How can I make it so everyone on our team works towards a common goal? How do I deal with agendas, politics, poor communication, clashes in value systems, etc.?
Every practice manager is faced with these types of questions and challenges. This is not specific to a health care practice, but is present in all business groups regardless of size or scope.
Patrick Lencioni is one of the most prolific and acclaimed writers on this subject. His basic book, “The 5 Dysfunctions of a Team” is written in allegory, narrative style. It’s quite easy to read through and digest, and has become deservedly popular.
While each of the 5 dysfunctions may be present in a clinical office, I find that the trust foundation is by far the most common issue, and the most damaging. If this piece is not complete or is flawed, you will find your practice growth stymied and you will have to keep solving the same problems over and over again.
Trust has a tri-layered meaning in this context:
- Honesty, integrity
- Competence
- Completion
Honesty and integrity is the traditional meaning of being trustworthy, and certainly has an application in the business context. After all, if you doubt the word of a co-worker or employee, you’re not going to get much done. When this is the case, we see elaborate auditing systems in place and a culture of assigning blame when things go wrong.
Competence in the context of trust is not a common use of the idea, but is also critical to the trust foundation. It boils down to having the faith and confidence that a team member will have the resources, knowledge and time to execute a task or a project. When this aspect of trust is not there, we see stalled projects, excessive or inappropriate delegation or micro-management. Micro-management is essentially reverse delegation; it’s doing someone’s job for them, because you do not trust that they will do it them selves.
Completion of cycles of action is the measuring rod for the level of trust in a team. Any patient (or customer) interaction starts a series of cycles of actions, all of which must be completed in order to have a positive experience. Anything left undone will cause re-work, losses and some level of resentment. Lack of trust in this area is demonstrated by piles of to-do’s, poor organization and prioritization, things getting dropped, lost or stopped, and always being “behind”. These things can come from other sources as well, but there is almost always a lack of trust as a powerful factor.
Building higher layers of trust is crucial to your company’s health.
How can you increase the level of trust in your organization? As usual, the team will follow the leader’s example. You must make your personal organization a paragon of what you want theirs to be like. If you have not seen the surface of your desk in many a moon, you cannot expect that your staff’s desk will be free of clutter and mess. “Nobody sees my desk, and all the patients can see her desk”? You’re fooling yourself; your staff sees your desk and they know what your standards are.
Mr. Lencioni has written a recently published book entitled “The Advantage”. It’s a compilation of why a healthy organization will have a permanent competitive edge in any arena. He makes a strong case for why a healthy company will beat a smart company most of the time. Ideally, of course, we seek both, not having to be one or the other.
Smart companies are characterized by attention to strategy, finance, marketing and technology. Nothing wrong with that; we have to be excellent in these areas. This is a natural are for leaders to focus on, because most of the preceding schooling and training were in these areas to begin with. After all, don’t we want to operate out of our strengths?
Healthy companies are characterized by low politics, confusion and turnover and high morale and productivity. These features are hard to measure, can seem superfluous, and can be difficult to track down when not at a healthy level. If you think back to your own organization when things were not going smoothly, there will usually be one or more of these features that became dominant to the point of overwhelming the system.
A powerful model is to build a smart company within the shell of a healthy company. The smart company delivers your goods and services in the most cost effective, modern and technically capable way. The healthy company provides the overall environment and working conditions that lead the team members to seek excellence.
Good resources for further information: