Can you define what is permanent in your medical practice? We are asking about your practice’s, nay your team’s, core principles – those that dictate the actions taken and decisions made by every employee. What are the characteristics that are embodied by each employee and resonate throughout your office?
If you are like a lot of practices, you’re drawing a blank, or perhaps making assumptions about what your values might be. Buzz words abound in the world of corporate value determination: honesty, integrity, enthusiasm, innovation, service, kindness. These are all wonderful corporate aspirations, but ask yourself, if these are your values, do they guide each employee in every decision, permeating the business culture and differentiate you from your competition?
In our quest here at YellowTelescope to get reinvigorated and grow both personally and professionally, we have been devouring Patrick Lencioni’s The Advantage: Why Organizational Health Trumps Everything in Business. We realized we could better define our core values as a growing consultancy which means it was time to read (and can’t we replace the word “read” with “grow” in nearly any sentence?). To boot, invigorated by the possibility of inspiring others to look inward, we immediately grabbed our camera, poured a delightful summer whisky, and finally recorded the long-awaited Episode 18 of the YellowTelescope YellowTelecast Best Practices for the Best Practices Podcast: Evaluating Core Values.
In this companion piece, we attempt to further our quest of applying professional concepts that show efficacy throughout the business world to our valued readership in the medical arena. Indeed, we continue to fulfill our “Why” years after outlining it in Issue #14 of our YT Newsletter, as we hope to help “motivated people reach their capacity.” Read on to learn Lencioni’s types of values, how to create your own, and how to apply them to your practice.
In The Advantage, Lencioni’s discussion of corporate values actually references an article he wrote a decade earlier for The Harvard Business Review entitled “Make Your Values Mean Something.” While highlighting the importance of corporate values, he also points out the inherent fallacy of the stated values of many organizations. Often ending up with values that are trite, contradictory, or shallow, executives can be misguided in the construction of their value statements. Though de rigueur in enterprise-level corporate culture, most medical practices haven’t even taken the step of developing values. Before doing so, to avoid costly missteps, it’s important to first define the types of values one should aspire to create.
Level 1 Value Creation – Non-Negotiable Values
Lencioni refers to the “minimum behavioral and social standards required of any employee” as the “permission-to-play values.” Perhaps this is our inner salesperson coming out, but we are partial to referring to them as “non-negotiable values.” These might seem obvious: “be honest,” “don’t steal,” “treat people fairly,” “dress appropriately,” “arrive on time,” and “have a positive attitude” all come to mind. These, among many others, are so obvious, they do not differentiate one practice from another since most practices will have similar minimum thresholds for employee behavior. Additionally, they cannot be considered core values because they won’t dictate or inspire the behavior of employees to achieve the goals of the practice.
Level 2 Value Creation – Core Values
Lencioni describes these as “deeply ingrained” values that “guide all of a company’s actions” without compromise for any reason. These are what ultimately differentiate your practice. They might stem from the doctor or other founding members of the practice. Lencioni cautions that it is an easy mistake to substitute your non-negotiable or permission-to-play values for your core values. Do not make “compassion for patients” part of your core values, for example. Unfortunately, there are practices that are not as compassionate for their patients as they should be, yet the vast majority hold patient care in the highest regard. Unless you are investing resources in patient care at a level far greater than the typical practice, you can count “compassionate patient care” among your non-negotiables, and get more creative in determining what truly sets your practice apart.
Level 3 Value Creation – Aspirational Values
Years ago, one YellowTelescope client whose successful marketing efforts yielded many more new patient consultations than the schedule could handle led to unacceptable wait times for patients (may we all be so lucky as to have a practice this successful). While disappointing and less than ideal, our tracking showed that the long wait times did not diminish sales, nor create negative reviews, nor result in patient walk-outs. In fact, there was evidence sales increased as patients booked in-office nearly every time realizing the doctor was truly in demand. The counterintuitive fact was that we realized that efficiency was not part of the practice’s core values, nor did it need to be as there were no negative side effects to the practice running late.
Despite that, as good people, good doctors, and good consultants, there was a desire to ensure superb patient service and so steps needed to be made even though profits were not going to be helped by fixing this problem. The development of new strategies to bring in fewer patients to decrease wait times while scheduling more procedures forced us to create a new aspirational value to have reasonable wait times, regardless of the impact on business. While this could be counted among the core values of many of our long-term YellowTelescope clients’ practices, it was an aspirational value for this practice to be worked on for years to come. Similarly, it is an aspiration for most practices to schedule 60-90% of patients in-office with deposit, while nearly 100% of YT practices achieve this as it is a core value of YellowTelescope to ensure our clients get these results over time.
Level 4 Value Creation – Accidental Values
Common interests among employees can spontaneously create values that managers must be careful to distinguish from core values to avoid being overly inclusive, therefore excluding new opportunities. A common example of this pitfall in cosmetic practices is hiring only those interested in being cosmetic patients. While it is easy, particularly at the genesis of the practice, to be surrounded by employees that share a passion for having cosmetic treatments, it is not sustainable as a practice grows to only hire these folks, as many of the values you need embodied in your team will often be held by those that don’t desire cosmetic procedures.
Here at YellowTelescope, a passion for the craft of distilling whiskey, and loving puns and palindromes, are accidental values we are careful not to make core values. We maintain a much broader set of criteria for hiring team members than a love of Lagavulin 16, the word “racecar” or the reality that shooting stars should be called “racestars.” We do, however, look for people who have an appreciation for goods and services thoughtfully crafted with care, and a love of the written and spoken word.
Determine then implement
Lencioni indicates that determining core values shouldn’t be about “building consensus” but more about “imposing a set of fundamental, strategically sound beliefs on a broad group of people.” Do not ask the entire office what they think the core values should be, just as you wouldn’t take a vote on any other major initiative in the practice regarding finances, HR, new services, or marketing. The doctor and ownership of the practice, along with a few top team members (the office manager and patient care coordinator, for example) should outline an initial list of non-negotiable, core, and aspirational values. Here is a list of 500 examples to get you started, and 190 more specific to well-known companies for further inspiration.
Then allow time for reflection as well as opportunities to tweak them as needed. Lencioni suggests that, like a fine wine (or in our case, whiskey), value determination takes time and shouldn’t be rushed. Start this process now as we head into fall. Have the goal of outlining your values during your end of year annual planning meeting (for tips on how to plan and execute this meeting, refer back to issue #21 of our newsletter). Perhaps go beyond the list and organize your values into a succinct, inspirational statement, as these companies have.
Make 2018 the year of your values. Find opportunities to weave your values into every facet of practice management. Keep the values posted in break rooms. Start your weekly team meetings with a review of the values, and ask employees to provide examples of implementation. Use your values as a gauge for employee performance in their semi-annual review, or even when simply discussing their vacation requests. Recognize employees who best embody your values publicly, and reinforce it with a gift or bonus.
Devote the time and energy required to remain steadfast in your defense of your core values, without compromise. The exercise of determining your values alone will illuminate what is lacking in your practice, and provide structure to remedy the deficiency. For additional guidance on managing your practice culture and implementing your values, contact us at firstname.lastname@example.org.