National Healthcare Advocacy and Communication Association (NHACA). This program equips healthcare professionals with the knowledge and tools needed to advocate effectively for accessible care at local, regional, and national levels. 

If you’re a provider who would like to grow your practice without overworking, and you’re passionate about supporting your patients, schedule a complimentary strategy call. We can help you grow your practice, recapture your time, and bring your focus back to providing the highest level of care for your patients. 

Together, we can ensure that every human has access to the healthcare they deserve, regardless of their age, insurance coverage, or employment status.

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WE NEED YOUR EXPERTISE

At Tracy Cherpeski International, we are writing a white paper for provider-owners to address the challenges of being a provider and business owner, specifically the challenges of juggling administrative and clinical duties with patient care. We are interviewing 100 practice owners for our research.

We appreciate you sharing your time with us to support our research. Our working thesis is that current research about providers is limited at best, and often does not address the challenges and needs of practice owners. 

We will use the results of our survey to write a white paper that will benefit practice owners and their teams from a business operations perspective. We will be delighted to share the white paper with you when it is completed.

3 Ways to Increase Staff Retention in Your Healthcare Business

“Good help is hard to find.”  

“The labor market is terrible.”

“I’m worried we’ll never find good people.” 

“This generation doesn’t value hard work.”

I often hear this early-on from my clients. 

The medical and dental field is fast-paced, and being the practice leader requires a lot of you, maybe even some kind of “super human” capabilities, which I hope you know is an unrealistic expectation. 

The solution is simple, but not necessarily easy, and will require you to gain clarity, learn to let go of some control, and trust that when you step into your CEO shoes, you will get the results you desire.

With turnover rates high, 26% in healthcare in 2022, you’re challenged with hiring well, training, providing sufficient support to your team, and creating a healthy workplace. You also have the pleasure of being the team lead, even if your practice manager is in charge of hiring, firing and training.

Some of the primary reasons for turnover are: 

• Staff is overworked 

• Work environment is stressful

• Lack of decision-making power

• Lack of recognition and direction from the top

I’m going to focus on the last reason, lack of recognition and direction from the top. I assure that you all are important, though in my experience in my 12 years of coaching and consulting clients, focusing on one area can often be supportive in addressing other sticky areas in need of attention. 

Here are 3 ways to increase employee retention:

1. Get clear about what you want for your practice. Look at the big picture and all the details. If my clients haven’t done this yet, we spend a day together in a VIP intensive to comb over the details, operational flows, wish lists and goals. With this clarity, we’re able to start working on updating, or in some cases, writing drafts of the operations and training manuals (what I lovingly refer to as the “office bibles”). 

   Once we’ve done this, we start to plan how they’ll communicate their mission, vision and expectations. 

2. Communicate your vision with your team. When I was a manager in a luxury health club, every employee was expected to know the company mission and values statements, and we were informed that we could be visited by secret shoppers at any time, so we needed to be ready to recite them. We were taught to embody, practice and consistently demonstrate the company values. As a result, our clients were genuinely happy, and the staff turnover at the location where I worked was low compared with the rest of the industry. 

   As employees, we knew what was expected of us and how to do our jobs. Job descriptions and company policies and procedures were crystal clear. As a new hire, I spent three days in their corporate headquarters in hands-on training, and was offered unlimited and unchallenged support for any questions or uncertainties that might arise. In short, I knew exactly what they wanted from me in my role, and how to meet and exceed their expectations.

3. Follow up like the wellbeing of your practice and team depend on it, because they do. Keep the lines of communication open. Trust but verify. Make sure your employees are empowered and sufficiently supported to do their jobs. Let go of control as much as possible, AND, check in with them regularly.

   I recommend that you bookend each day with a morning huddle and an evening debrief. These should last no longer than 10 minutes each, and ideally you ask questions and listen while your practice manager documents the details. You will follow-up in your weekly manager meeting. If there is a need for more staff follow-up, your practice manager can handle that.
   

One of my clients is a provider and owner of a practice with 10 providers, 10 technologists and 5 administrative professionals in two offices; the providers and practice manager work remotely. The practice more than doubled in patient demand, number of providers and technologists over a two year period. By any standard, this is huge growth in a short period of time. When we started working together, the turnover at the practice was well below industry average, at less than 10% turnover for several years. However, morale was dipping and frustrations were mounting.

My client was concerned about how this would impact the practice overall, and wanted to get a handle on it. I conducted several interviews with their team at all levels and length of tenure. I learned that every person who worked at the practice held the owner in the highest regard, and they all expressed they felt they were lacking direction, and some of the administrative team felt underappreciated and overworked.

I reviewed the interview results with my client and their practice manager, and before we set to work writing operations and training manuals, we got back to basics. 

We re-visited the practice mission and values, and put those in writing. Then, in collaboration with department heads, they updated their manuals. Once they had good working drafts (I recommend that these are living documents, to be adjusted incrementally over time), we planned implementation. They started having shorter, more frequent meetings for each department, and full-practice meetings. After a few months, my client told me it seemed like everyone had breathed a sigh of relief. The practice continues to be incredibly busy, and yet morale is at an all-time high. They have had zero turnover in the last year. 

Notice that morale is at an all-time high, and they didn’t put ping pong tables or snacks in the break rooms or go on fancy trips. They got clear about their mission and expectations, communicated them clearly with the team, and implemented a system for followup and quick resolution for issues that arise.

If you want to have a happy, engaged team, you don’t have to get fancy or complicated. Get clear. Communicate. Follow-up. Rinse, repeat.

If you would like support in improving morale and retention, schedule a complimentary Practice Assessment Strategy session. We help our clients navigate the challenges of being a provider-owner by taking back their time and finding the right strategy to grow their practice without burning out. 

We’d be honored to explore what’s possible for you and your team. 

