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May, 2012

"Practice Impossible" Leadership Skills for a Thriving Clinic

By Ray Tuck, DC and K. Jeffrey Miller, DC, DABCO

We recently became interested in the television program Restaurant Impossible, a Food Network show hosted by Robert Irvine, a noted chef and restaurateur. The premise of the show is to help failing restaurants by giving them a complete makeover. The makeover is carried out by Chef Irvine, a builder and an interior designer. The catch is the makeover has to be completed in 48 hours on a budget of only $10,000.

If you follow the program for a short time, you will quickly see that the chef focuses on five factors of the restaurant business regardless of the size and type of restaurant. The five factors are: leadership, the staff, the menu, the décor and marketing. You will also realize that the methods he uses are applicable not only to the restaurant business but to any business and this is why we like the show. The chef uses many of the same business principles we have used in running successful practices and in consulting for other chiropractors. We have to note however, that our delivery would be a little softer than Chef Irvine.

This series of articles will work through these business principles from our chiropractic perspective. In part one, we focus on leadership. In the television series, most of the restaurants are locally owned, with the owner typically serving as the "manager" as well. The scenario every time is that the restaurant is losing money, the staff is upset and the customers are either dissatisfied or have left. As the chef digs in, he commonly finds the manager cannot answer many basic questions about his own restaurant. He does not know basic business statistics like: which dishes sell the best, which dishes produce the most profit, what he has in inventory or total overhead.

When it comes to the staff, he has provided minimal training, requires long hours, provides low pay and has shown very little leadership. If it is a family business, the staff suffers even more. The owners are often at odds with each other and the staff doesn't really know who's in charge as one owner says this and the other says that. A problem here is the owner is in the position of manager by default. He owns the restaurant and, consequently, he is in charge. However, this does not mean he is a leader. When Chef Irvine points this fact out the owner/manager is usually surprised and defensive and they often seem sorry they asked for help.

The hardest transition for these restaurants is usually the transformation of the owner/manager but this is also the most important. It is the same for a troubled practice. Owning a practice does not make a doctor a leader. Owning and leading are not equivalent. In his book, The E-Myth Revisited, Michael Gerber reviews this reality by saying that just because someone is a great technician does not indicate they will be a great business owner. There are key fundamentals that every business owner must know to be successful that are above and beyond technical or trade skills. Yes, owning the practice places the doctor in charge and makes him the decision maker. But, does the doctor manage well and earn the respect of the staff and patients? Are the decisions he makes appropriate, trustworthy and productive?

Does the doctor set an example, keep his word, admit fault, manage his time, manage money, notice trends, adapt to change, innovate, set goals, prioritize and market? Does the doctor have the ability to hire, communicate, motivate, educate, compensate, reward, draw boundaries, discipline or fire employees? In our experience, we find there are some specific qualities that a good leader must focus on in order to be successful in his or her chiropractic clinic. Though the list could be significantly longer, we have limited it to three qualities for review in this forum. They are: lead by example, have goals and a plan of action documented to achieve them and, grow your people and give continual feedback.

Lead by Example

In most settings, employees will follow your lead. Have you ever been to a service business and been mistreated by the staff only to realize later the manager was just like them? Conversely, have you ever noticed when you go into a business where everyone is singing and happy and the manager seems to be the biggest instigator? It's because everyone looks to their leader to emulate. Therefore, the first step in leading an office is to act exactly as you wish your staff to act. For example, the ability to keep one's word, admit fault and give credit are important characteristics of a true leader. These are many of the qualities that make a leader human. If these characteristics are present, the leader can have a strong professional relationship with the staff. Is that you?

Another example is time management. It is one of the leadership qualities most important in leading by example. The doctor must show up to work, meetings, etc. on time. It is hypocritical to expect punctuality of employees when you are not punctual. The doctor must also be punctual in the office. He must see patients in a timely manner. If the doctor expects the patients to show up and be on time, he must operate on time. The number one complaint against doctors for decades has been waiting time. In many offices, where waiting is a problem, the doctor's lack of time management is the primary issue. We often say that a staff will care as much as you do. Therefore, you must show them you care through your actions.

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