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Practice Building, Practice Management

Who Are the Leaders in Your Practice? Growing a Healthy Practice Through Leadership

Who Are the Leaders in Your Practice? Growing a Healthy Practice Through Leadership
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Wendy Hauser, DVM
Peak Veterinary Consulting, Parker, Colorado

One of the most rewarding roles in managing a study group of practices is working with professionals who bring innovative ideas to the field of small business management. Dr. Wendy Hauser’s unique approach to cultivating everyday leaders is a topic worth sharing through the Practice Building column in Today’s Veterinary Practice. Dr. Hauser—a veterinarian and former practice owner who speaks from real world experience—is the owner of Peak Veterinary Consulting and author of The Veterinarian’s Guide to Healthy Pet Plans.

I hope you enjoy this second article in the 2-part series: Who Are The Leaders in Your Practice? Read Part 1—Characteristics of Good Leaders—in the March/April 2015 issue, available at tvpjournal.com.

—Dr. Travis Meredith

Early in my tenure as a technical services veterinarian, one of my territory managers observed, “You can tell the practices that have ‘it’ the minute you walk through the door.” He was referring to the rare hospitals that have a strong collective sense of who they are and why they are in business.

In these hospitals, everyone understands that their contributions to the work environment are a critical part of effective and efficient functionality. Management, operations, and culture strategically integrate to form a cohesive organization.

How did my territory manager readily identify these hospitals? The moment you enter an “it” hospital the:

  • Team is attentive, smiling, and calm
  • Interior is well-organized, odor free, and exudes a sense of professionalism
  • Clients appear engaged, relaxed, and confident in the care their pets are about to receive.

How are “it” hospitals and development of practice leaders related? In every way! These hospitals and their leaders have a clear vision of the hospital’s purpose, and the leaders communicate this purpose, and the goals it creates, to the rest of the practice team. In hospitals lacking leadership, the animal health care team is disjointed, with each member following his or her own agenda. Absence of a common purpose creates barriers to effective teamwork, negatively impacting patient care, client relations, and job satisfaction.

This second article of a 2-part series will examine the:

  1. Necessary components of a healthy organization
  2. Role that cultivating leaders plays in the overall success and sustainability of veterinary hospitals.

DEFINING LEADERSHIP

Leadership has been defined as the act of motivating a group of people to act toward achieving a common goal.

In my previous role as a technical services veterinarian, I visited an average of 20 veterinary hospitals per week. Within most hospitals, I frequently observed a lack of clearly defined, shared goals. While each employee was doing his or her best to get a job done, the employees were functioning as independent entities rather than a team. Organizational direction was lacking.

This lack of organizational direction was most obvious when it came to client communication—clear, consistent messaging to clients was absent. For example, teams did not know who should be making preventive care recommendations, let alone what the recommendations were. The end result? Clients did not partner with their animal health care teams to provide necessary preventive care for their pets.

Is this the fault of the hospital’s leadership? I don’t believe leaders consciously decide not to have clear goals; rather this result evolves due to passivity and lack of awareness.

The hospital is an investment, both monetarily and emotionally. When leaders spend time growing the business by building foundational attributes (see Growing a Healthy Organization) needed to sustain organizational health, the benefits are tangible—there are minimal workplace politics and confusion, and employees understand their roles and responsibilities within the hospital team, which leads to the following:

  • Higher morale
  • Better productivity
  • A stable team with minimal turnover.

This strong foundation serves to differentiate your hospital from your competitors.

GROWING A HEALTHY ORGANIZATION

Achieving organizational health requires effort and attention. It doesn’t happen overnight but, instead, is achieved in incremental steps that are reinforced on a daily basis. Attributes leading to organizational health are not difficult to develop, but do require perseverance, discipline, and realization that these skills build upon themselves; there are no shortcuts to the process. So, where does organizational health start?

1. Trust

In order to have a functional unit, all members of the team must have unwavering trust in each other, and this concept is not exclusive to the leadership team. The knowledge that your team has your back is one of the best descriptions of how trust works among team members.