Why Time Management Doesn't Work, and What You Can Do About It

Photo by Nick Morrison on Unsplash

Time is the one thing all humans have same amount of each day, unlike money, energy and abilities. I’ve yet to have any clients who use their allotted time the exact same way, but what I’ve witnessed over the years is something my happiest clients have in common, and it’s not how they “manage” their time. It’s how they lead their time.

Does any of this sound familiar to you?

You’re successful, AND you feel trapped by your success.

You feel like you never have enough time. You’re wearing multiple hats as the business owner, chief strategist, team leader, fire-putter-outer, and all-around “it” person in your business. You have a team, and they’re great, yet, you still find yourself doing so many things that monopolize your time and zap your energy. 

You wonder if you made a mistake unplugging from the system you left behind, because maybe after all, it would be easier to go back to working for someone else. You may even be wondering if you’re cut-out to achieve the success and freedom you crave.

You are not alone. Many business owners tell us a version of your story when they come to us: 

• They’re overworked.

• They’ve become disillusioned with being in business for themselves and are considering going back to work for a different organization (the VERY THING they left due to burnout and other frustrations!)

• They’re not experiencing the time and financial freedom they envisioned when they started their business.

Will it get better? Yes!

Imagine if you could gain control of your schedule. Picture working only on tasks that are directly related to strategic business priorities and providing excellent customer care. 

What would you accomplish if you were able to block time for research, writing and publishing; speaking and teaching; and advancing your status as an expert in your area of speciality? 

How about the practical stuff? Eat lunch every day. Leave on time every day.  

Envision your team as happy, proactive, engaged and committed to your values and vision. They’re looking for ways to support growing your business and serving more clients or customers with the highest level of attention and care. They understand the value of your time, and they appreciate your commitment to honoring their time as well as your own.  

You may have been wondering how it’s possible to create this kind of utopia, especially if you currently feel like your business could swallow you whole at any given moment. 

Fear not. With some analysis and adjustments to how you structure your time, your mindset about what’s required of you to run a successful business, and how you view time itself, you can make this beautiful picture a reality. 

Start with understanding the importance of the three pillars of Time Leadership: 

1. Discovery

2. Analysis

3. Action

In the first pillar, Discovery, you examine what is most important to you. Do not skip this step. Write it all down. What are your values? What do you really want? Is it time with your family, leisure time, start another business, pursue a hobby, travel the world? Get really clear about what you want for your business and for your life. Write it all down until you have no answers left to the question: What do you really want?

Next pillar, Analysis, is where you comb over how you use your time. Write down every single task, meeting, water cooler chat and everything in-between. Now assign a monetary value to every half hour block of time. This is tedious, but it’s also eye-opening. How much money are you costing your business doing tasks better suited to others on your team? 

If you’re slightly horrified, good. Then you’re ready to take action.

The third pillar, Action, is where a lot of business owners and entrepreneurs want to start, but without clarity, will run in circles, exhausting themselves and costing their businesses dearly. I always recommend my clients start with one or two areas to take action for a while. Don’t flip your business model or your calendar on its head. You’ll regret that. Focus on 1-2 actionable items that are relatively easy or simple to implement. Once you’ve gained momentum, you can work on more changes.

This is just the surface of Time Leadership, but once you start here, you can start to get a feel for how to think and act as the leader of your time and of your organization. 

Time Management implies controlling and getting as much done as possible, whereas Time Leadership is about guiding your attention and focus to the things that are most important.

If you’ve found that time management tactics aren’t working, then it’s time to go back to the drawing board, get clear, craft your strategy, and THEN implement your tactics. Remember that tactics without strategy will not get you where you want to be. Strategy without tactics, ditto. But start with a clear strategy and simple tactics, and you’ll build momentum. Momentum is your friend, so long as you’re taking inspired action and know the direction you want to head.

Think about jump starting a stick shift car. If you’ve ever done this, you know what I’m about to tell you. The key to getting the engine started is momentum. The biggest hurdle is to get the car moving. The first few steps are a total bugbear, but then you’re moving. Once the car starts to move, you can walk faster and eventually start running. Once you’re running, you jump in, put the car in gear and drop the clutch. The car will magically start. Entrepreneurship is kind of like this. Slowing down in order to speed up, and deciding to start thinking like the leader you are, by prioritizing and assigning monetary value to your TIME will help move you in the right direction, and will alleviate a whole lot of the overwhelm and stress of running a business. 

Let’s review and remember the 3 pillars of Time Leadership:
Discovery - what do you really want?

Analysis - how much is your time worth, how much do you cost your business, and how much are you leaving on the table performing tasks better suited to your team or outsourced?

(Inspired) Action - What’s the next best step? What is one thing I can get done right now that has high value and contributes positively to the bottom line?

Remember that time management without a strategy, meaning clarity and vision, is like getting in your car without putting a destination into your chosen map or GPS. Going for a random drive is cute, but if you really want to get somewhere in a certain amount of time, you’d best provide those inputs. 

Time leadership is about directing your time and energy to the important tasks that help you grow your business and make money. Contrary to what many business owners think, not everything is a fire to be put out immediately. Being clear about what’s most important will save you time, money and effort, which will enhance your fulfillment and impact. 

That’s all I’ve got for you today. Make sure to take notes, and please do take a moment to write a review and share this podcast with fellow entrepreneurs so they can also learn with us. Entrepreneurship can feel like an isolated island, so the more we can come together, the more supported we feel.

I’d like to leave you with a quote:

Time is the coin of your life. It is the only coin you have, and only you can determine how it will be spent. Be careful lest you let other people spend it for you.     

 - Carl Sandburg

If you are a physician or practitioner practice owner, schedule your complimentary strategy session to learn how to take back your time and energy while growing and scaling your practice.