The Five Playbooks to Create and Sustain Your Championship Medical Practice

We tend to forget that sports are big business—until the next professional athlete signs a $100 million contract or there is a debate over a city investing hundreds of millions of dollars to build a venue to attract a professional team.

Even more, we forget that business, although serious, also can be seen as a sport. What would it be like if you ran your medical practice as if it were a sports team? What could the advantages be, and how could it make a difference in positivity, productivity, and—most importantly—profitability?

This article offers five playbooks that can make up your championship medical practice game plan:

• Playbook 1: Championship Communication;

• Playbook 2: Championship Strategy;

• Playbook 3: Championship Personnel;

• Playbook 4: Championship Leadership and Teamwork; and

• Playbook 5: Championship Execution.

Let’s look at what’s included in each playbook, and you can decide which areas you need to focus on to move toward becoming a championship medical practice. At the end of each playbook, you will have a chance to assess the current status of your practice. Each playbook includes a number of components. Your practice will be better at some than others. Give an overall value to the concept as it applies to your practice in that category.

Playbook 1: Championship Communication

Every company or healthcare provider I’ve ever worked with has complained about communication in one form or another. You’d probably agree that communication can always get better. You’ve probably even had conversations between your clinical and administrative staff on communication issues, trying to identify areas that could be improved.

This will never end. The best you can do is to continue to be diligent in defining the communication challenges as specifically as possible so that you can refine communication for constant improvement.

Three areas of your practice should be evaluated when it comes to communication:

• IT communication: This is about your hardware and software technology. How is it functioning? Is it up to date? Does it allow for the effective flow of communication between your hardware and workstations and remote devices such as smartphones?

• Process and flow of communication: Are the right messages getting to the right people at the right time? What systems have you put in place to define who needs to know what information and when? Is it working to the level you’d like?

• Interpersonal communication: Is communication among people working in your practice positive and productive? Is it civil, or does it create confrontation and conflict? Is it direct and candid or passive-aggressive? Does it build trust and foster teamwork or create and reinforce silos and workarounds?

Playbook 1: Championship Communication Assessment

(Rebuild Required) 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 (Championship Quality)

Playbook 2: Championship Strategy

When personnel for all 30 major league baseball teams or all 32 National Football League teams (or any other sports league, for that matter) arrive at training camp to begin their seasons, every athlete, coach, administrative person, and part-time employee knows the vision for that team. It is to win the championship. For football it’s the Super Bowl, and for baseball it’s the World Series.

Each team also has a strategy to achieve that vision. As you probably are aware, some teams go into training camp confident they are a serious contender for the championship that season. Others know their strategy is to build toward fulfilling that championship vision a few years down the road.

In 2015 the Kansas City Royals won the World Series. It had been 30 years since the team last won, in 1985. The team’s general manager, Dayton Moore, had been hired mid-season in 2006. In his book More than a Season: Building a Championship Culture, Moore wrote, “based on where we were at in 2006, if everything went perfectly . . . it would take us eight to 10 years to be in a position to reach the World Series.”(1)

But that was the vision from day one for Moore and the Royals team he was brought in to rebuild. Communicating that vision with transparency gave the organization laser-like focus. In 2014, Moore’s eighth year leading the team, the Royals reached the World Series and lost—before returning in 2015 to win in year nine.

Having a championship game vision is key to a medical practice’s strategy. It provides inspiration that creates the aspiration that leads to motivation. What is yours?

Included in Playbook 2 also are your practice’s mission, values, and principles, and its purpose. These create the foundation upon which you will base decisions on patient service, what your practice will do and what it won’t.

So the question to ask for this playbook is, “What is your practice’s World Series or Super Bowl, and how can you define your championship game vision?”

Playbook 2: Championship Strategy Assessment

(Rebuild Required) 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 (Championship Quality)

Playbook 3: Championship Personnel

Playbook 3 is one in which you invest a lot of time. This is all about recruiting, retaining, and replacing your team members. It’s about getting the right people in the right environment so you can get the right results.

Sports teams invest significant amounts of resources in this playbook. Medical practices do not need to invest more resources here, but they do need to invest in better resources and make smarter decisions in this playbook.

What is your process for evaluating talent prior to hiring, and how much time do you invest in hiring the right people? The five categories that must be evaluated are skills, knowledge, attitude, talent, and education and experience (SKATE).

You probably have some tool similar to this. What you most likely do not have is the next part of the SKATE hiring process: a “must versus should” assessment. Most medical practices skip this assessment when defining the job criteria, or confuse the two, or do not clearly define the ideal criteria for each category.

