Thursday, December 25, 2008

On reflection

Well as you may have noticed, I've been away for a time... It's been a busy couple of months with travel to Ghana East Africa and Honduras in Central America on safe water projects with International Aid Inc. / HydrAid.

It's been a real privilege this past year to provide leadership for IA's global initiative to bring safe water to the billion + people who lack it. People who have no choice but to work hard every day to obtain the only water available to them with the knowledge that it brings disease, disability and death to their children. A child dies every 15 seconds due to unsafe water and over half of the world's hospital beds are occupied by people with water borne disease.

Remember that trip you took out of the country when you were told not to drink the water? Well, more than a billion people have no choice but to drink it every day ...and they pay a terrible price for doing so. For a contribution of about $50 a HydrAid BioSand Safe Water Filter can provide an entire family all the safe water they need for drinking, cooking, and bathing for a lifetime.

Join me - Get involved... HydrAid is great cause for Practices, Service Clubs, Teams, Churches, and families. Make a difference!

Share the safe water story with this award winning video Thank you!

May you and yours have a blessed Christmas and a prosperous 2009!

All The Best

(c) 2008
Monday, December 1, 2008


"Life begets life.
Energy becomes energy.
It is by spending oneself that
one becomes rich"

- Sarah Bernhardt
Wednesday, November 12, 2008

Variable / Incentive Compensation

With the changes in our economic climate and continued erosion of reimbursement, many clients are calling lately who are ready to pull the trigger on a new compensation system for their Practices. All are asking for help because a change in compensation can be a high risk event if not handled properly. Some have tried before but found themselves with a compensation system that neither they nor their employees found satisfying.

If you are not thinking about variable compensation that is based on an individuals contribution to Practice performance and job security you should be. No excuses... Its time!

Performance Builders offers consultation and management tools to get it done right. The cost of doing it wrong has a risk that is great. The cost of doing it right is an investment with a great reward.

Take action now... need help call.


(c) 2008
Performance Builders
Tuesday, October 14, 2008

Performance Matters - Idea #26

Here's a piece of sound advice that saves time, enhances performance, avoids confusion, and protects integrity... Communicate what you know when you know it.

Too often leaders communicate what they have been exploring, thinking about, talking about, or hoping for. Their communication leans toward what could be rather than what is. Essentially they "put the cart in front of the horse".

The result is that leaders trade supposition for reality. They find themselves explaining, defending, and defusing that which may never come to be. Employees and colleagues find themselves refocused away from matters that matter. The inevitable conclusion is rumor, gossip, and resistance or unreasonable expectations.

In doing so they send mixed signals, create confusion, waste valuable time, fan emotions, and erode their own credibility.

The first responsibility of a leader is to define reality. When matters are communicated before they have been decided upon leaders compromise themselves, the organization, and those who follow.

This advice becomes critical in times of change, transition, and restructuring when uncertainty, emotions, and insecurity runs high.


(c) Copyright 2008
performance Builders
Thursday, October 9, 2008

On Reflection

"Worry is a misuse of the imagination." - Dan Zadra

"Live out your imagination not your history." Anonymous

With the world's economy in dire straights and mainstreet feeling the pressure, I'm finding myself in many conversations with clients who are reassessing their business practices and strategies. They are realizing this is not a time for business as usual. It is time to take stock of where you are, where you are going, and how you will get there. It is a time when clear thinking, right strategy, informed decisions, and firm action count.

This is a time unlike any other in the past 80 years. It is a time not only of challenge and threat but also one of unprecedented opportunity. This is a time of opportunity that is unlikely to be repeated in your lifetime. It is a time when some Practices will move ahead and prosper while others will fall by the wayside.

What do you imagine your future to be? What steps are you taking today to place prosperity in your future?


(c) Copyright 2008
Performance Builders
Tuesday, September 30, 2008

Performance Matters - Idea # 25

Retired CEO of Herman Miller and author Max DePree (from my hometown) wrote that, the first responsibility of a leader is to define reality, the last is to say thank you, and in between to be a servant.

By servant he meant someone who takes care of the needs of others and positions them for success. A servant is one who removes obstacles and honors those who are served. Such attitudes are not common practice today but are certainly the traits of effective leaders.

Be honest in your communications with others, even if the message you bring is not comfortable. People deserve the truth. Only then can situations be changed and opportunities be grasped.

The more you respect others the more you are obligated to share the truth!

Learning the skills of a servant leader that leads not from the front of the parade but from its middle is a goal worthy of pursuit and mentoring. Where are you leading from.? Do you routinely define reality? Do you position others for succes? Are you satisfied with your leadership?


(c) copyright 2008
Performance Builders
Friday, September 26, 2008


"There are so many men who can figure costs, and so few who can measure values." - Author unknown
Monday, September 22, 2008

Performance Matters - Idea #24

Avoid taking, or needing to take, defensive positions. It's been often said that, "the best defense is a strong offense".

It's true.

Defense takes time and resources to just to maintain the status-quo. The same time and resources committed to executing offense strategies and tactics can generate competitive advantage, forward momentum, and force others into defensive positions.

One defensive move or position generally leads to another, and another. One offensive move generates new options...

Opportunities invariably favor those on offense rather than defense.

Keep in mind that in situations of "either or" a "both and" option usually exists. The best ultimate option is one that provides both offensive and defensive advantage.

Play your game, don't follow the crowd. When everyone is zigging there is generally value in zagging.

Is your business or profession fighting just to keep up? If it is it is likely you are taking defensive positions. There are options and alternatives - MANY of the them. Options for growth, reward, and influence. There is certainly one or more that will fit you just right.

Look around. Ask for advice. Listen carefully. Decide boldly. Execute aggressively. Play offense. The alternative is just defense...


(c) copyright 2008
Performance Builders
Thursday, September 18, 2008


"Real experts do not call themselves experts. They let you discover their expertise for yourself." - Alan Cohen
Saturday, September 13, 2008

Performance Matters - Idea #23

Make decisions that need to be made. Don’t make decisions that don’t need to be made.

Life is all about decisions - those you need to make and those you don't. And, its recognizing the difference.

