Harness the leader in you

Transformation is a buzzword these days. When applied to leadership, it changes how we think and approach our team. It can very well serve to change how we approach our patients as well.

Transformation is a buzzword these days. When applied to leadership, it changes how we think and approach our team. It can very well serve to change how we approach our patients as well.

By its very nature, transformation means “to change.” It is not just any change. This change is pivotal, affecting the way we think and feel as we emerge in a new place of heightened awareness. We create a meaningful experience from a positive shift in our life.

How does this relate to practice?

In order to perform the higher order visioning and leadership in practice, one learns it’s an asset to delegate. Through delegating, we leverage our talents, benefit from the use of other individuals’ talents and thus can focus on what we prefer to spend our time on. However, this may pose some difficulties, and it certainly did for me. In allowing a procedure to be done by someone else, I found three challenges to overcome. You might also identify with them.

1. Who has the time to train and follow up? By the time I explain what I want done, it’s just faster to do it myself.
2. If I delegate something, what if I’m left out of the loop?
3. They won’t do it the right way.

In overcoming these concerns, the generative questions would be:

• What challenges need solving?
• What is my preferred future?
• What things are important to dedicate my resources to?
• How do I consider the values, judgments and insights of the people in the practice?
• How can I do the visioning for the practice if I am caught up in all the minutiae of the day-to-day running of it?
• Am I willing to let go of some things in order to achieve what I want?
• What procedures can be delegated to others?
• How do I want my people to report to me?

There are lots of ways we can delegate – to frontline staff, clinical staff, bookkeeping, cleaning staff, perhaps a marketing team or patient advocate.

Initially in practice, I did not delegate because I simply could not afford to. It was the one-doc-do-everything scenario. So, like many of you, I played many roles – the CEO, CFO, operations, assistant, HR, project management and doctor. In retrospect, this was an invaluable experience as I gained a deep appreciation of what performance I wanted for each position. From that experience, a procedural manual of job descriptions with checklists was created for training, accountability and feedback to those I entrusted and delegated to. My suggestion is to begin writing down all the elements of what needs to be done in the office. Revisit and revisit as you go along.

First challenge: “By the time I explain what I want done, it’s just faster to do it myself.”

This may be true in the short term, but not so in the long run. When we hire, we want our team to transform while under our leadership. We create that by helping staff gain confidence, take ownership, problem solve and grow through a nurturing environment. Factor in time for training to properly explain what we want and create a process for that to happen. Providing specifics for staff to accomplish increases the sense of ownership of their position. Staff will usually accept more responsibility and, quite frankly, are wanting to. 

How is this achieved?

Allot time to train staff from a checklist. If you currently have staff, involve them in the development of a new and improved job description. Let them add to it and fill in the blanks. One can accomplish this during a staff brainstorming session where a specific job task is considered. Create bullet answers from the question, “What would a masterful performance look like?”  Allow everyone to contribute, and all ideas are written onto a whiteboard. Asking clarifying questions like, “describe or help me to understand what you mean by…” helps us to make assumptions and gain an understanding of what others see. For example, the procedure for meeting and greeting patients may look very different to me than to you. 

From the developed list, everyone gets to provide his or her answer to each bullet. The format of, “What I like best is (and why),” works well. This builds self-esteem and team dynamics. If a particular item is not picked as being appropriate, rather than negating it, replace with the question, “What would work better for me is…” We ultimately want to avoid any language that implies something is wrong with someone else’s perspective.

There are several benefits to this exercise:

• Learning what’s important to others in creating the ideal position as we look for the good offered in each bullet.
• The group becomes solution and performance oriented
• Expectations are uncovered which leads to heightened awareness
• Greater buy-in because each person has contributed to development

What emerges is a description of a masterful performance to use and measure against for future training and reviews.

If you do not have staff, do the process above by asking the same question to a few colleagues about your own role. You’ll gain new perspectives of a masterful performance that may offer invaluable feedback. For example, I’ve seen doctors completely unaware of the impact of their tone and body language in their communication to patients.