Recently, one of our clients was looking to hire an inside administrative support person. When I facilitated the process, the practice manager proclaimed that one of the requirements under “attitude” was the person must be willing to learn and grow.

I asked, “Do you want someone who is ‘willing’ to learn and grow, or someone who has a ‘desire’ to learn and grow?”

She said, ”Oh, of course, a desire would be better than just being willing.”

I said, “Right, and would you rather have someone who has ‘desire’ to learn and grow or someone who has a ‘drive’ to learn and grow?”

She jumped on that and said, “Yes, a drive would be even better, that way the person would be coming to me.”

For this hire, the “must” criterion is “a drive to learn and grow in the industry.” The “should” became a “desire or willingness to learn and grow.”

Within six weeks this practice hired a young woman, 21 years old, who is picking up her training at an accelerated rate, is proactive in applying what she’s learning, and is asking questions about learning things she notices are gaps in her training and that she feels confident she can help with.

For each job for which you are hiring you need to have absolute clarity on your “must” job requirements. Too many hiring processes ignore this, and personnel are brought into the organization without the “musts” and with too many “shoulds.”

The power of this distinction is that when you are clear on the “must,” the “should” comes off the board, because it becomes irrelevant, creating absolute clarity on the type of person you must look for. Because if there is a “must” on the board, you are not going to settle for a “should.” Otherwise the “must” is not a “must.”

Once you use the SKATE must/should hiring criteria to hire the right team player, then it’s on to building a performance management system that effectively and consistently improves individual and organizational performance.

Athletes have their performance managed on a daily basis. They get feedback all the time. There are statistics on the scoreboard in the arena, there is a box score in the newspaper the next day, and coaches evaluate them after every game or practice.

How often are your employees involved in performance dialogues? If your medical practice is like most, the answer is “never.” Performance feedback monologues may be delivered once or twice a year, though, and most practice managers tell me they are ineffective.

A good performance management process effectively evaluates the employees’ strengths that they contribute to the operation along with the opportunities for short-term development and growth. Once those are agreed to between a team member and his or her supervisor, the opportunities are prioritized and developed into aspirations to move toward over a 90-day period.

The process my clients work on is called the SOAR (strengths, opportunities, aspirations, results) assessment, which comes with a Position Accountability and Results Scorecard (PARS) for tracking progress.

To make your performance management processes more effective, evaluate it against this standard by asking the following question: “Is your performance management process consistently improving individual and organizational performance?”

If the answer is “no,” it’s time to implement a new process to create a medical practice full of championship personnel.

Playbook 3: Championship Personnel Assessment

(Rebuild Required) 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 (Championship Quality)

Playbook 4: Championship Leadership and Teamwork

Recently, I was exploring issues in their company with a prospective client. Over lunch she said to me, “We need to get our people more engaged in teamwork.”

I asked, “Is ‘teamwork’ a part of your employees’ performance expectations, and do you have incentives aligned to support and reinforce teamwork?”

She looked at me as if I had shined a light on a concept that surprised her. It was a revelation to her.

In most businesses, including medical practices, it is assumed that teamwork will just happen, yet silos and information control issues continue to exist even in the smallest work environments.

This is due to two reasons:

1. Incentives, consciously designed or, more often, not, typically are set up in a way that reinforces people working to cover their own area of responsibility first and foremost.

2. “Teamwork” and “collaboration” are not typically emphasized enough in job descriptions and performance review processes (see Playbook 3, earlier in this article).

For those reasons, one of the biggest complaints I hear from medical practice managers and other small business leaders is that their employees do not engage in teamwork, nor do they step up to leadership roles, either formally or informally.

One of the most successful leaders in the history of professional sports, Mark Messier, the only player to captain two different National Hockey League teams to Stanley Cup Championships, has said, “ . . . a championship culture inspires a leadership culture where everyone is a leader in his own way.”(2)

If you’d like to create a championship workplace culture like the one Messier speaks about, where employees aspire to lead in their own way, and step up to lead projects, people, and departments, it is important that the first three playbooks are implemented and consistently executed. The first three playbooks you read about here will create a work environment where championship culture is easy to manifest.

That’s because you will have created a high-trust work environment. In high-trust workplaces, employees aspire to leadership roles and enjoy collaborating and teamwork with coworkers because they feel good about the environment and want to contribute to make it even better. Without that foundation, people will hunker down into self-protection survival mode with a CYA (cover your a-) mindset.

There are four things you can do to nurture teamwork and leadership at your medical practice:

1. Make “teamwork” a job expectation that is clearly defined in all job descriptions where you need it, and make sure it is part of how employees are evaluated. What gets measured gets done.

2. Create incentives that reward teamwork (e.g., create goals that require teamwork with cross-department metrics, and reward everyone involved with the initiative equitably).