What are some decisions that need to be made? Here are a few...

What is your purpose in life? business? relationships?

What are the values that will drive the decisions you make?

What decisions do you need to make that will take you toward your vision and aspirations?

What decisions do you need to make that will prevent you from moving away from your vision and aspirations?

What are some decisions that don't need to be made? Here are a few...

Don't make decisions for other people.

Don't show up for every argument you are invited to.

Don't rush decisions that can wait for awhile. Allow time for matters to become clearer.

Don't allow others to define your priorities.

Decisions are are your most potent tool. Decide well.


(c) copyright 2008
Performance Builders
Thursday, August 7, 2008


“There is only one success - to be able to spend your life in your own way.” - Christopher Morley
Friday, August 1, 2008

Performance Matters - Idea #22

Run the Practice like the business - because it is. Make no apologies for the need to make a fair and reasonable profit.

Profit is the reward for taking risks. Profit provides jobs for people and job security. Profit provides competitive wages and benefits. Profit provides continuing education. Profit produces skilled team members. Profit creates opportunities for professional advancement. Profit buys new equipment. Profit allows innovative programs. Profit allows community service and leadership. Profit contributes toward influence.

Even non-profits need a positive margin to remain healthy and relevant - "no money, no mission".

How much profit should one expect from a practice? Well it depends on the decisions you make - not just the big ones but all the little ones that add up over time.

Practices that I have benchmarked in recent years have margins that range from about -40% to +45%. WOW what a range. Too many Practices accept inadequate profits. Think about it... 75% of practices statistically do not perform in the the top quartile of performance. 50% of Practices perform below average.

Every Practice has opportunities for better profits.

The only things that hold them back are an understanding of the possibilities, the decisions they make and the actions they take. Every Practice represents unrealized potential and promise!

The way to earn a fair profit is not through budgeting but instead through profit planning. There is a difference - a big difference.

Be willing to take your reward for the risks you take, the service you provide, and the value you create. You deserve it. Your family deserves it. Your community deserves it.

Take your Profit and live generously! Need help... just ask.


(c) Copyright 2008
Performance Builders
Saturday, July 26, 2008


"We do not inherit the earth from our ancestors; we borrow it from our children." Native American Proverb
Sunday, July 20, 2008

Performance Matters - Idea #21

Do you have an early warning system in your Practice to let you know when performance isn't measuring up? The kind of system that lets you know when a decision needs to be made? The kind that lets you know so in a timely fashion? One that enables you to ask better questions and make better decision based on evidence. One that takes you by the hand and takes your Practice to where it needs to go? One that can do so reliably?

What kind of evidence is the right evidence? Like Goldilocks its important that performance evidence is not too big and not to small - but rather, JUST RIGHT. You want all and only the evidence that makes a difference. And, you need it to be simple, convenient, and strategic.

When you have such a system things get done. When you have such a system you Practice with confidence, worry less, and sleep better. When you have such a system your finanical reward grows!

I've had the privilege to work with many Practices over the past 3 decades - small, large, and super-sized. It seems they all shared a common problem - no good way to track critical performance data in real time such that all the information they needed to manage performance was always at hand and reliable. Most Practices even struggled to pull such critical data together. It frequently took them weeks or even months to gather such data together and then the data was rarely trustworthy. The truth was that they were essentially "flying blind".

That truth led me to create an Excel Workbook tool for performance management for my clients to use - PERFORMANCE MASTER. It sets up easily, requires just a few minutes to enter data, and provides self-interpreting reports and graphs. It is built around 13 essential Practice Performance Standards and tracks the 17 must-have performance metrics that determine the success of every Practice.

Clients using PERFORMANCE MASTER routinely comment that it has enabled them to fully understand and control their Practice for the first time. They also like to brag about how it has enabled them to grow the Practice and find more profit in it.

Master your Practice performance -Let's talk!


(c) Copyright 2008
Performance Builders
Sunday, July 6, 2008

Stepping Away...

Well friends I'm stepping away from the BLOG for a week or two to enjoy a little summer sun. See you here again around the 20th.
Saturday, June 28, 2008
"There is only one success -- to be able to spend your life in your own way." - Christopher Morley
Wednesday, June 25, 2008

Performance Matters - #20

Problems are an inherent part of management. The question is who owns the problem. Too often managers take on problems that they don't own, and shouldn't own. Here are a few thoughts on problems and decisions pertaining to them.

First, don't make decisions that don't need to be made. It may not be your problem, it may not be your decision, it may not need a decision, or it may not need a decision now. Making a decision you do not need to make is always A WRONG DECISION!

Second, don't take on problems that are not yours. Those who report to you should not be allowed to bring problems to you that is in their area of responsibility. Instead, if they can not solve a problem on their own they should come to you with solution options they have considered and with questions pertaining to problem clarification and solution implications. After discussing those matters with you it is still their decision not yours.

If problems are yours and a decision is appropriate, always solve problems quickly and definitively, do not allow them to “brew”.

Be proactive!

Not deciding or deciding in a reactive manner is never as effective as being proactive. Being proactive builds motivation, trust, and loyalty.



Performance Builders
Copyright 2008 Performance Builders
Friday, June 20, 2008


"Success usually comes to those who are too busy to be looking for it."
- Henry David Thoreau
Sunday, June 15, 2008

Performance Matters - Idea #19

Understand that most Practice managers and supervisors have have earned their titles by having been successful professionals with a technical/scientific training. Most have never received training in business and management; and if asked, most would acknowledge that they honestly receive more personal/professional satisfaction in the clinic than shouldering the burdens of management.

The litmus test is to ask them the question, "What gets you up eagerly on Monday mornings and what keeps you willingly after hours?" For most its not management issues.

Management requires a markedly different set of priorities and skill sets than clinical services.

Most who are in Practice management roles have had little training or mentoring to prepare them for success and satisfaction in a manager's role. Most have questions - lots of questions. Most have vulnerabilities that contribute significant unrecognized risk to the Practice.