Building trust is more involved than it appears on the surface. It is built when one person is vulnerable enough to be completely transparent with another, to the point that staff members are confident that, when they ask for help, their teammates will provide aid, or they can acknowledge making a mistake without fear of being judged or demeaned.

All members of the team, including management, must know each other in order to build trust—they need to understand each other in an elemental way. This level of transparency is built through safe communication and empathy. See Trust in 24 Hours for a description of how trust was developed among colleagues attending a leadership course.

Professional relationships must exist in the workplace for a team to perform efficiently, but these relationships should not be confused with interpersonal relationships. An example of a harmful relationship is the formation of workplace cliques. Cliques are exclusionary by nature and destructive to trust. The team must function as a unified group.

Trust in 24 Hours

I had the privilege of taking an intensive 5-day leadership course comprised of veterinarians and veterinary managers. While we were cordial with each other, there was no trust within our small group.

The course began with the evaluation and understanding of each individual’s personality profile. On the second day, the instructor led us in an exercise to encourage us to be more vulnerable with one another. Basically, group members shared the following information—our:

  • Foundations (where we came from)
  • Visions for the future
  • Personal traits that we knew irritated others (eg, interrupting, communicating too directly)
  • Personal and professional commitments
  • Vulnerabilities.

During this exercise, an incredibly powerful moment occurred when one of the participants shared that he had come to the course because his hospital team felt it would provide an opportunity for him to refocus his energy toward his own hospital. His wife had been terminally ill and, for the past year, he had been her primary caregiver until she passed away the month before the course.

To this day, I am in awe of this participant’s transparency and courage. His willingness to place himself in such an exposed position not only showed his trust in the group, but encouraged each participant to treat him with empathy and inspired us to be equally transparent and honest. Out of this exercise, we grew from a collection of acquaintances into a group of people invested in each other—all within 24 hours.

2. Personality Profiles

Another important part of the team dynamic is personality testing. Team members should have a basic understanding of how their personalities and those of their colleagues impact both their actions and interactions with others. This mindfulness is the cornerstone of emotional intelligence, discussed in part 1 of this series.

Emotional intelligence is the ability to effectively manage ourselves and our relationships by awareness of, and response to, emotions.

An individual’s awareness of his or her strengths and weaknesses allows that person to self-regulate and modify counterproductive traits, while finding solutions that allow positive qualities to thrive. When team members understand each other’s profiles, interpersonal communication becomes more respectful and effective.

For example, consider the interaction between two team members—one who is extroverted and one with introvert characteristics. Extroverts tend to be very quick thinkers, whereas introverts prefer time to consider the question before answering. A common workplace scenario occurs when the extrovert asks the introvert a question:

  • The introvert must process the question and formulate a response.
  • In the meantime, the extrovert may ask two more questions before the introvert can answer the first one.

The outcome is highly unsatisfactory for both team members:

  • The introvert is confused, thinking, “Which question does my teammate want answered?”
  • The extrovert is frustrated because he or she has not yet obtained an answer.
  • The extrovert might even make a comment about this length of time, and then the introvert feels “attacked” and wonders why his or her opinion was solicited in the first place.

This interaction is extremely common and damaging to the workplace dynamic.

A basic awareness of each other’s behavioral profiles would easily address this destructive conversation. When the extrovert asks a question, he or she is aware that the introvert will need a little time to process the request. The extrovert has the self-awareness to be patient and does not ask additional questions, and the introvert does not feel pressured and is able to provide an answer in a safe, respectful environment.

Awareness of personality tendencies allows for self-regulation in other areas as well, such as the examination room. For example, extroverts may need to consider whether they “run over” introverted clientele.

