Quotable - Truth Series

“You want the Truth? ...You can’t handle the Truth!” Jack Nicholson, in the movie A Few Good Men

Safe Water Update - Philanthropy

For those of you who have been tracking with me over the past couple of years through the Gray Institute GIFT mentoring program or my Performance Matters Management Series (email), you are aware of my advocacy for safe water for impoverished families in developing countries.

I'm pleased to share with you some exciting news that was announced this week concerning the structural reorganization of the global HydrAid BioSand Filter safe water initiative. The HydrAid initiative has been transferred from International Aid, Inc to a new joint venture involving Cascade Engineering and The Windquest Group.

The HydrAid program was launched by International Aid, Inc in 2007. I was privileged to serve on International Aid's Board of Directors during that time and to later provide operational leadership for HydrAid during its implementation in 2008. The recent reorganization increases HydrAid reach and capacity to provide safe water and save lives throughout the developing world.

The following links provide details about the HydrAid Filter and the new Joint Venture. The HydrAid filter is being used in an innovative program involving Thirsting To Serve (a Rotary nonprofit organization) and Project Handclasp (a US Navy nonprofit organization).

I invite you to join me in making a making a tax-deductible charitable contribution to Thirsting To Serve. Your donation is a real Game Changer for families in desperate need!

Thanks !

Bob

(c) Copyright 2010
Performance Builders

Quotable - Truth Series

"The truth in you remains as radiant as a star, as pure as light, as innocent as love itself." - A Course in Miracles

Game Changers - Benchmarking

As we have discussed in resent postings, The Game is Changing!


It has been said that, "A bend in the road is not the end of the road, unless you fail to make the turn". Does your road have a bend ahead? Can you see it or is shrouded in darkness and fog? Are you prepared for it? Are your skills sufficient to negotiate it successfully?


We all travel our own unique practice path defined by education, experience, geography, facility, services, systems, resources, values, philosophy, team, etc. But it is important to remember that each person's unique path is in many ways just like everyone else's!


Thus there is opportunity and value in learning from what others are doing.


I have the distinct privilege every week to talk with many practices across the country and around the world - to understand their challenges, to learn about what they are doing, and to influence the decisions they make and the strategies they implement. Over the next several weeks I will be sharing with you what I am working on with leading practices.


Hint: There's a reason why they are leading practices!


Let's begin with BENCHMARKING.


Benchmarking is the science and discipline of objectively and quantifiable comparing the performance of one thing to another. School teachers compare student performance with grades of A - F, grade point averages - 0 - 4, and class rankings from 0-100. Athletic performance is compared by benchmarking certain performance statistics that are relevant to a particular sport - yards rushing, batting average, shots on goal, shooting average, etc). Wall Street uses benchmarking to compare the performance of various investments - stock price, return on investments, shares traded, EBITDA, PE Ratio, etc. The auto industry benchmarks its products through spec sheets - horsepower, torque, acceleration 0-60 mph, miles per gallon, etc.


Benchmarking provides a systematic methodology for ranking, evaluating, and tracking performance. Benchmarking is transparent - it makes differences obvious. Benchmarking is discriminatory - its purpose is to differentiate and stratify performance. Benchmarking identifies differences, defines priorities, demands decisions, and justifies rewards.


Like GPS, benchmarking tells you where you are, what direction you are headed, your relationship to your destination, and how fast you are traveling. Being lost can have two elements - not knowing your destination or not knowing your location! Both may be solved with accurate information.


In business there are three types of benchmarking:
1. Performance benchmarking measures and compares performance statistics. ...where are we?
2. Operational benchmarking defines and compares work processes and systems. ...what roads are we taking?
3. Prescriptive benchmarking establishes and details best practices for replication. ...who can give us directions?


Each benchmarking strategy offers opportunity to improve performance, increase competitiveness, and earn greater reward. Together the strategies enable businesses to get "un-lost", to find its way out of the woods, to get on the right road, to find Shangri la.


