The Efficient Opthalmologist

Practice success rests on having core values

Honesty and accountability should be basic principles.

By Steven M. Silverstein, MD, FACS

Steven M. Silverstein, MD, FACS, is a corneatrained comprehensive ophthalmologist in practice at Silverstein Eye Centers in Kansas City, Mo. He invites comments. His e-mail is ssilverstein@silversteineyecenters.com.

For decades, medical practices have suffered from expensive, time-consuming, and energy-draining problems resulting from paradigm shifts in health-care delivery and reimbursement. It has been almost impossible for practices to prepare for or combat these problems. The bottom line is that change in health care is the only constant, and how that change is handled will require a huge overhaul in the way traditional medical practices are managed.

The old cliché that doctors are not like other business people and medical practices cannot be run like a business simply has to go away. A serious look at organizational culture – creating a culture in a deliberate and intentional way – is a critical step toward building a medical practice that embraces change when competitors are buckling under it. The most successful businesses know exactly who they are and not just what they do.

For some unexplained reason, most doctors have not thought that way about their businesses, but if they do, they may experience greatly enhanced patient satisfaction, loyalty and increased patient volumes. Here, I will explain why having a set of key core values can point your practice toward both financial success and a stellar reputation for your practice.

Core values are the foundation

Most medical practices are partnership arrangements with two-to-several physicians coming together to form a business. Within an industry where change and uncertainty are constant, conflict is inevitable. Partners will have to come together on how to manage change, modify systems, purchase equipment, handle HR issues and more. Even in the best of circumstances, the very nature of a medical practice is one where instability in the organization opens the door to gossip, speculation and insecurity among the staff. What will help us through these turbulent times is changing the way we think about how we run our businesses and learning from the pros in other industries.

In the book The Value of Core Values, (a must-read for all business owners), author Lisa Huetteman provides a compelling argument for institutionalizing the core values we hold as most important in our lives and work. When we intentionally derive core values, employees will begin to think differently about the practice, and partners could begin to think differently about each other.

Ms. Huetteman provides the following action steps, which I have gleaned from her book and tailored to a medical practice:

1. Figure out what your core values are – really. Rank your values with the values you consider non-negotiable at the top of the list. Keep the list in front of you for several weeks as you make decisions that determine whether you really consider these to be valid guiding principles. If you violate a value without regret, it is not a core value. Continue to reflect, review and refine until you have identified the non-negotiable principles upon which your life and medical practice are based. If you commit to this, then your commitment has to be genuine. Going backward can cause great damage and loss of credibility and integrity. No one will take this initiative seriously unless you do.

2. Determine who you really are and carefully introduce these principles to your team. The process is best accomplished through a collaborative effort involving the appropriate people on your team. I suggest you plan a retreat with a facilitator. You will have to ensure that everyone is on board and totally committed. You will have to live by these values, so take the time to define them clearly. If your values are vague, people will interpret them through their own filters – which could lead to confusion and inconsistency. It may take several sessions to figure all of this out.

3. Define your core values fully in terms of workplace behaviors. Detail specific behaviors that do and do not correspond to each. Instill them in HR policies, job descriptions, marketing, compensation, rewards arrangements and decision-making processes.

4. Examine all your systems and procedures, then make the necessary upgrades to support your values. Start with employee hiring processes. Develop procedures, interview questions and checklists that will help interviewers and others identify candidates who share your organization’s core values. Do not allow the pressure to fill positions to cause you to compromise on hiring decisions.

Frame interview questions to solicit examples of how candidates would respond in certain situations involving values. Do not simply ask them if they agree – you want people who are excited about living your values because they know it is the right thing to do, not just because they know you expect it.

5. Communicate your core values at every opportunity. The most successful companies constantly communicate organizational core values. In your practice, this could mean a patient communication piece, signage in your waiting rooms, patient satisfaction surveys that focus on how well they felt your team demonstrated core values – and how well they were valued, appreciated and served. Also employ external marketing and philanthropic opportunities.

6. Transparency is a critical success factor in improving a culture. Your team has to feel a sense of honesty and accountability in all of this. Successful businesses are led by confident leaders who welcome open, honest dialogue. If you are holding your staff accountable for representing these values, you must be held accountable as well. When all of the members of an organization are accountable to the same standards, mutual accountability becomes natural, objective and supportive. When shared values are absent, accountability can become threatening, subjective and confrontational.

External challenges can be met

Honoring core values increases employee loyalty, creates a healthy, robust culture in your office and leads to a high level of patient satisfaction – which is what grows practices. As we all brace ourselves for the financial challenges ahead, our best bet is to focus on those things we can control.

Being intentional about building, defining and refining your culture will lead to a happy team and, despite the widespread practice of job hopping in this industry, your practice will become a destination for people seeking jobs. People ultimately want to feel part of something meaningful, and the right employees will thrive in that atmosphere. It is not always about a few cents more per hour or less drive time. It is about feeling valued and knowing you are making a difference. OM