Help managers and supervisors to acquire the skills and perspectives they need to optimize their value to the Practice. Provide them with competent training and mentoring support. Doing so will yield significant benefit to the Practice that will be measured in performance, retention, and return on investment.

Oh, and keep in mind that all mentors and training programs are not created equal.

We see a significant number of Practice managers return to school for long hours and at considerable cost to earn an MBA. We also see many of them return to the Practice with newly acquired MBA perspectives but not sure how to leverage their Practice for better performance, more reward, and less risk and worry.

Then there are professional association so called mentoring programs that engage those who want to be mentors but who more often than not lack the technical skills and breadth/depth of experience to make them truly valuable to those they would mentor. Such relationships are in fact too often dangerous to those being mentored.

The best advice is to secure mentoring and training support from those with proven ability to bring our the best in managers and the best in Practice performance.


(c) Copyright 2008
Performance Builders
Wednesday, June 11, 2008

Good Cause - HydrAid Safe Water

I've had the privilege to consult with a client the past few months that is dedicated to providing safe water to impoverished people world wide - HydrAid TM BioSand water filter. HydrAid is a subsidiary of International Aid, a faith-based not-for-profit (501 (c)(3) company.

They provide simple to use water filters that produce 75 gallons of safe water daily - that's enough for all of the water needs for a household of 10 people. The filter will last at least a decade. The cost is a mere $50 each. Heck, at that price donate one each month!

Did you know that unsafe water carries disease. Unsafe water is the cause of about half of the disease in the world - more than AIDs and cancer combined! And waterborne illnesses are killing more than 5,000 children each and every day. It is the largest cause of death for children–nearly one child every 15 seconds.

You can make a difference. Visit their website at to learn more. And, while you are there join with me in making a donation.

Consider what you likely spend on coffee and bottled beverages each month, then give generously. You will be glad you did! Your gift will be health giving and life saving.

Oh, and be sure to share the HydrAid story with friends and family.

Saturday, June 7, 2008


"You are not here merely to make a living. You are here in order to enable the world to live more amply, with greater vision, with a finer spirit of hope and achievement. You are here to enrich the world, and you impoverish yourself if you forget the errand." - Woodrow Wilson
Saturday, May 31, 2008

Performance Matters - Idea #18

Marketing today results in tomorrows clients/customers/patients. Marketing is the life blood of every Practice. Unfortunately marketing is not a core competency of most Practices.

Marketing is both an art and a science. Marketing takes time. Marketing takes repetition. Marketing takes patience. Prioritization and persistence are keys to success.

All marketing initiatives are not of equal value. Many marketing initiatives are frankly wasted. Keep in mind the marketing is about creating awareness and interest. It is about securing mind-share. it is about building trust and relationships.

For clinically based Practices perhaps the best marketing is the contribution of time and expertise in the community that demonstrates the professionals knowledge, skill, and personality. Doing so creates value, appreciation, loyalty, and word of mouth endorsements.

Focus on meaningful community service activities that you and your team can participate in together at both company and personal expense. Pick events and activities that showcase what it is that will be attract the kind of clients you desire.

Market continuously - you are always on stage. Marketing materials are good. Personally stated marketing messages are better. Marketing actions are best. Market!

Need help with Practice growth strategies? Give Performance Builders a call - we have innovative solutions that get results!


Copyright 2008
Performance Builders
Tuesday, May 27, 2008


"I have found it advisable not to give too much heed to what people say when I am trying to accomplish something of consequence. Invariably they proclaim it can't be done."

- Calvin Coolidge
Saturday, May 17, 2008

Performanxce Matters - Idea #17

Conduct team building activities that will help people better understand their own and each other’s gifts and potential contributions. Use those activities to stimulate conversations that will bring people to greater levels of understanding, respect, and possibility. Use those conversations to encourage one another and to position each other for success.

Here are some ideas on where to start.
Read Leadership Above the Line by Sumner.
Read The Five Dysfunctions of a Team byLencioni.
Explore the powerful tools at
Explore Strengths Finder by Rath /

Provoke the potential of those around you. Need help? Give us a call...


(c) Copyright 2008
Performance Builders
Sunday, May 11, 2008


“The only thing that holds you back from getting what you want, is paying attention to what you don't want.” - Abraham-Hicks
Tuesday, May 6, 2008

Performance Matters - Idea #16

Encourage continually – Build on success. Work at the threshold of failure. But position people for for imminent success. Give the gift of courage by constantly encouraging.

A short story to illustrate the point...

Jaime Escalante, the teacher on whom the movie Stand and Deliver was based, tells an amazing story about a mistaken identity and the difference it made in a young man’s life.

This teacher had two students in his class who were both named Johnny. One Johnny was an excellent student, a happy child, and always had his homework completed on time. The other Johnny was always in trouble, never had his work finished, and generally made the teacher’s life miserable.

The night of their first PTA Open House of the year a mother stayed after the meeting to ask about her son, Johnny, and how he was getting along in the class. Assuming it was the mother of the “good” Johnny, the teacher replied, “I can’t tell you how much I appreciate him. I am so glad he’s in my class.”

The next day, for the first time all year, the “problem” Johnny had all his work done, he spoke up in class, and never once caused a disruption. He even volunteered to help another student.

The teacher was astounded! At the end of the day when everyone else had left, “problem” Johnny came up to the teacher and said, “My Mom told me what you said about me last night. I haven’t ever had a teacher who wanted me in his class.”

That Johnny became one of the best students the teacher ever had – and all because of a mistaken dose of appreciation!

No matter who we are and what our situation in life is, we all want and need to be appreciated."

-Source Unknown

Be Strong, Be Strong, Make Each Other Strong! - Ancient Jewish Chant


(c) Copyright 2008
Performance Builders
Monday, April 28, 2008

Performance Matters - Idea #15

Celebrate frequently and authentically.

Job satisfaction, loyalty, and performance has much to do with friendship, purpose and recognition. Celebration is evidence of all three.

How often do you celebrate with your team? How many ways do you know how to celebrate? Perhaps a chief celebration officer (CCO) is needed.