In the health services sector key benchmarks include operational, utilization, and financial metrics. A comprehensive benchmarking dashboard includes approximately three dozen points of comparison (metrics). Each metric provides a unique reference point although incomplete perspective on practice performance. Together benchmark metrics tell a story - a story of achievement and failure, a story of missed reward and future opportunity.


Every practice has room for improvement. Not one-time improvement but improvement that once-secured will provide enhanced reward day after day for years to come! Leading practices understand that benchmarking is a low cost investment with a guaranteed return on investment.


Make no mistake, benchmarking is all about improving profitability, competitive advantage, and building practice equity!


Benchmarking is a simple but sophisticated process. The results are transformational - a real Game Changer! Where is your road taking you?


The next post will consider variable compensation - a potent and necessary Game Changer!


All The Best!


Bob


(c) Copyright 2010
Performance Builders

Quotable - Truth Series

"Truth is like the sun. You can shut it out for a time, but it ain't goin' away.” - Elvis Presley

Game Changers - On Reflection...

So we have been considering Game Changers for the past few weeks. I’ve shared the trends that I am tracking. I’ve gone out on a limb and shared what I see in my “Crystal Ball”. Now I’d like to share a brief case study that comes from my personal / professional experience that is relevant to these discussions...


As I look about the industry today, I see signs that are reminiscent of 1995. At that time I was privileged to be a senior executive with an innovative, fast growing, quality oriented rehabilitation practice that operated 180+ clinical operations in 7 states with a staff of over 900 people. While the company had been growing at an average of 30% annually for over a decade with exceptional success, and the previous year had been the best on record, we sensed that significant change was imminent. Most others in the industry didn’t agree.


We followed our intuition and I accepted the challenge of taking a cross disciplinary team offline for five months to research the market, consider the situation, develop a strategy, and implement a plan of action. In our findings we concluded that within three years there would be surplus of professional staff (unheard of, in fact we were recruiting internationally to meet staffing needs) and that the company would need to reduce its expenses by 25% within 18 months without resorting to layoffs (we believed there were growth opportunities ahead for us). The goal was to enhance performance. The goal was achieved.


Then in 1997 the Federal Balanced Budget Act was enacted. It was implemented in FY 1998 for the purpose of reducing Medicare costs. Over the next three years there was indeed a surplus of physical therapy staff. Competitors laid-off staff and more than a few went out of business. Meanwhile, our company used its new competitive advantage (less overhead and greater productivity) to take on new business and lay the ground work for a major expansion.


As I said, I see signs reminiscent of 1995 in today’s market only on a greater scale. History, experience, and intuition suggest it is time for reflection, decisions and actions. It is in that context that I read my “Crystal Ball”.


In the next post I’ll discuss some of the strategies that I’m privileged to be working on with leading practices around the nation.


Bob


(c) Copyright 2009
Performance Builders

Quotable - Truth Series

“The truth is more important than the facts”. - Frank Lloyd Wright

Get the Big Picture

Since we are on the topic of Game Changers, I would like to recommend three books that effectively frame the ongoing national health debate...

1. The Healing of America by T.R. Reid
2. The Coming Generational Storm by Kotlikoff & Burns
3. Who Killed Health Care by Herzlinger

If you are a health professional, these books are must reads.

You might also find Demanding Medical Excellence by Millenson to be a valuable read.

Bob

(c) Copyright 2010
Performance Builders

I'm Back - Leadership

As you know I've been away for a couple of months - a time for volunteer activities with SafeWaterTeam and Free2Play, participation in GIFT Gathering-3, 2010, continuing education, recreation, and memorable time with family and friends. Loved it!


Over the next few weeks, I'll share a new series of blogs on leadership. We'll take some time to consider insights into leadership and explore the nature of leadership, management, mentoring, and coaching.


The measure of leadership is not "follower-ship", but rather the creation of new and capable leaders.


I look forward to leading the way...


All The Best!


