0:00:02 - Mark Henderson Leary

Welcome to Practice Freedom. What if you could hang out with owners and founders from all sorts of healthcare private practices, having rich conversations about their successes and their failures, and then take an insight or two to inspire your own growth? Each week on Practice Freedom, we take an in-depth look at how to get the most out of both the clinical side and the business side of the practice, get the most out of your people and, most of all, how to live the healthy life that you deserve. I'm Mark Henderson Leary. I'm a business coach and an entrepreneurial operating system implementer. I have a passion that everyone should feel in control of their life, and so what I do is I help you get control of your business. Part of how I do that is by letting you listen in on these conversations in order to make the biggest impact in your practice and, ultimately, live your best life. Let's get started. 

Welcome back, practice leaders. Welcome back to another mini quick hit. I think it's a bit quick. I say that a lot and I never know whether I'm going to end quickly or not. This is a topic that is so I don't know, misunderstood In the last couple of conversations I've had in the last couple of weeks well, actually two. 

Today, a lot of what came up was around what you might call data I will say focused outcomes, and really the theme of this is giving people numbers. In EOS we would call this measurables part of the data component, and I think the essence of this. Well, one of the things that happens in implementing a tool system or a system of tools into a business is a lot of the things we do are very rich in their impact and it's better to just do them than to get too wrapped around the axle on why they work and what they do, because sometimes there's one thing that does a lot and this is one of those things. We say, like we got to give everybody in your organization at least one number, one, two or three numbers on a weekly basis that tell them what a good job or enough or something qualitative about their work. That really is most important. And you know there's the first thing that has to happen, because there's a lot of context on this. But before we go in, I'm going to dive into that, but I want it before we get in, I want to remind you, if you're stuck in this process, if you don't know what's going on, if you don't understand what I'm saying and you really want to have that great high value culture, high performance, high accountability, where everybody feels like they're part of a great culture, really helps patients or your clients or whomever perform at the highest level and gets that maximum bang for the buck buck. It gives you the life you deserve as a leader and your stock. Please reach out. I want to help. I truly do. Practicefreedomcom slash schedule. Get some time We'll talk about it. Back to this idea. 

So one of the things that really inspired this was this conversation really about revenue cycle and talking to Matt about that. He really was pointing to this thing that he sees in revenue cycle of there's the people who are doing this work have 14 jobs or 10 objectives, and I see this in all positions in all businesses. All the leadership teams that show up in my session room or I show up in their room where we're working with them. The number one thing across all leaders that we want out of the work we do together is role clarity. We got all these willing, capable people doing so many different things and in every organization there is always still a need to have multiple hats and jump in where necessary. But that good intent over time always creates this absolute muddiness of what is most important. There's a thousand things I could be doing and they all feel so urgent and so building this discipline of, well, what actually does matter the most. Well, that's one of the things we pull through. 

What are the numbers? If this function, this role, this process, which? All those are great questions. If we're thinking about an individual, we've got to ask that question. We think about a process, we've got to ask the same question Is the process too complicated? Do we have too many people? What matters most? What do we need to measure? And if we've got people in our process, people in the roles who have 10 things that they do sometimes, what kind of results are you going to get? You're going to get confused, inconsistent, intermittent results, a little bit of everything, not a lot of what matters most. And so when I say you've got to figure out what the one, two or three numbers are for this individual arm, the first thing you have to start doing is saying well, what do they do? That's most important. And if you have 10 numbers, then that's a signal that you've not done the work to get clear on the most important part of their work, and so that's the first benefit of that. The second benefit of that, of course, is getting them some clarity and the opportunity to understand, first of all, know, oh, that's what's most important, that's what we need to do. Let them focus their energy on what's going to get them rewarded in recognition terms, or sometimes monetary terms, which I don't recommend you. Go there first. If ever, I think it's most important to give a clear measure of what winning looks like. Talk about compensation on another day, and so how does this work? 

I mean, there's lots of stories, but I remember the very first time I experienced this I tell the story a lot as a grocery store clerk in college. There was only a couple of things I knew that were important, and the first thing was to not lose money in the cash register because you had to turn in the right amount of money that matched that number at the register tape, and getting that right was important. If you did that wrong too many times, you were fired and like $5 mattered. Of course that was known, but that was kind of binary to get it right or not. But the one thing that wasn't binary was items per minute. Now I don't in retrospect, this was a high volume grocery store, so I think it really did matter. They had to move people through. The faster they moved people through, the more money they made. And if they could get that six to seven person deep line to move faster, they made more money. And if because I'm, I can imagine you walk into the grocery store and it's 10 people deep like you might turn around. 

So really the number one most important thing in their mind which does not seem crazy at all to me was really, more than anything, it's in Boston, right, do they? You have to be nice. No, that is not important. Customer satisfaction not important at all. Damaging the groceries not important. What's important? Speed, items per minute. 

And so every day at the end of my shift with that register tape would come up and one of the numbers on there was that items per minute. And, man, I took that so seriously. If for no other reason, that was the only feedback I got. So it wasn't exactly I was not sitting down and mentoring conversations with the grocery store manager. Oh, mark, we really see you moving up in the grocery checker hierarchy here. You can be the lead checker sometime soon and we got a real career path unfolding for you. I was like be on time. If you're going to exchange shifts, please make sure that the person who switches with you is on time. And that was it. So that was how I, as a performer, as an achiever, increased my performance Truly, and I committed to it. 