Selecting Core Values for Your Practice

In my prior hospital, I utilized the following process:

  1. In a blinded survey, I asked a series of questions, including, “What 3 words would you use to describe this veterinary hospital?” Invariably, the submitted words were value based.
  2. The hospital leadership was confident in the ability of the team to choose words that would be good descriptors of our culture. As a further testament to the hospital leadership’s trust in its team, management was not involved in the subsequent discussion or selection of values. Instead, the final list of submitted words derived from the survey were sorted and combined into 14 value-based words that were similar in context (eg, educator, educational). These words were put on index cards, with the word on one side and the word’s definition on the other. Three additional blank cards were supplied, as well as a marker and dictionary.
  3. During a team meeting, culture and core values were discussed. Team members then went to a centrally located table where the cards, dictionary, and marker were placed. They were instructed to select the words that best defined our hospital (who we were and why we were there). The team was asked to select no less than 4 but no more than 7 words. If they felt a word was missing during the selection process, they could add the word on a blank card, look up the definition, and include it.
  4. Once the process was complete, the words were reviewed during the staff meeting conclusion, allowing one more opportunity for discussion and modification.
  5. Finally, we put our core values on posters outside the examination rooms and in the lounge, as well as the treatment area. Each week, we chose a core value to spotlight and the following week, in a brief meeting, we would share how we caught each other living that value and ask this question: Where did we miss opportunities to emphasize the core value?

3. Creative Conflict

The outcome of building trust within a team is lack of behavioral pretense. When teams trust each other, everyone “belongs,” and since the team “has each other’s backs,” they do not need to hide weaknesses or mistakes. As the team becomes more vulnerable, candid communication occurs, and team members feel safe engaging in creative conflict.

Behavioral pretense occurs when an individual behaves in a manner that is in opposition to what he or she believes, in order to “fit in.”

Creative conflict is best defined as the ability of a group to challenge preconceived ideas and opinions to formulate the best possible answer. For example, until a question has been exhausted and all options defined, individuals feel comfortable asking each other, “What else?” This question is asked to clarify the problem, exposing the best answers, and the focus is on uncovering and resolving the conflict in a positive manner.

One example of this concept is prebooking wellness appointments 6 and 12 months in advance. Despite excellent research that suggests all hospitals should implement this easy process, much resistance exists within the profession when it comes to incorporating this practice into everyday operations. Explaining the “why” behind this recommendation and its benefits to patients sets the stage for dialog that examines preconceived ideas. By fully exploring all concerns and asking “What else?,” the team engages in creative conflict that delineates whether the concept will be embraced by the staff, ensuring program success. Or, if resistance is great, it will be clear that more research needs to be done and alternatives identified.

Growing a healthy organization occurs incrementally. Creative conflict will be difficult for your team to embrace because it is initially uncomfortable. By appropriately introducing this concept in a safe, managed manner, the team will appreciate the value the process brings to decisions as well as their accountability in the decision- making process, resulting in a more positive workplace culture.

Keeping Conflict Out of Creative Conflict

I was asked during a leadership training session: “What if your team won’t engage in discussions?”

When I ask my team a question, and receive no response or am told, “that sounds great,” it is likely that creative conflict cannot occur because trust does not exist. Without trust, your team does not feel safe and, therefore, cannot engage in meaningful dialog.

In addition, creative conflict is not mean spirited; personal attacks have no place in the conversation. It is the role of leaders to set clear expectations and guidelines regarding conflict and then manage the interactions, interrupting when the conversation threatens to derail or become negative.

4. Shared Values

During a dinner meeting with a new practice owner and her spouse (who was also the part-time manager), the spouse proudly commented that he was working on the hospital’s mission statement and had just compiled its core values. I asked him how these core values had been defined, and he replied that the values outlined what he wanted the hospital to represent. This conversation raises interesting questions: What are core values and whose values are they?

Core values are the deeply ingrained principles of an organization; they should:

  • Unite, define, and act as a guide for every decision within the hospital
  • Be unique to a hospital, differentiating it from competitors and, thus, becoming part of its brand
  • Represent the value system of the hospital as a whole.