Celebration begins with something to celebrate... achievement, anniversary, opportunity, loyalty, or even just having "time to" celebrate. Celebration always acknowledges the something that is being celebrated in words written or spoken from the heart.

Celebration can be time spent together or time spent apart - try a celebration that allows employees unexpected time with family. Celebration is more about opportunities to bond than it is about money or time.

Celebration takes practice. Practice frequently. Celebration builds and defines community!


(c) copyright 2008
Performance Builders
Saturday, April 26, 2008


"To become something new, we must first become all that we can no longer be"
‑ Kevin Kelly
Wednesday, April 23, 2008

Performance Matters - Idea #14

Have you ever wondered why so much emphasis is placed in the work place on people improving their "weaknesses"? Why isn't more focus placed on understanding peoples strengths and then using them to their maximum potential. It comes back to what I've written about before, "Do more of what you do best and less of all of the rest."

Think how much happier and satisfied people would be if that was a core strategy of the business. Think how much more successful the business could be if that were a core business strategy!

Play to people’s strengths rather than trying to make them into someone they are not. Each person has a unique combination of gifts and experience unlike any other person. Managers need to get to know their people - what makes them tick? What is their unique knowledge, experience, skills? What stirs their passion? What do they aspire to?

For many manager's their greatest weakness is not knowing the answer to the above question for all of their people.

There are some great tools out there for helping a person or a team discover their strengths and to start the conversations that will help them better utilize them. Are you in conversation with your team? Are you engaging the tools to leverage the talent you have?

When people play to their strengths they actually increase their energy and loyalty. When they are working in their weaknesses they consume energy and and burn loyalty.

Get more out of each person by playing to their strengths.


(c) copyright 2008
Performance Builders
Sunday, April 20, 2008

Performance Matters - Idea #13

Recognize that about 5 % of any team are positive leaders who are fully committed to the organization’s performance and success – they are passionate about it. They lead by example.

Another 15% are negative leaders who undermine the organization’s performance and success. These are equally passionate people who very often operate in a passive aggressive mode. They lead by words usually spoken in private.

Both groups are opinion leaders! Both groups contribute to defining the culture, attitudes, and behaviors of the team. Both represent the team / organization to the community.

The remaining 80% of a team / organization are followers who can be effectively influenced by either the positive or negative leaders.

Management’s job is to effectively keep negative leaders in check or better eliminating them from the team quickly and decisively. Who you keep on your team says much about how you and your team will be perceived. Your team culture is worth protecting. There are no excuses for keeping negative leaders on your team. You are always better without them and so is the rest of your team!


(c) Copyright 2008
Performance Builders
Friday, April 18, 2008


"The body is limited. The mind is not. To enlarge your world, expand your mind." - Alan Cohen
Tuesday, April 15, 2008

Performance Matters - Idea #12

A portion of every professional’s compensation should be variable. Doing so provides professionals with feedback as to how well they are performing and contributing to the enterprize. Doing so also provides important financial management to practice managers. Variable expense can be managed to respond to changing conditions. Fixed expense means managers can only go along for the ride - even if it means damage to the practice.

Use incentive compensation to discriminate between high value and low value contributors. There are differences in the contribution of team members that deserve to be recognized. There are differences in individual contributions over time. There are differences in what the practice and its patients need as various times. Incentive compensation provides a mechanism for constant fairness, challenge, and accountability.

The matter of incentive compensation will be come ever more important in the coming years. Changes are occurring fast and will occur even faster as the clock continues to tick.

Those who will be best able to weather the impending financial challenges of change will be those who start now to reorder their priorities and their practices. Now would be a great time to start...

(c) Copyright 2008
Performance Builders
Monday, April 14, 2008


“I had been my whole life a bell, and never knew until at that moment I was lifted and stuck…” - Anne Dillard

What talents are hidden in those around you waiting for your hand to lift them?

What talents remain unexpressed in you yourself?

What voice would they give to your opportunities and success?
Saturday, April 12, 2008

Performance Matters - Idea #11

Research by The Gallop Poll has found that the greatest factor in employee loyalty and satisfaction is associated with each employee having a "best friend" at work.

Respect, nurture, and facilitate those friendships. Give them room to breath, grow, and to be celebrated.

When hiring ask yourself whether new employee candidates are likely to find a best friend amongst your team - do they share interests, values, and culture with others of your team?

Do you have a best friend at work? Whose best friend could you become?

Don't forget that the same principle applies to customers / clients / patients... are they finding a best friend in your practice? Are you also building their loyalty?


(c) Copyright 2008
Performance Builders
Tuesday, April 8, 2008


“We try to change events in order to avoid changing ourselves.” - Richard Rohr
Monday, April 7, 2008

Performance Matters - Idea #10

It is important to understand that money is not the most significant job satisfaction issue for most professionals. Of course every professional wants to be compensated fairly and competitively. When that does not occur, money does talk and rightly so. But there are other matters that matter.

Such matters include appreciation, encouragement, recognition, personal and professional development opportunities, friendship, respect, a quality environment, honesty, and transparency in communications and relationships. Then there are matters of opportunity for advancement in responsibility, leadership, job title, benefits, etc.

Of particular importance is the opportunity to do more of what one is best at in order to build confidence and contribute in an energy building way. The other side of the coin is to do less of what one is not best at in order to prevent energy drain.

Consider how you can use "soft benefits" to compliment your "hard currency" compensation system. When you do, everyone wins!


(c) Copyright 2008
Performance Builders
Sunday, April 6, 2008


"A bend in the road is not the end of the road unless you fail to make the turn." - Anonymous

What bends are there is your road?


"To become something new, we must first become all that we can no longer be"
‑ Kevin Kelly
Friday, April 4, 2008

Performance Matters - Idea #9

People react, they do not take direction. One's influence is not realized and one's leadership is not tapped until that truth is understood.

Manage the environment to provoke those reactions that will benefit the organization and its stakeholders.

Manage conversations to provoke new thoughts, new understandings, new appreciations. Conversations that are confrontational and that expose a persons vulnerabilities position people on the borders rather than at the heart of their potential.