3. Delegate opportunities for staff members to lead projects to nurture their abilities as leaders (remember that delegation is not abdication and they will need monitoring and coaching for development).

4. Provide other opportunities for leadership training and development so that you build “bench strength” to create a staff “depth chart” for succession when the need arises.

Playbook 4 - Championship Leadership and Teamwork Assessment

(Rebuild Required) 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 (Championship Quality)

Playbook 5: Championship Execution

At a seminar I hosted recently, an attendee said to me, “These strategies are not exclusive to just teams that win championships; all teams do this. So how do you explain the difference between the winners and losers?”

What a great question that was for me. It challenged me to turn on the skills I learned in my improv comedy training, and I said, “Well, of course all teams follow these strategies, so I guess the difference is in the execution.”

And everyone in the seminar seemed to agree.

The strategies and concepts in the first four playbooks aren’t anything you don’t already know. As you read through the sections above you probably found yourself acknowledging the strategies you know and are not executing to the level you could and should.

“‘Failure to execute’ is one of the biggest problems in organizations today,” Brian Tracy wrote in Eat That Frog.(3) “Many people confuse activity with accomplishment. They talk continually, hold endless meetings and make wonderful plans but in the final analysis, no one does the job or gets the results required.”

At the end of the day—or the season, in this metaphor—it’s the execution that separates losing teams from winning teams, winning teams from playoff teams, and playoff teams from the champions.

Playbook 5: Championship Execution Assessment

(Rebuild Required) 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 (Championship Quality)

Conclusion

The strategies and tactics outlined above are the fundamentals of any business operation. Consistently executing the fundamentals is what wins championships, because champions don’t necessarily do extraordinary things, but champions always do fundamental things extraordinarily well.

Toward that end, here are some questions you can use in addition to the Playbook Scorecards to evaluate your medical practice:

• Are you executing on the strategies in playbooks 1 to 4 at a level that will have your medical practice performing like a champion?

• If not, which playbooks are you executing at a high level?

• Which playbooks should you be executing better?

• If you were to execute one of the playbooks better, which would you choose?

• If you were to execute on that playbook better, how would it make a difference for your medical practice?

• Is communication among people working in your practice positive and productive? Is it civil or does it create confrontation and conflict? Is it direct and candid or passive-aggressive? Does it build trust and foster teamwork or create and reinforce silos and workarounds?

References

1. Moore D. More than a Season: Building a Championship Culture. Chicago, IL: Triumph Books; 2016.

2. Mark Messier and the attributes of leadership. Ivey.com . www.ivey.uwo.ca/news/news-ivey/2015/1/mark-messier-and-the-attributes-of-leadership/ . Accessed May 2. 2018

3. Tracy B. Eat That Frog. San Francisco: Berrett-Koehler Publishers, Inc.; 2001.

Highlights of the Five Playbooks

Playbook 1: Championship Communication Assessment

• IT communication: This is about your hardware and software technology. How is it functioning? Is it up to date? Does it allow for the effective flow of communication between your hardware, and workstations, and remote devices like smartphones?

• Process and flow of communication: Are the right messages getting to the right people at the right time? What systems have you put in place to define who needs to know what information and when? Is it working to the level you’d like?

• Interpersonal communication: Is communication among people working in your practice positive and productive? Is it civil, or does it create confrontation and conflict? Is it direct and candid or passive-aggressive? Does it build trust and foster teamwork or create and reinforce silos and workarounds?

Playbook 2: Championship Strategy Assessment

• What is your practice’s World Series or Super Bowl?

• How can you define your practice’s championship game vision?

Playbook 3: Championship Personnel Assessment

• For each job for which you are hiring you need to have absolute clarity on your “musts” in the list of job requirements. Too many hiring processes ignore this, and personnel are brought into the organization without the “musts,” and with too many “shoulds.”

• The power of this distinction is that when you are clear on the “must,” the “should” comes off the board as it becomes irrelevant, creating absolute clarity about the type of person you must look for. Because if there is a “must” on the board, you are not going to settle for a “should.” If you can, the “must” is not a must.

Playbook 4: Championship Leadership and Teamwork Assessment

• Executing on the first three playbooks of The Small Business Championship Game Plan creates a work environment with a foundation of high trust.

• In high-trust workplaces, employees aspire to leadership roles and enjoy collaborating with coworkers because they feel good about the environment and want to contribute to make it even better. Without that foundation, people will hunker down into self-protection, survival mode with a CYA (cover your a-) mindset.

Playbook 5: Championship Execution Assessment

• Champions don’t necessarily do extraordinary things, but champions always do fundamental things extraordinarily well.