Bob


(c) copyright 2010
Performance Builders

Game Changers - Crystal Ball Part 2

In the “Crystal Ball” Part 1 post we identified the rise of function, the erosion of reimbursement, and the increase of labor expenses as significant emerging realities in the industry. This post considers four additional emergent trends that will need to be included in the strategic plans of every practice.


4. Competition within the neuro-muscular-skeletal market will increase significantly. This will be driven by another perfect storm that involves: the aging demographics, erosion of traditional reimbursement, increasing co-pays, deductibles and out of pocket expenses, expansion in scope of practice and service offerings, expansion of unregulated providers, more sophisticated marketing and internet based services. Competitors will include physical therapists, chiropractors, personal trainers, osteopaths, and podiatrists among others. The increase in competition will be obvious within each of those professions and across them as a group. Meanwhile expect cross disciplinary alliances to form that will leverage a shared philosophy of treatment and complimentary skill sets. Applied Functional Science will become an important rallying point.


5. Tremendous professional and business opportunity will emerge out a rapidly changing market over the next five years and beyond. BUT, most of those opportunities will be what might be described as “out-of-the-box”. Practices that are trapped in traditional business models and practice patterns or who are slow to change and are late adopters of innovation will find opportunities passing them by. The market will favor practices that are “plugged into the market”, visionary, creative, open to innovation, accessible to financial resources, able to attract and hold superior talent, willing to take risks, and skilled at execution – i.e. those who are Fast Change Artists. Providers who once viewed practice acts and regulatory controls as protective walls in which they could professionally practice will likely find those same walls becoming barriers to entry into emerging out-of-the-box market opportunities.


6. Cash-based business will, out of necessity, become an important element of every practice’s financial strategy and portfolio. This not to say the insurance is going away, but rather that Cash-based out-of-pocket compensation will need to be a growing portion of every Practice Portfolio. That will require sophisticated consumer oriented marketing, more client-centric operations, a superior service experience, and a value orientation. Such business will be conducted to a large extent outside of the walls of the provider’s facility. Professionals will need to engage in financial matters in a much more hands-on-manner than they have historically been willing (comfortable) to do.


Clinical practices and financial practices will collide – there will be casualties.


7. Practices will run like businesses or fail. Excellent clinical skills will be necessary but not sufficient. Competencies in leadership, marketing, operational management, service excellence, and financial savvy will be essential. This is not a far-off situation. It is the case today, although many practice owners and most clinical professionals have not yet recognized it or are unwilling to confront the inevitable. What is needed is a new emphasis on business structure, strategy, planning, investment, business models, competitive advantage, operational performance, accountability, decision support, risk sharing, variable compensation, etc. At least a third of practices today are at high risk of failure over the next few years simply because their business model and performance is not sustainable. Another third of practices are in the balance, i.e. they could tip either way dependant on their short term business decisions. The remaining third of practices are positioned to expand by taking over new business opportunities that will result from the business failure of their competitors.


Whether they are prepared to seize those opportunities is another matter - a matter of vision, risk taking willingness, capital, and expertise.


In the Chinese alphabet the symbol for crisis is a composite of the two symbols - one represents opportunity the other threat. And so it is with any period of change – in times of change some will find or make opportunity and flourish while others will succumb or be consumed by it. There are the hunters and the hunted...


There is an old saying in the worlds of sports and business that goes like this:


“Every morning in Africa, a gazelle wakes up. It knows it must run faster than the fastest lion or it will be killed.

Every morning a lion wakes up. It knows it must run faster than the slowest gazelle or it will starve to death.

So, in Africa it doesn’t matter if you are a lion or a gazelle. When the sun comes up, you had better be running. “ - Anonymous


To run the race, to compete, one must prepare and train. There has been and will continue to be a leveling of the "playing field". Practices large and small, fast and slow, credentialed and uncredentialed, well-circulated and newly-minted all share the the same unforgiving plains of competition. Make no mistake, the game is played for keeps.


Next post I’ll share a brief story from a chapter in my professional experience that is relevant in this consideration of Game Changers.


Bob


(c) Copyright 2009
Performance Builders