Be thoughtful and intentional when provoking. It is rare to solicit positive contributing reactions when provocation is directed at ones fears and weaknesses rather than one's dreams and strengths.

Discover the promise and potential that lies in every person and organization. Provoke that promise for mutual good. After all, that is what good leadership, mentoring, and coaching is all about.


(c) copyright 2008
Performance Builders
Tuesday, April 1, 2008

Performance Matters - Idea #8

Recognize that a professional’s most valuable contribution is their discretionary effort – harness it by providing appropriate challenges, recognition, and reward for effort and performance. Align people with their passions and play to their strengths.


(c) copyright 2008
Performance Builders
Friday, March 28, 2008


"Knowledge is just rumor until it is in the muscle." - New Guinea Proverb
Tuesday, March 25, 2008

Performance Matters - Idea #7

Hold employees accountable for performance standards.

Define standards, establish a tracking system, provide a mechanism to measure staff performance daily , and provide staff with comparative feedback on how they are performing relative to standard and each other.

If performance is below standard it should be the employee’s responsibility to bring the matter and recommended solution to the manager/owner – it should not be the manager’s responsibility to police professionals or carry a stick.

Lacking the necessary performance tools that empower employees, the responsibility and burden rests with managers and owners. Performance begins with a process. How is your process and performance?


(c) copyright 2008
Performance Builders
Thursday, March 20, 2008


"In the beginner’s mind there are many possibilities. In the expert’s mind, there are few." -Suzuki Roshi
Tuesday, March 18, 2008

Performance Matters - Idea #6

Continuing education is considered to be just a benefit in most Practices. The result is predictable - employees use "the benefit" to pursue their interests rather than the interests and needs of the Practice.

Continuing Education is a powerful tool for Practice growth and competitive advantage. It's too valuable to leave to the discretion of employees. It should be recognized as the powerful strategic tool it is and managed accordingly.

A professional development plan should be a part of every performance review. It should lay-out a multi year strategy for developing staff competencies and individual strengths for the strategic benefit of both the Practice and the employee. It should go a step further by creating expectations and obligations for employees returning from continuing education events to share what they have learned with the rest of the team - the student becomes the teacher. The result is a win/win/win outcome.

Training that does not translate into enhanced Practice service, growth, and revenue is frankly wasted. Leverage continuing education by making strategic investments in your people and harnessing its strategic potential in your Practice.

Focus less on performance appraisals than on professional development plans. Keep development aimed at increasing value as a team player and Practice contribution rather than on personal interests/agendas. Put professional development plans in writing and let the professional own the responsibility for attainment within timelines and budgets.


(c) copyright 2008
Performance Builders

In doing
Thursday, March 13, 2008

Performance Matters - Idea #5

In most Practices matters related to an employee's annual performance review and compensation review occur at the same time. When that happens matters of performance and professional development are too often overshadowed by employee considerations "what is my raise"?

This raises two concerns for employers.

First as reimbursement continues to erode (it has and it will) and labor shortages drive up compensation expectations it will become harder and harder to justify "the traditional annual increase".

Second the importance of personal performance and strategic professional development (more on that next time) will become ever more important for the Practice to maintain a strategic advantage in the market and for the the professional to maintain job security.

Matters of compensation invariably carry with it an emotional overtone whenever employee expectations are not fully met. When that happens matters of performance rarely receive the consideration they merit. The result is that both parties lose.

Disconnect the link between annual compensation reviews and performance evaluations / professional development planning. Do so by scheduling compensation reviews to coincide with the beginning of the Practice's fiscal year and performance reviews / professional development planning with the employee's anniversary date of employment. In some situations an alternative schedule may need to be used when those dates occur close to each other.

Favorable employee performance and contribution do not necessarily translate into a practice's ability to increase compensation – this reality will become more pronounced in the years ahead.

Linking these matters often contribute to false expectations and resulting problems. Create some time between those discussions to assure that each topic gets its just consideration.


(c) Copyright 2008
Performance Builders
Tuesday, March 11, 2008


""Well done is better than well said." - Ben Franklin

"After all is said and done there's a lot more said than done." - Anonymous
Sunday, March 9, 2008

Performance Matters - Idea #4

Protect the viability of your Practice and the job security of loyal staff through the use of appropriate employment agreements.

Have professional staff sign confidentiality, no-compete, and non-solicitation agreements, and annual conflict of interest / full disclosure statements to minimize the potential they will jeopardize the viability of the Practice or the job security of other team members by leaving the Practice and taking key referral relationships and staff with them.

While every professional has the right to pursue their own careers and opportunities it only makes good business sense to prevent them from doing so at the expense of the Practice and its loyal staff.

The Practice is a business - its important to run it as such by implementing appropriate legal controls.


(c) copyright 2008
Performance Builders
Thursday, March 6, 2008

Performance Matters - Idea #3

As a business owner or manager remember that clients come second!

What did I just say? Heresy you say? Are you thinking that clients should come first?

In the book The Customer Comes Second by Hal Rosenbluth, the author offers an important insight - it is the responsibility of management and owners to model out to employees the behaviors they expect employees to demonstrate in serving customers.

Employees are on the front line of customer service. Management is one step back. One can not expect employees to treat customers differently than they themselves have been treated by management. Employees learn by observation and experience. What kind of experience are you creating for employees? Does it align with the kind of experience you expect your employees to provide for your clients? Do you walk your own talk? Are employees getting a mixed message?

Demonstrate your values through your behavior and actions. Remember that you are always teaching whether you intend to or not.


(c) Copyright 2008
Performance Builders
Sunday, March 2, 2008


"In the beginner’s mind there are many possibilities. In the expert’s mind, there are few."
- Suzuki Roshi
Saturday, March 1, 2008

Performance Matters - Idea #2

Be sure that every team member understands that service is not about them.

Service is about those people who the Practice is privileged to have the opportunity to serve.

Consider posting a message of this in staff areas as a daily reminder.

One Practice I know painted, "Service - it's not about me." on the office wall over the staff's workstations. Staff could see it but clients could not. It served as a constant reminder of every team members constant priorities.


