How Healthy is Your Practice?

By: Kay Wakeham
Monday, October 7, 2013

Get fit with cohesion and clarity.

I just finished reading Patrick Lencioni’s book, The Advantage: Why Organizational Health Trumps Everything Else in Business. His premise is that being a “smart” organization is not enough for a competitive advantage. Smart organizations focus on the traditional side of business (i.e. strategy, marketing, finance and technology). In contrast, “healthy” organizations go the extra mile to eliminate dysfunction and confusion. This health of cohesion and clarity matters more than anything else in business.

How does this apply to your practice? I’ve seen and heard of many instances when physician leaders are not on the same page. This creates confusion for the staff. Often, practice administrators and managers are caught in the middle. They are expected to motivate the employees to give their best, but this confusion gets in the way. The administrators feel it is impossible to get the docs in alignment. But is it?

What can you do to increase cohesion and clarity for a healthier practice? Lencioni outlines “The Four Disciplines Model” for becoming a healthy organization.

1. Build a Cohesive Leadership Team

A lack of cohesion in your practice leadership team leads to an unhealthy environment. I have worked with several leadership teams who knew they were dysfunctional but couldn’t explain why. A team effectiveness assessment can identify the cause. Even one area of dysfunction can cripple the team. Once the dysfunction is uncovered, actions can be taken to overcome it. For example, if lack of trust is the culprit, team and communication style exercises can improve the situation.

2. Create Clarity

Your practice leadership team must be fully aligned and committed on six fundamental questions. These questions focus on reasons for existence, acceptable behavior, purpose, how to succeed, what is most important and areas of responsibility. If your practice leadership does not have clear answers to these key questions, spend some time gaining agreement. Consider scheduling an off-site retreat for the practice leaders to fully focus on this critical clarity process.

3. Overcommunicate Clarity

Once the practice leadership team has fully achieved clarity, it is time to communicate to the rest of the team. This is an extremely repetitive process, so you have to be patient. Employees need to hear messages numerous times before they believe them. The communication should come in various forms (verbal, email, text, etc.). The messaging also should be consistent in that it comes from all leaders, not just one. How do you know if you’ve successfully communicated to your team? They should be able to answer the six clarification questions accurately.

4. Reinforce Clarity

The answers to these fundamental questions must also be operationalized into your practice. That means every people process must reinforce them. This includes hiring, firing, policies, performance management, training, compensation and benefits. For example, acceptable behavior or core values should be integrated into the people processes. If respect is one of your core values, then employees should be hired, fired, reviewed and compensated based upon exhibiting that behavior.

Building organizational health in your practice is a simple and low-cost process. It requires time and discipline from practice leaders. What can you expect in return for your investment of time and discipline? A healthy practice can benefit from growth, increased profitability, patient loyalty, higher productivity and low turnover. This can be your competitive advantage in the ever-changing world of healthcare reform. Get fit with cohesion and clarity.

Kay WakehamFor more information on creating a competitive advantage for your practice, email Kay Wakeham, MBA, PHR, Chief Performance Officer at The Growth Coach of San Antonio at or call 210-492-2400.