And I was double overhand technique, going crazy boop, boop, boop, boop, boop, just really cranking them in. And those customers were like what's going on? I can't even see what you're checking. Are those even my groceries? What are you doing? And they would freak out. And I was like that is not my problem. My problem is I want to get that 60 items per minute or a hundred months per minute, whatever that goal we had this time. This is a slightly different story, but it was a good story. 

On what matters most, we had a few people on the support desk and they were answering those first and second line questions about broken computer stuff and the ticket queue was really getting higher and higher and clients were getting more and more frustrated with it, how slow tickets were being resolved. And I had come to the conclusion that we had two people on the support desk who were just not right people for the job and they were not as effective. And I mean, there's a couple of things that come together in this, but one of the things that came to mind was I thought I had said something kind of offhandly to the service manager. I said, you know, I wonder if having these people on the desk isn't creating more problems than solving. And I didn't really think that through. But as they left, because what we were wrestling with was, you know, we had to hire two people and it was just a long cycle I didn't know if we could do it and we were going to let two people go and have two people down. But that moment I was like, wait, these people might actually be making more problems than they're solving. So if that's the case, then why don't we just take them off entirely and relieve ourselves of the burden of trying to fix that? And so we did. 

And we rallied around a goal with bringing one person because we knew we could get one person quickly rallied around one number and that was getting that ticket queue down. We have all kinds of numbers and all kinds of things we measured, but what we wanted to do was reduce the ticket queue from 100 and some odd in the queue to whatever. The goal was 75, I don't know, and I had like a three-month goal or something like that or whatever. It was either a 30-day goal, we did it in one week, or it was a three-month goal, we did it in 30 days. Whatever would happen, we hit the goal with absolute clarity and focus on it in a third of the time and that really happened. And that focus we have to not forget how important it is to have that focus and that purpose. And so, talking to Matt in the last interview with him, we really talk about how we've got these important processes like revenue cycle or support or intake, and we just give them all these jobs and we expect them to use all this judgment and we measure them 14 different ways. We don't even tell them, going through the discipline of what are the one, two or three numbers. And if you can't figure out the numbers, then you probably have a clarity problem, probably have a clarity problem. 

If your front desk person is not measured on scheduling activities, whatever your practice or business is, then you're missing an opportunity. Are people calling and canceling and are they not being asked to reschedule? Or you know, I've seen two different ways to measure. You measure, sort of like the percent reschedule Cancels without reschedule. Is that being measured? Yeah, or when somebody schedules, do you schedule them what percentage of the time? Or if you call them to schedule, what percentage of the time do you schedule them and do you ask? This is a great one from Eugene Schatzman. He talks about how they build a process to make sure that they're asking the question. I'm glad to have you on the schedule schedule, but is there anybody else in your household who also needs to be on the schedule? Because the schedule can get a little busy for us and so with that focus, you can find yourself even better in your scheduling and so making sure the schedule is full. 

The people who do that you're scheduling people Do they know that's their job? Do they know that's the number one, most important thing? And are you measuring that? In revenue cycle, for example, are you looking at the number of touches? Are you measuring how many calls and contacts are being made? But are you measuring how many repeats there are? Are you measuring what percentage of those are getting resolved, closed, paid, and putting that incentive and that clear focus and making sure they're not doing anything other than increasing their technique, and are you coaching them to their language and the words and are they somebody in the role who can and will do amazing with that? And if you're finding that you put, like this, one focused job in front of somebody and they don't look like they love it, that's not a reason to give them more to do. That's a reason to get somebody in that job who loves it. So the exercise here of can we put data, can we put measurables in front of somebody and say we know exactly the one, two or three most important activities and outputs, and something about that is that the qualitative, quantitative aspect of the dials, the activities, the schedules, the outcomes of the phone calls they're doing Do we know enough about that to be absolutely crystal clear on what's most important? How can we get better, how can we coach, how can we improve and create those conversations and stripping all that fat out of the process? You know, and the last thing I want to add to that I want to keep this short Last thing I want to add to that is this is an opportunity for us to look at the behaviors we have. 

Control over Revenue cycle is a great example, because it's so easy to look at the behaviors. We have control over Revenue cycle is a great example, because it's so easy to point at the payers and the reimbursements and the bureaucracy and the things outside of our control as the reason we're suffering. And be that as it may, we probably don't have a lot of influence on that. What we can influence is how we respond to that and if we let go of that victim mentality and say this is how we measure our performance in the arena and you have I mean, I want you to think of it like this you send your people into the ring as gladiators and if you're not thinking about it at that level, then you probably have inefficiency in the process and the system. 

Make sure when you look at the people in the process, you know what battle you're sending them into and treat it like there's a threat to their success. And how do they know they're successful? What is the beast and how do they know when they've won against the beast with one, two or three critical numbers, especially measuring those inputs Are they doing the right activities, are they having the right conversations, the next steps, and is it working? And measuring in a quick cycle so we can improve on a weekly basis. I hope that's helpful. Just to kind of recap the idea of those one, two or three numbers should give you clarity of what matters most, and if you don't know what matters most, then they don't either. 

We got to get each of these roles crystal clear on what matters most. Strip everything else out of their role. Either don't do it or put it in someone else's seat who is better fit for that, so we can have the right person in the seat. We can measure what matters most, we can improve it and give those people the recognition they deserve for performing at a high level and making it a big impact, as always, of course. Hopefully, this is helpful. Share this with friends and people who can use it. If you're stuck, don't stay stuck, reach out. I want to help Practicefreedomcom slash schedule. Give us the feedback and we'll see you next time on Practice Freedom with me. Mark Henderson Leary. Thank you.

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