(c) Copyright 2008
Performance Builders
Thursday, February 28, 2008


"In business and in all of life, only truth is sustainable". - Bob Wiersma
Wednesday, February 27, 2008

Performance Matters - Idea #1

Begin by establishing Ground Rules pertaining to staff behavior. About 5 such rules is generally about right. A few more or less is fine. The intent is not to create an exhaustive list but rather over arching behaviors that can be used to address any situation that a team member might come up against. Ground Rules are the litmus test for appropriateness and excellence in relationships.

Ground Rules should summarize key values that will be practiced in personal relationships internal and external to the Practice. They should address how people will be treated. Ground Rules are always non-negotiable! They represent minimal acceptable conduct. All team members are required to pledge their support to the Ground Rules should be posted and discussed regularly. They should be a part of new team member orientation and should be routinely addressed in performance review.

Consider values such as mutual respect, honesty, integrity, transparency and completeness in communications, confidentiality, commitment to learning & teaching, etc.

Shared values should be discuss frequently, practiced daily, and celebrated.

Failure to establish Ground Rules is essentially permission from management that anything goes. What results is chaos and the Practice's inability to reach its full promise and potential.

Begin with meaningful Ground Rules!


(c) Copyright 2008
Performance Builders
Saturday, February 23, 2008

Speaking About Performance

I don't know about you, but I don't aspire to be average. Read my lips, "There is nothing distinctive about being average"! Average is so... so average!

It amazes me how often Practice owners, managers, and clinical professionals compare their performance to the average and then rationalize their satisfaction with their performance.

That's no way to lead. That's no way to serve. That's no way to grow. And, that it is certainly no way to win!

When your child is sick or injured do you go to the Internet and talk with friends to find an average hospital and an average physician? When you celebrate a special event do you dress in your everyday clothes and and take friends and family to an average restaurant? If you want to be the best athlete you can be do you go looking for an average coach and trainer? Do you aspire to play on an average team? Do you cheer your favorite team because they are having an average season this this year?

We aspire to have the best, to associate with the best, and to be the best!

Great performance is the product of great preparation and positioning.

I'd like to take the next few weeks to share performance building ideas with you that will change the way you manage, how your team performs, and how others will view your Practice. I'd like to share ideas with you for transforming your Practice from good, to better, to best.

Let's take a look at 36 ideas that will transform your Practice starting right now!


(c) Copyright 2008
Performance Builders

Tuesday, February 19, 2008

Play It Forward Conclusion

Well that provides an overview of the Play-It-Forward marketing strategy. Over time, you will likely discover it to be the corner stone of your marketing plan - the marketing difference that makes the difference. Of course there are many more Performance Builders strategies to provoke your practice to perform to its potential - contact us to learn more.

By the way, appointment no-shows and passive discharges (clients / patients who quit showing up) are indicators that there are opportunities for improvement in client relations. No-shows and cancelations are also evidence that one has a marketing problem! They represent people who are unlikely to be bragging about their achievement or your service.

They represent lost opportunities for your shared story to be told.

Your goal is to make every client your loyal friend and advocate by training them to Play-It-Forward.

Consider how you could build an encouraging, enriching, empowering, and emboldening Pay-It-Forward, word-of-mouth marketing strategy into your Practice.

Consider the lives you could touch if every patient / client became an advocate (marketer) for you and your Practice! Think win / win / win! The client wins, you win, and the community wins!

Encouragement + Evidence = Empowerment

A well executed "Play It Forward" strategy is just one of some 2 dozen Performance Builders strategies that contribute to the reduction of no-shows and cancelations and the increase in growth and profitability in any Practice.

I hope the Play-It-Forward strategy contributes real value in your Practice! If it does I would love to hear about your story.

All the Best!

(c) Copyright 2008
Performance Builders
Friday, February 15, 2008


"It's not who you are that holds you back, it's who you think you're not."- Anonymous
Tuesday, February 12, 2008

Play It Forward Idea #7

Idea #7 The best marketing messages are delivered not by you, but rather by others who speak on your behalf - i.e. your advocates.

Remember the three TRUTHS we began with? Navigage back and take a second look...

Consider events that you could periodically host that would provide a no risk opportunity for people (new client prospects) to experience an example of your hospitality, knowledge, skills, service, and empowerment. Imagine events where new prospects could share conversation with people whose goals and dreams you have already benefited. Create a setting where your old clients can casually tell their story once again (brag) and feel like the expert. Provide a trusted environment where new potential clients can benefit from the experience and recommendations of your advaocates. ...people who will advocate on your behalf because they believe in what you have done for them in thier lives.

Think about what opportunities you could create – what if…


(c) Copyright 2008
Performance Builders
Friday, February 8, 2008


"We must adjust to an ever changing road…while holding onto unchanging principles” - Anonymous
Tuesday, February 5, 2008

Play It Forward Idea #6

Idea #6. Let clients know that by virtue of their relationship with your Practice, the Practice will take special care of friends and family that they refer to you.

If they are interested, provide them with a few of your Preferred Business Cards that they can pass along to family and friends. Include on your Preferred Card a “private phone number” that they and friends can use to access your Practice and assure they will receive “Preferred Access and Services”.

Perhaps there are special considerations you could offer those who come to you by way of such recommendations – use your imagination.

People love to be able to provide friends with special privileges or services whether it is at a local business, a special restaurant, or your Practice. Friends take care of friends.

Friends taking care of friends is playing it forward. Treat every client as a friend and begin the Play It Forward Chain Reaction that will eventually leade back to your Practice!


(c) Copyright 2008
Performance Builders
Sunday, February 3, 2008


“Success is not final, failure is not fatal: it is the courage to continue that counts.” - Winston Churchill

All The Best!


Performance Builders
Friday, February 1, 2008

Play It Forward Idea #5

Idea #5. Make a quality copy of the client's story of achievement and photo, and send it to them at home a week or so after discharge. Include a brief note that acknowledges your privilege and pleasure in serving them and recognition of their achievement. You can assume with confidence that if it is well done it will be shared (played forward) with friends and family.
Thursday, January 31, 2008


"Perception is a mirror, not a fact." - Schucman and Thetford, A Course in Miracles
Tuesday, January 29, 2008

Play It Forward Idea #4

Idea #4. Be generous with your authentic praise and recognition of your clients achievement throughout your time with them. That should be easy if you are continually and intentionally positioning them for success in mind, body, and spirit.

