From Practitioner to Practice Leader
Sequent Editorial
Posted: 6/1/2009
Many doctors are faced with the challenge of transitioning their practice to its next level of performance. This transition comes in many forms, here are just two: 1) a practitioner who has successfully taken their practice to a point that will require a team of people to continue to grow and progress or 2) an established practice that has been around for years and realizes it’s time to hand it off the practice to a new physician leader.
There are challenges with any transition. But one of the most daunting is the dual role that the physician / practice leader must fill. On one hand, he is a content expert within the practice with all the responsibilities that come with providing medical care. On the other, he is responsible for the overall success of the practice, including the management of the “business” and the leadership of its people. This dynamic often creates a lack of clarity in roles, which in turn causes confusion and frustration for both the physician and for other associates in the practice.
If this confusion and frustration develops, a growing medical practice can “hit the wall”. The practice leader doesn’t know how to do what needs to be done during this phase of the practice life cycle. The problem is that the thinking and behaviors that created success at one level frequently all but guarantee failure and frustration at the next. For example, as a doctor drives her practice to success, she turns a blind eye and ear to all those who say it can’t be done. She must be aware of all the obstacles facing the practice and personally overcome them, often through sheer determination and force of will. But as this success creates opportunity for further growth, it becomes increasingly difficult for the physician to continue to be the only key to the success. The physician/driver becomes the bottleneck when everything has to be done by or through her. The behaviors essential to bringing the practice to life, become the very behaviors that keep it from growing and expanding to meet the vision established when the practice was founded.
Whatever the transition, a change in behavior is required for the practice to successfully operate at the next level. Once the desired result is identified, the practice leader must cultivate a culture that will bring that new objective to reality. When all is said and done, it’s not what you think or say that determines your culture; it’s what you and your people do.
To help understand the process of behavioral change within a practice, you must think of it as an emotional process, not a cognitive one. People don’t do what they do because of what they know; they do it because of what they feel. If you are a parent, how many times have you asked your children “why did you do that – you know better than that?” This might be the wrong question; seeking to understand feelings would be more fruitful. Therefore, understanding that after investing your energy and even identity in creating a thriving medical practice, it is no wonder that you are concerned about turning over the practice to someone else who hasn’t put in the same effort.
While the practice leader may be perceived as egocentric, self awareness may be a key characteristic that is missing. Unlike the “gap that nobody knows,” the leadership behavior gap is very visible to everyone but the leader. As identified in Jim Collin’s “Good to Great,” the twin characteristics of great leadership are humility and strength of will. Unfortunately, in a culture where humility is interpreted as weakness, it proves to be a prerequisite to learning and lasting security in the new role of the leader. A willingness to learn can also be seen as a weakness. Why? It is simple, because someone who already has all the answers has no reason to learn. Feeling secure in the new role can prove difficult because the gap between self perception and reality can not be bridged if the leader does not acknowledge it.
Here is the real problem. If you want to avoid change and excuse your current behavior, identify your personality type and say “that’s just the way I am.” However, to overcome the behavioral obstacles which will allow you to lead the practice to the next level; you must identify what you really want and do what it takes to get there.
The key to change is to then go about being purposeful in how you want to accomplish the change and accepting that you must change at the same time. Look it is simple; you can’t keep doing the same thing and expect a different result. How many times has a physician given good heart-felt guidance to a patient, but the patient ignored the advice they sought from you? How did that make you feel?
The process of taking leadership skills to the next level lies in three overarching components.
- Identify a compelling vision for your future role. This would be something worth working for. It will bring personal fulfillment and be aligned with the ongoing needs of the practice.
- Create an organizational structure starting with the leadership team that you can trust to help grow your practice. This does not mean cloning yourself. This would only serve to increase overhead without embracing the diversity of thought and skill required at the next level.
- The most difficult step is changing habits. This is where the combination of humility and strength of will are required in therapeutic doses. When you realize and accept the fact that some more learning is required, you are moving in the right direction.
With a compelling vision, the right team of leaders, a solid game plan and good coaching; the practice leader can learn to shift his or her contribution from physician to also becoming the practice leader.
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