I am a fan of checklists and follow-ups using intrinsic validation as a strategy. Ideally, checklists protect against faulty memory, interruption and distraction. As Dr. Atul Gawande describes further, “People can lull themselves into skipping steps, even when they remember them… This has never been a problem before, people say. Until one day it is… Checklists remind us of the minimum necessary steps.”

Make the checklist explicit. “They offer verification and instill a kind of discipline of higher performance.”

Good checklists are one page and cover the important points of that procedure. Checklists can be in the style of performing and checking as you go along – like airline pilots with a “Read-then-Do.” There’s also the “Do-then-Confirm” checklist whereby you perform the job from memory then pause to confirm everything was completed.

  A few ideas for checklists are procedures like opening the day, greeting patients, telephone or new patient procedures. From a doctor’s perspective, you may have checklists for common procedures like the new patient, consent, report of findings or even closing-a-file.

As Gawande noted, the presence of a checklist “established a higher standard of baseline performance.”

When a problem occurred, my “old way” was to tell staff how to correct their performance. I knew want I wanted, so I’d tell them. However, this comes across as a reprimand, and the person rarely grows or takes ownership, and their self-esteem often goes down.

As an alternative way, in helping transformation and growth, identify the specific problem and have the person compare themselves to their checklist and self-rank in comparison to the masterful performance they’d developed.

Ask these questions to gain insight:

• What am I learning about myself?
• How could I have handled this differently?
• What would work better for me?
• What do I need to accomplish this?
• What is my plan as a go forward?

If we are really interested in their self-awareness and taking responsibility, any question we have should get them thinking of ways to solve the issue without us necessarily solving it for them. If they are stuck, then and only then do we jump in and offer a solution that begins with, “May I make a suggestion?” or “What if you were able to…?”

Second challenge: “If I delegate something, what if I’m left out of the loop?”

I was scared that something would happen and I wouldn’t know about it so I micromanaged my team. Then I got frustrated when every detail was reported to me and I was back to telling everyone how to solve problems. I felt like I couldn’t win. However, I realized I’d created the environment for these behaviours to occur and they did not have to be mutually exclusive.

Find the harmonious point of checking in on a regular basis, but do so in an overarching way. Have them provide brief summaries to account to you on a set schedule and help them to provide solutions to what’s arisen if they’re stuck. Have a checklist of absolute “must tell me “ items. Initially, it’s difficult to let go, but in doing so, it provides you freedom.

Third challenge: “They won’t do it the right way.”

This essentially means, “They won’t do it my way.”  As much as I’m really good at what I do, I’ve learned that not everyone else has to or should do it the same way as I do. That was a hard pill to swallow. People have different
approaches to how a task is done, and as long as the performance indicators are reached in a standard that you’ve set, let them self-express. Being open to new approaches and letting them try it on creates interest and connection for them to deliver their best.

Keeping abreast of quality control through checklists, staff training, performance evaluations, and them knowing the overall vision for the practice are connection points for following up.

While addressing this with staff, the same goes for patients. Consider the old model of “me-doctor-you-patient” or “I’ll tell, you listen and do.” With this method, our patients rarely transform their lives. It stifles their creativity, personal growth and robs them of their responsibility in the process of taking charge of their own health.

If we ask patients more generative questions first, they too can begin to transform. Get to the deep probing questions because many times we help them gain clarity.

• What do you want and why?
• Did something or has something in your life contributed to this current challenge?
• What do you feel needs to change?
• When do you want to do something about this?

Then we can begin to follow up with their chiropractic care, and more importantly self-care, and help them move through this into something better.

A simple statement on transcending and transforming where we currently are by changing our perspective in this moment was well stated by holocaust survivor, Victor Frankl: “We can discover this meaning in life three different ways: by creating a work or doing a deed; by experiencing something or encountering someone; by the attitude we take toward unavoidable suffering and that everything can be taken from a man but one thing: the last of the human freedom – to choose one’s attitude in any given set of circumstances.” 

Dr. Liz Anderson-Peacock, a cum laude CMCC graduate from 1986, is a keynote speaker, author and transformational leadership executive coach. Her practice is currently limited to pediatrics and pregnancy. Visit her weekly blog at www.drliz.ca/blog .