Upon completion of their treatment / training, ask if they would be willing to share their story of achievement with others – i.e. with your new clients who may not know what to expect and who may need encouragement, and with your referral sources whose knowing would benefit their other patients. Give them the choice of sharing their experience anonymously or by name.

To enable them tell their story, provide them a page of your practice stationary with the title “My Experience…” at the top. Invite them to write what they would like about their experience and what it has meant to them. They can complete it at your office or return it to you in the self addressed stamped envelope you provide them.

Two alternatives would be to provide them a special phone line that allows them to tell their story to voice mail from which you can transcribe it, or email them a reminder and allow them to email their story back to you.

Be sure to obtain their written permission to use their story.

If they are willing, you might also take a digital photo that can accompany their story (also with their written permission). Invite them to pose with you and perhaps another of your staff who they have come to specially appreciate - perhaps you can even show-off their achievement in the photo. Remember that the photo is an act of recognition and celebration, so take a couple of minutes to enjoy it together!

Post the photo(s) in a prominent location (the wall of fame) in your office for a few weeks for others to see; then move it to an upscale album or two that is placed in your reception area for viewing by those who visit your practice. Include the both their picture and their story in the album.

Make it an inviting album that people will want to pick up and browse. Be sure to include "celebrity clients", and pictures of your clinical team, and special community events or groups you have sponsored. Your album becomes your "Brag Book"... a silent marketing partner that is always in your reception area.


(c) copyright 2008
Performance Builders

Perhaps portions of your album could also be incorporated into your website...
Saturday, January 26, 2008


"To know, and not to do, is not to know." - Leo Buscaglia

I'm consistently amazed at the number of Practice owners and managers who "know" but don't do... There are hundreds of reasons for not doing but all of them spell "missed opportunity", "potential not realized" and "reward left on the table".


(c) Copyright 2008
Performance Builders
Friday, January 25, 2008

Play It Forward Idea #3

Idea #3. Routinely give your clients an opportunity to tell the story of their progress and achievement. Invite them to tell it to you, members of your team, or to someone that happens to be in your practice at the moment (e.g. another client, visitor, referral source, etc.).

Why? Because their story is too good, and your reputation to important, to leave its telling to chance.

Give your clients an opportunity to practice telling their story – help them embellish it a little (every good story gets embellished). Polish it! Give it some punch!

Remember, good stories get told and retold. They get remembered. Your client's story becomes your marketing as it is told about the community. Your client becomes your advocate! They do your marketing and feel great doing it!


(c) Copyright 2008
Performance Builders
Thursday, January 24, 2008


“The worst prison would be a closed heart.” Anonymous (often attributed to Pope John Paul II)
Wednesday, January 23, 2008

Play It Forward Idea #2

Idea #2. Provide each client regular tangible evidence of their gains toward their goals – that evidence could potentially be in the form of graphs, photos, video, letter, email, mementos, achievement awards, etc. Be sure it is something of perceived value and would not be perceived in any way as tacky.

Frequently recognize achievements to give clients something personal to take home and brag about. Always be sure the recognition has been earned and is authentic! This is easy to assure if you are consistently positioning the client for imminent success - i.e. encouraging them.

Again make the evidence something that they will want to share, and be able to conveniently share with family and friends - something that will provoke the conversations where they can do a little bragging and in doing so brag about your Practice.

Be sure to include your Practice logo on the evidence you share with them. Then on their next visit be sure to ask them who they shared their evidence with - doing so assures them that sharing is expected and essentially gives them permission to do so.

All The Best!

(c) Copyright 2008
Performance Builders
Sunday, January 20, 2008


“I love those who yearn for the impossible.” - Goethe
Saturday, January 19, 2008

Play It Forward Idea #1

Lets continue the previous post by beginning to explore 7 ideas that taken together will provide the framework for putting a Play-It-Forward (PIF) strategy into practice - your Practice. Perhaps you won't change the world, but you are likely to change someone's world.

We'll consider another idea every few days till all 7 are discussed and then we will piece them all together into a single Practice changing strategy. By implementing these ideas in your Practice, it will certainly change your world.

Idea #1. Measure performance gains for all clients and patients on the basis of one or two overarching goals they define – i.e. based on functional abilities that are important and motivating to them. Sure, you can have your professional goals for them as well, but there will be nothing more inspiring and motivating to them than their goal! It is what will keep them coming back and tuned into you!

What is it they want to be able to do or achieve? ...To get rid of pain, to be able to do something without pain, to be able to do something again, to be able to do something for the first time, to find pleasure, to prevent something from happening, to fulfill a dream, to become, to...

Keep it personal, that way it will be something that they will want to talk about in their circle of family and friends. You want them to talk! Even better you want them to brag about what they accomplished with your help!

It all begins with your understanding of, and commitment to, their personal goals. In doing so, you forge the first link in what will be a PIF chain reaction that will grow your Practice and your influence.

All The Best!


(c) Copyright 2008
Thursday, January 17, 2008


“Weakness of attitude becomes weakness of character”. - Albert Einstein
Wednesday, January 16, 2008

Play It Forward

I had a GIFT Fellow comment recently about having watched the movie Play It Forward, with Keven Spacey, Hellen Hunt, and Haley Joel Osment - perhaps you remember it. The Play I Forward philosophy says, when someone does you a favor, don't pay it back but instead play it forward. Suppose that philosophy caught on... how could such a chain reaction change the world, your world? She posed the question, what would a play it forward strategy look like in a physical therapy Practice.

That's an interesting question...

A fundamental premise of Applied Functional Science is encouraement,or "positioning people for success". There are important pay-it-forward marketing strategies that have significant business implications for those commited to excellence and growth. I'd like to share with you some ideas over the next several postings that create pay-it -forward, word-of-mouth marketing opportunities that can benefit clients, community, and practice.