Therefore, leaders should seek input from all employees, which gives everyone in the hospital “ownership” during the process. While this seems like a daunting task, there are ways to make this process manageable (see Selecting Core Values for Your Practice).

It is important that core values be lived and reinforced. Too often the exercise to define shared values is just that—an exercise to be completed. Core values should guide actions. When it is time to make decisions, ask, “How does this align with our core values?” As a group, your team should decide how to bring these values to life.

Likewise, core values help guide hiring choices. Present your practice’s core values to prospective employees and then ask them when they have used these values to make life decisions. The answers will help determine candidates who will be a good fit for your culture.

The leadership team must believe in the value of developing a healthy organization and be willing to assume collective responsibility to achieve this outcome. In order to achieve these goals, the leadership team will need to invest both time and emotional energy. In the context of the many moving pieces within a hospital’s daily operations, this can seem like an overwhelming expectation. In reality, support from other members of the leadership team and commitment from the hospital staff help drive the necessary changes.

IN SUMMARY

When a hospital takes incremental steps to define and strengthen its foundations, wonderful things can happen. Employees have a renewed sense of purpose and accomplishment, and leaders can dedicate their time toward helping the team develop new skill sets and become future leaders. Investment in positive changes benefits clients, patients, and the business, making your hospital an “it” hospital, too.

Resources For Cultivating Leaders

Leaders are like gardens—they need sustenance to continue to thrive. In the veterinary profession, it is very easy for one to become isolated, leading to stagnation. Many exciting opportunities exist to challenge leaders; here is a list of some of my favorites.

For Hospital Leadership

American Animal Hospital Association (AAHA)

AAHA offers a broad range of learning experiences for veterinary hospital management. Popular courses include the Veterinary Management Institute (VMI), Veterinary Management School (VMS), and the new AAHA ExCEllence series.
aaha.org/professional/education

For Veterinarians

AVMA Leadership Conference
avma.org/Events/LeadershipConference/Pages/default.aspx

AVMA Future Leaders Program
avma.org/Members/FutureLeaders/Pages/default.aspx

Catalyst Practice Consultants Illuminating Veterinary Women’s Retreat
illuminating.catalystvetpc.com

Power of Ten
The Power of Ten—an initiative from the Association of State Veterinary Medical Executives—helps grow veterinary leadership at a state level. Ten recent veterinary school graduates participate in a 1-year program designed to develop leadership, communication, and business skills. This program is administered by state veterinary medical associations and is currently available in 7 states.
vmaexecs.org/?page=PowerofTen

Veterinary Leadership Institute
veterinaryleadershipinstitute.org/programs

Women’s Veterinary Leadership Development Initiative
womenveterinarians.com

For Managers and Technicians
AAHA Distance Education Veterinary Technician Program (DEVTP)
aaha.org/professional/education

MWI Inventory Management Workshops
mwivet.com/solutions/workshops.aspx

Patterson University
pattersonvet.com/ProfessionalEducation


Resources

Lencioni P. Getting Naked: A Business Fable About Shedding the Three Fears that Sabotage Client Loyalty. San Francisco: Jossey-Bass, 2010.

Lencioni P. The Advantage: Why Organizational Health Trumps Everything Else in Business. San Francisco: Jossey-Bass, 2012.

Sinek S. Start With Why: How Great Leaders Inspire Everyone to Take Action, 2nd ed. New York: Portfolio/Penguin, 2011.

Ward S. Leadership. About Money 2015. Available at sbinfocanada.about.com/od/leadership/g/leadership.html.

 

Wendy HauserWendy Hauser, DVM, is the owner of Peak Veterinary Consulting (peakveterinaryconsulting.com). She previously was a small animal practitioner and practice owner. Dr. Hauser is engaged with AAHA in both new initiatives and leadership, and helped design the Colorado Veterinary Medical Association Power of Ten, a recent graduate leadership academy. She is coauthor of The Veterinarian’s Guide to Healthy Pet Plans and enjoys consulting with practices and presenting workshops on hospital culture, leadership, client relations, and operations.

 

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