Posts
With the holiday season comes the annual question, "what should the Practice do about giving a holiday bonus this year?" Well before you answer that question consider this?
Is your holiday gift a seasonal thank you or is it part of the employee's compensation?
If it is the later and you are thinking now about what you should do, you are in trouble. That's because you should have a predetermined formula for calculating compensation bonuses or you can never be fair about it - either you will be under-rewarding the employee or the Practice. Neither is healthy or acceptable. What should the formula be? That depends. It depends on matters of risk, competition, performance, contribution, leadership, finances, labor availability, relationships, promises, and more. Do the best you can to be fair to both your employee and your Practice this year but more importantly start now to determine a fair, rational, and disciplined bonus calculation formula for next year. Even better move to a variable compensation program - that will solve the bonus matter and in fact the entire compensation matter once and for all.
If your holiday bonus is simply a thank you, consider an alternative this year... Give the gift of time. The holidays are a little slow for many Practices, so consider giving your people an extra day, or portion thereof, off to spend with family and friends! Then make a donation to a charitable organization in the name of Practice team! Perhaps you might even want to get together as a team to spend part of a day volunteering to help a charity. It's great service to your community, recognition for your employees, morale builder, and don't underestimate what it will do for your Practice's reputation in the community.
Enjoy your holidays and make them rewarding - it matters!
Bob
Copyright 2007
Performance Builders
Saturday, November 24, 2007
Wednesday, November 21, 2007
Thank You
Well the holiday season is here again ... tomorrow is Thanksgiving Day, and there is so much to be thankful for. Thank you to friends / clients for another great year of challenges, achievement, and most of all FRIENDSHIP!
Be well. Do good. Dream BIG! And, may your holidays be blessed!
Thank you!
Bob
Performance Builders
Be well. Do good. Dream BIG! And, may your holidays be blessed!
Thank you!
Bob
Performance Builders
Friday, November 16, 2007
Marketing
I took a call from a new client this week asking for help in growing his practice - i.e. getting more referrals. We talked for about an hour and a half about options, priorities, strategies, and "how to".
On one hand every practice is unique in many ways - clinician training, skill levels, services offered, location, facilities, community, and more... Problem is most practices don't leverage those differences to make a difference in their marketing initiatives.
On the other hand it could be said, "every practice is unique just like every other one" - in other words a lot of differences don't make a difference. This is particularly true in an industry that is relatively unsophisticated in marketing and one that depends on "me too" strategies - think newsletters, office visits to referral sources, and bring in the bagels. These are marketing techniques that don't make much difference in most markets. There needs to be better ways... and there are!
Then there is the matter of reality... In a recent study is was reported that something like 90% of professionals rated themselves in the top 5% as it applied to performance. Its appearently very crowed at the top! Sounds like Garrison Keillor's' Lake Wobegon "where all of the children are above average". Of course statistically 50% of Practices are below average and most don't know what average is. And of course, most Practices performing above average also have plenty of room for improvement and and reward! Many Practices will fail at their marketing efforts simply because they don't begin with the reality of how they are, and could be, growing. ... There are so many opportunities!
Then there is the simple side of marketing that can be condensed down to simple formula... "Get known, get liked, get trusted, get referrals." There are no shortcuts and there are lots of paths that potentially lead to the top of the marketing mountain. The key is to find the one trail that will increase your odds and that corresponds to the level of marketing fitness that is right for you and your practice.
One more thought... If you want to grow your practice, there are only two ways to do so - you can improve innovation or improve marketing. Those are the only options! If either is to happen in your practice, it will have to begin by you setting aside scheduled time each week to focus on growth related issues, developing a plan, then working that plan. Consider building those elements into your business New Years resolution for 2008.
Bob
Copyright 2007
Performance Builders
On one hand every practice is unique in many ways - clinician training, skill levels, services offered, location, facilities, community, and more... Problem is most practices don't leverage those differences to make a difference in their marketing initiatives.
On the other hand it could be said, "every practice is unique just like every other one" - in other words a lot of differences don't make a difference. This is particularly true in an industry that is relatively unsophisticated in marketing and one that depends on "me too" strategies - think newsletters, office visits to referral sources, and bring in the bagels. These are marketing techniques that don't make much difference in most markets. There needs to be better ways... and there are!