In addition to client benefits, there is a tangible business asset side to it as well that builds practices and provides rewards.

First a little perspective…Keep in mind that people buy from, and support, those they like and trust. But before they can like you they need to find you – that’s where marketing comes into play. So consider a strategy to build a pay-it-forward element into your marketing plan (if you don’t have a marketing plan consider this model as a potential foundation for building one). This is not an overnight marketing scheme that exploits people, but rather a marketing strategy that is built on relationships and respect – one that builds sustainable growth and loyalty.

Here are three marketing insights that you ignore at your expense…

1. New clients are the result of someone making a decision. So the question to ask is, “What can I do to make decisions to use my Practice easier and faster?” Remember faster decisions mean more decisions because a deferred decision too often results in no positive action being taken – i.e. a passive “no”.

2. People are too busy to research and fully consider every decision they must make. Many people also feel unqualified to make decisions about complex issues pertaining to everything from health matters, to vacation destinations, to automobile selection. When it comes to these matters people tend to defer to the advice of others whom they trust. Think of it as a shortcut (faster and easier) to a decision.

3. People are generally adverse to risk. That’s why "try it before you buy" offers tend to be so effective – they provide low-risk opportunities to experience and experiment. And, that is also why "word-of-mouth" recommendations are so powerful.

So how does one practically turn these “TRUTHS” into an encouraging and empowering pay-it-forward marketing strategy that can produce the chain reaction that culminates in growth for the Practice and more people benefiting from your expertice? More on that next time...


(c) Copyright 2008
Performance Builders
Monday, January 14, 2008


“Failure is simply the opportunity to begin again more intelligently.” - Henry Ford
Sunday, January 13, 2008

Compensation Negotiations

I had an email from a colleague recently asking about compensation expectations of a prospective part-time therapist. The back-story is that the therapist was coming from a large Midwestern city and moving into a smaller community in the southeast. The employer was taken back by the compensation expectations of the therapist.

In such situations there is no substitute for fact finding to sort through the fog of conflicting expectations. Here are some of the considerations that needed to be discussed...

1. Cost of Living – turned out there was more than a 20% difference between the two communities that needed to be considered.
2. APTA conducts periodic compensation surveys that are posted on its website. Such data provided relevent benchmarking opportunities for comparison.
3. The number and flexibility of hours worked at the two locations could have been a factor.
4. There were important questions to discuss about the relative level of supervision and responsibility required between the two positions in question.
5. There was the possibility that special skills may not have been required in the new position.
6. There were matters concerning whether there was any premium time (evenings and weekends), adverse conditions (hard to staff location), or exclusive services (e.g. high-end club) involved with the previous position.
7. There were potential commuting and parking reimbursement amounts included in the previous salary.
8. There was the possibility that the prospective therapist may have been paid additional salary in lieu receiving employer paid benefits.
9. It wasn't clear initially if the hourly rate the therapist quoted was paid as an employee or an independent contractor… if it was the latter the therapist would be responsible for all payroll taxes - that would add another 7.65% to the therapist's obligations while saving the employer an equal amount.
10. And finally there was the consideration of third party reimbursement between the two communities - how might that affect a Practices capacity to compensate?

Recruitment discussions invariably result in the discussion of compensation expectations of the two parties. More often than not there is a gap between what is offered and expected. Too often a potential deal breaks down or negotiations heat up because the facts are not on the table. The result is comparing the proverbial apples to oranges. Before discussing the specifics of compensation amounts it is always a good idea to explore contextual questions in order to put both parties on the same page. There is no substitute for good due-diligence.

Bob Wiersma
Performance Builders

Copyright 2008 Performance Builders
Saturday, January 5, 2008


"In a sense, knowledge shrinks as wisdom grows, for details are swallowed up in principles....but the habit of the active utilization of well understood principles is the final possession of wisdom." - Alfred North Whitehead
Wednesday, January 2, 2008

Best Practices

It seems everyone is talking about "Best Practice" these days. But lets ask a tough and perhaps controversial question... Is Best Practice what is best for your Practice?

Say what? Heresy are you thinking? Let's dig a little deeper...

If every Practice was just like every other Practice (think clone) - same training and skill set, same service offering, same space and equipment, same patient mix, same community, same location, same competitors, same business performance, same ...well you get the picture; then Best Practice might be just the answer.

Even then one must always ask, "Best for whom?"

The fact is that every Practice has certain uniquenesses that set it apart from the rest - for better or for worse. It is just those differences that make Best Practice problematic. There is of course no competitive advantage in sameness - competitive advantage comes from the exploitation of differences and innovation. If everyone adopted Best Practice then by definition everyone would be average - again, there's no competitive advantage in average.

If all were average, then who would discover Better Practices? How adaptable and sustainable would our Practices be in an ever changing world if there were little to no diversity in our gene pool? Evolution and genetics teach us that the ability to survive and thrive is found in diversity, options, and alternatives.

Could standardized Best Practice keep up with the pace of our ever evolving, rapidly changing, and increasingly more complex world? Where would innovation come from in such a Practice environment? Can conformity withstand obsolescene?

Success in Practice is similar in many ways to success in financial investment, where the first principle is risk management. A key strategy in reducing financial risk while retaining a favorable return on investment is a diversified portfolio. If one were to apply that principle to Practice management, one might be more interested in a portfolio of diversified "Better Practices" than an undiversified supposedly Best Practice.

Performance sustainability over time is more about innovation, agility, resiliency, and adaptability to a rapidly changing environment than it is about the exploitation of yesterday's Best Practice.

Those Practices that are satisfied with being average will be satisfied with Best Practice. However those Practices that aspire to lead, serve well, and earn exceptional reward will be better served by collecting emerging Better Practices and customizing for their Practice.

Best Practice is ultimately a joyless box of conformity. Better Practices represent an endless journey toward new challenges, opportunity, performance, and reward.

Will it be conformance or performance for your Practice?

In which environment will you practice?

Is your Practice plugged into innovation? Is it wired for innovation? Will it power your future?


Copyright 2008
Performance Builders