Then there is the matter of reality... In a recent study is was reported that something like 90% of professionals rated themselves in the top 5% as it applied to performance. Its appearently very crowed at the top! Sounds like Garrison Keillor's' Lake Wobegon "where all of the children are above average". Of course statistically 50% of Practices are below average and most don't know what average is. And of course, most Practices performing above average also have plenty of room for improvement and and reward! Many Practices will fail at their marketing efforts simply because they don't begin with the reality of how they are, and could be, growing. ... There are so many opportunities!
Then there is the simple side of marketing that can be condensed down to simple formula... "Get known, get liked, get trusted, get referrals." There are no shortcuts and there are lots of paths that potentially lead to the top of the marketing mountain. The key is to find the one trail that will increase your odds and that corresponds to the level of marketing fitness that is right for you and your practice.
One more thought... If you want to grow your practice, there are only two ways to do so - you can improve innovation or improve marketing. Those are the only options! If either is to happen in your practice, it will have to begin by you setting aside scheduled time each week to focus on growth related issues, developing a plan, then working that plan. Consider building those elements into your business New Years resolution for 2008.
Bob
Copyright 2007
Performance Builders
Wednesday, November 14, 2007
On Reflection
"The faster you go and the harder you push, the more distant you take yourself from what it is you truely seek." - Bob Wiersma
What are you truely seeking?
Go deeper not faster...
Bob
PerformanceBuilders
What are you truely seeking?
Go deeper not faster...
Bob
PerformanceBuilders
Saturday, November 10, 2007
GIFT
If you are looking for the ultimate competitive advantage for your practice check out the 10 month Applied Functional Science mentorship program offered by the Gray Institute (http://www.grayinstitute.com/). It's a terrific investment in yourself and your practice with an unmatched return on investment.
Some 100 GIFT Fellows graduated from the program last week. The excitement was palpable as Fellows completed the program and returned to their practices with new knowledge, strategies, skills, and confidence to transform their practices and clients. If you are interested in applied biomechanics GIFT is a must!
GIFT - you have to check it out!
Bob Wiersma
Some 100 GIFT Fellows graduated from the program last week. The excitement was palpable as Fellows completed the program and returned to their practices with new knowledge, strategies, skills, and confidence to transform their practices and clients. If you are interested in applied biomechanics GIFT is a must!
GIFT - you have to check it out!
Bob Wiersma
Thursday, November 8, 2007
Productivity
While practices often talk about clinical productivity, they seldom discuss clinical productivity gains measured over time. The question is, "Are we becoming more productive as practices and as an industry over time." Other industries expect continuous improvement in productivity. Shouldn't we?
Consider productivity gains in other industries - both manufacturing and service. If we go back to the end of World War II (mid 1940s) and track productivity gains through 2005 we find that US productivity increased an average of 2.2% annually for a 385% cumulative improvement! Going back to 1987 we find an improvement of 2.7% annually for an improvement of 50% over 15 years.
How has clinical practice productivity changed during that time? Well the simple answer is that we don't really know for sure. Neither practices nor national associations seem to track it. What doesn't get measured doesn't get managed.
During the past 12 years that I have been benchmarking practices (several hundred over that time) I have not found evidence that there has been any substantive improvement in productivity. In reflecting back 30+ years to my early days in clinical management I would have to say that there hasn't been any meaningful improvement in the industry during that entire time. Why is that?
Of course it is easy to blame increasing documentation burdens third party requirements and the like, but I think the real reasons are more of our own making. Simply stated, "We perform at a level that is acceptable to us" - a level to which we have become comfortable. In other words, "our practices are perfectly designed to get the results they get."
The opportunities for productivity improvement are many including: staffing, scheduling, delegation, supervision, and documentation just to name a few.
As reimbursement continues to erode, productivity becomes ever more important. How high is your productivity bar set. What are your expectations for productivity improvement over the next 5 years. What strategies will you employ to reach those goals. What will you need to do better? What will you need to do different? What will you need to stop doing?
Its time to redefine the productivity discussion. It time to begin talking about annual productivity gains. Its time to make it an urgent priority in every practice. Its time to move the productivity bar higher this year, next year, and every year thereafter! Improving productivity need not mean lowering quality. Aggressive performance challenges are the seeds to break through innovation. Its time to innovate! Our practices and our industry will not survive without it!
Bob Wiersma
Copyright 2007
Performance Builders
Consider productivity gains in other industries - both manufacturing and service. If we go back to the end of World War II (mid 1940s) and track productivity gains through 2005 we find that US productivity increased an average of 2.2% annually for a 385% cumulative improvement! Going back to 1987 we find an improvement of 2.7% annually for an improvement of 50% over 15 years.
How has clinical practice productivity changed during that time? Well the simple answer is that we don't really know for sure. Neither practices nor national associations seem to track it. What doesn't get measured doesn't get managed.
During the past 12 years that I have been benchmarking practices (several hundred over that time) I have not found evidence that there has been any substantive improvement in productivity. In reflecting back 30+ years to my early days in clinical management I would have to say that there hasn't been any meaningful improvement in the industry during that entire time. Why is that?
Of course it is easy to blame increasing documentation burdens third party requirements and the like, but I think the real reasons are more of our own making. Simply stated, "We perform at a level that is acceptable to us" - a level to which we have become comfortable. In other words, "our practices are perfectly designed to get the results they get."
The opportunities for productivity improvement are many including: staffing, scheduling, delegation, supervision, and documentation just to name a few.
As reimbursement continues to erode, productivity becomes ever more important. How high is your productivity bar set. What are your expectations for productivity improvement over the next 5 years. What strategies will you employ to reach those goals. What will you need to do better? What will you need to do different? What will you need to stop doing?
Its time to redefine the productivity discussion. It time to begin talking about annual productivity gains. Its time to make it an urgent priority in every practice. Its time to move the productivity bar higher this year, next year, and every year thereafter! Improving productivity need not mean lowering quality. Aggressive performance challenges are the seeds to break through innovation. Its time to innovate! Our practices and our industry will not survive without it!
Bob Wiersma
Copyright 2007
Performance Builders
Monday, November 5, 2007
Truth
I had the privilege last week of presenting a short video production I had created on Truth to a Gathering of about 100 Fellows in Applied Functional Science that had gathered from around the world. The Gathering was sponsored by the Gray Institute for Functional Transformation and was attended by professionals committed to seeking truths about human movement and function.
Truth is a thing of mystery. The truth for each of us is a product of our individual values, experience, and understanding. Concurrently there are larger truths that unite us. Those truths that order the universe and that lay at the core of our three dimensional being of body, mind, and spirit - truths that transcend the ordinary but are evidenced in the ordinary.
Such truth transcends personal experience and transforms reality.
The presentation was mixed with motivating thoughts, sometimes disturbing realities, and of course humor. It began with a quotation by Calvin & Hobbes,“It's not denial, I'm just selective about the reality I accept” and ended with a quotation by William Sloane Coffin, “The world is too dangerous for anything but truth and too small for anything but love.” In between was a collection of amazing insights by writers, scientists, musicians, politicians, theologians, humorists, and others.
Truth too often receives little more than lip-service. Truth is played fast and loose in relationships, business, religion, and politics. The truth of the matter is that truth matters! Its frequent absence is painfully apparent in every dimension of life.
In the professions of health and fitness one is privileged to touch lives - bodies, minds, and spirits. In such a sacred relationship there is room for nothing but truth! Practice demands truth and truth takes practice. Truth with others begins in truth with ourselves.
In the words of Roman Caesar Marcus Aurelius, "If it is not right do not do it, if it is not true do not say it." After 2000 years, these are still good words to live by and by which to conduct business....
Bob
Copyright 2007
Performance Builders
Truth is a thing of mystery. The truth for each of us is a product of our individual values, experience, and understanding. Concurrently there are larger truths that unite us. Those truths that order the universe and that lay at the core of our three dimensional being of body, mind, and spirit - truths that transcend the ordinary but are evidenced in the ordinary.
Such truth transcends personal experience and transforms reality.
The presentation was mixed with motivating thoughts, sometimes disturbing realities, and of course humor. It began with a quotation by Calvin & Hobbes,“It's not denial, I'm just selective about the reality I accept” and ended with a quotation by William Sloane Coffin, “The world is too dangerous for anything but truth and too small for anything but love.” In between was a collection of amazing insights by writers, scientists, musicians, politicians, theologians, humorists, and others.
Truth too often receives little more than lip-service. Truth is played fast and loose in relationships, business, religion, and politics. The truth of the matter is that truth matters! Its frequent absence is painfully apparent in every dimension of life.
In the professions of health and fitness one is privileged to touch lives - bodies, minds, and spirits. In such a sacred relationship there is room for nothing but truth! Practice demands truth and truth takes practice. Truth with others begins in truth with ourselves.
In the words of Roman Caesar Marcus Aurelius, "If it is not right do not do it, if it is not true do not say it." After 2000 years, these are still good words to live by and by which to conduct business....
Bob
Copyright 2007
Performance Builders
Monday, October 29, 2007
Aspire
Performance is never an accident: it is the result of high intention, sincere effort, intelligent direction and skillful execution: it represents the wise choices of many alternatives.
Aspiring to average performance inspires no one. Average is... well average. To aspire to achieve more it's essential to first know how much more is. The alternative is to become complacent with the status quo. If you want to jump high its aways good to have a high bar to aim for. How high is your bar?
Research has demonstrated that over 90% of professionals believe that they perform in the top 10% of their peers. The truth is that 50% are below average and another 40% don't make the top 10%. Statistical reality guarantees that 90% of professionals are not in the top 10%. So why do so many people persistently allow themselves to be fooled by themselves?
How is your Practice performing? Have you compared it recently to other Practice? Do you know where opportunities for better performance and better reward are in your Practice? Do you know what 90th percentile performance looks like in all of the performance dimensions of your Practice? How much reward are you leaving on the table day after day, year after year? Is your bar set too low? Are you fooling yourself? Are you professionally curious enough to ask?
Comparative performance data for your Practice is just a phone call away. Make wise choices. Performance Matters!
Bob
Copyright 2007
Performance Builders
Aspiring to average performance inspires no one. Average is... well average. To aspire to achieve more it's essential to first know how much more is. The alternative is to become complacent with the status quo. If you want to jump high its aways good to have a high bar to aim for. How high is your bar?
Research has demonstrated that over 90% of professionals believe that they perform in the top 10% of their peers. The truth is that 50% are below average and another 40% don't make the top 10%. Statistical reality guarantees that 90% of professionals are not in the top 10%. So why do so many people persistently allow themselves to be fooled by themselves?
How is your Practice performing? Have you compared it recently to other Practice? Do you know where opportunities for better performance and better reward are in your Practice? Do you know what 90th percentile performance looks like in all of the performance dimensions of your Practice? How much reward are you leaving on the table day after day, year after year? Is your bar set too low? Are you fooling yourself? Are you professionally curious enough to ask?
Comparative performance data for your Practice is just a phone call away. Make wise choices. Performance Matters!
Bob
Copyright 2007
Performance Builders
Friday, October 26, 2007
Just say "NO"!
I’ve had several clients recently ask for help in decisions that ultimately led to their dropping out of low paying insurance networks. More Practices should be thinking about doing so!
There is good business and bad business. Its important to know the difference. Too often Practice owners are drawn into a poor paying insurance networks for the wrong reasons:
1. Fear of being left out of a market segment
2. Fear that a competitor will get the contract instead of them
3. The assumption that if other Practices are accepting the contract that it must be OK
4. Irrational justification that somehow there is value in volume even when it is not profitable
5. Worry that referral sources may not refer unless all referrals are accepted
6. The assumption that the fees offered are non negotiable
The rationale for not entering into poor contracts includes:
1. Less work can mean less expense while yielding the same profit - right size the Practice and enjoy some well deserved time off!
2. Let competitors have losing contracts since it diminishes their capacity to compete for more favorable business - go ahead burden the competition!
3. The acceptance of poor contracts reinforces payers behaviors that lead to further erosion of reimbursement - Every low rate accepted encourages all payers to do it again!
4. Word gets out... if you accept poor paying benefit plans your Practice will attract more such plans and clients and less of the rest - go after the market you want!
5. The time freed from serving poor paying plans can be used to innovate new services, enhance skills, and market for the more favorable clientele you want!
5. Social responsibility can be maintained by establishing a realistic budget for un-reimbursed care to limit the Practice’s financial exposure.
In order to make good decisions on what networks to participate in one must first fully understand their true cost of services and what a healthy profit margin is for their Practice.
It’s important to keep in mind that there may also be contractual complications to consider – e.g. favored nation clauses in other payer contracts and high risk Medicare compliance issues.
Its easy to "Just Say NO". But first, do your homework - know when "NO" is the right answer for your Practice and you know why you want to say it!
Its time to take a hard look at who is in your portfolio of payers. Like poor performers in a stock portfolio, it may be time to get rid of some of the dogs.
Bob
Copyright 2007 Performance Builders
Wednesday, October 24, 2007
Growth
Some headline considerations on business growth...
There are two types of growth
1. Internal – operational improvement
2. External – more customers / transactions
When to consider growth strategies
1. A change in the profit pool
2. A direct threat from a new competitive model / disruptive technology
3. The current growth formula stalls out
There are only 2 ways to grow
1. Improve innovation
2. Improve marketing
Considerations
1. Commitment for growth (desire & motivation)
2. Cost of growth (investment, risk, and ROI)
3. Capacity for growth (asset allocation)
4. Competency for growth (training & experience)
“Life is defined by the capacity to move and grow.”
Is your Practice on the move?
Is it growing?
What are its signs of life?
In today's Practice environment if you are not growing you're dead!
By the way, I am constantly amazed at the number of Practice owners that are in a growth stall. While owners take significant risks to start their business they are hesitant to take modest incremental risks to grow it. Often it requires nothing more than a good idea or two and the commitment to free up the necessary time to pursue the opportunity. Growth is not something that can usually be delegated. What can be delegated are current responsibilities. Successful entrepreneurs have a unique and proven talent. They are generally capable of creating more value through strategic growth initiatives than through the direct delivery of services. Yet they allow themselves to become trapped by the routine responsibilities of their current book of business at the expense of creating a new and larger one.
There are an incredible number of new opporunities in today's evolving markets... Its time to grow!
Bob
Copyright 2007
Performance Builders
"Your Practice is the sum total of all of the decisions you have made."
"You can't change the past but you can change the future."
There are two types of growth
1. Internal – operational improvement
2. External – more customers / transactions
When to consider growth strategies
1. A change in the profit pool
2. A direct threat from a new competitive model / disruptive technology
3. The current growth formula stalls out
There are only 2 ways to grow
1. Improve innovation
2. Improve marketing
Considerations
1. Commitment for growth (desire & motivation)
2. Cost of growth (investment, risk, and ROI)
3. Capacity for growth (asset allocation)
4. Competency for growth (training & experience)
“Life is defined by the capacity to move and grow.”
Is your Practice on the move?
Is it growing?
What are its signs of life?
In today's Practice environment if you are not growing you're dead!
By the way, I am constantly amazed at the number of Practice owners that are in a growth stall. While owners take significant risks to start their business they are hesitant to take modest incremental risks to grow it. Often it requires nothing more than a good idea or two and the commitment to free up the necessary time to pursue the opportunity. Growth is not something that can usually be delegated. What can be delegated are current responsibilities. Successful entrepreneurs have a unique and proven talent. They are generally capable of creating more value through strategic growth initiatives than through the direct delivery of services. Yet they allow themselves to become trapped by the routine responsibilities of their current book of business at the expense of creating a new and larger one.
There are an incredible number of new opporunities in today's evolving markets... Its time to grow!
Bob
Copyright 2007
Performance Builders
"Your Practice is the sum total of all of the decisions you have made."
"You can't change the past but you can change the future."
