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Posts for category: Problem Solving

Mrs. Jones stormed out of your office today because she waited too long to be seen! Suzie called in sick leaving you short-handed! You overhear an argument escalating at the front desk about an overdue bill! Mr. Johnson returned his night splint and wants his money back because he claims it did not help him! What next?

This was definitely not the kind of day you expected when getting out of bed this morning. You planned to treat patients and improve lives, not dowse fires all day. It is no surprise to have occasional problems throughout the day. That’s Murphy’s Law. However, when 80% of your day is spent putting out office fires, leaving only 20% to focus on productivity, you need to do something – quickly – before those flames burn out of control.

The most common approach is to address that crisis immediately and move on. If you fit that description, you probably know that dealing with the calamity du jour at the moment it happens does little to solve the underlying problem and is the most disruptive. I often ask, “why is it easier to react, (i.e. ‘stop, drop and roll’) when managing a problem, than it is to actually fix it?” There is no denying the “stop, drop and roll” method works in a real life emergency fire situation – thankfully I have no personal experience. However, stopping production, dropping whatever you’re doing and then just rolling with each disaster as it happens generally results in unwanted and repeated interruptions. This is a reactive approach and changes nothing.

Let’s say a patient presents with a dirty, angry, open, oozing wound. The immediate approach to stop the bleeding might be to apply a bandage. Yet you know that simple first aid alone is not a good solution. It is fairly certain this patient will return with a worse condition because the underlying problem (the infection) was not addressed. A more proactive approach would involve managing the infection; specifically, cleaning and dressing the wound and taking necessary measures to prevent further contamination. Similarly, burning problems at work are also not eliminated by quick, easy fixes and are rarely a “one and done” solution. It’s pretty certain that those smoldering ashes will only re-ignite and create a worse situation next time around. Do you really want to deal with the same problems over and over again? Clearly, that is a waste of valuable doctor time.  In fact, if one does not work to prevent these hypothetical fires; they are practically guilty of arson.

Don’t fight fire with fire. Instead, consider these three strategies towards a more proactive fire-fighting approach.

  1. Be a leader. Only you can prevent fires. With leadership comes the responsibility to create a healthy business and you cannot do that if you are always in crisis mode. So, before any proactive approaches to in-office fire prevention can be offered, it is important, first and foremost, to understand that not every disruption is a catastrophe. “Catasrophizing” is nothing more than a reactive attitude, sure to cause confusion and does little to help finding answers. Yes, it is difficult to think about permanent solutions and big picture stuff when the flames around you are dancing out of control. After an incident real firefighters have a debriefing to identify what went right and what went wrong. Sometimes applying a quick fix when real crisis strikes allows you to move past an unpleasant situation, ok then debrief. Identify what you can do different or better in the future and how to prevent the errors from happening again. Don’t ignore it or stop trying to find an answer. That is the difference between survival mode and making actual progress.
  2. Put Together an Operational Framework, outlining the way certain conditions need to be handled. In other words, plan ahead to avoid the inevitable. For example, you know that Mrs. Jones (and likely other patients) are upset when made to wait for appointments and will likely walk out. Can this be prevented? Maybe reviewing your scheduling patterns or re-thinking time spent chit-chatting is in order. Is treating every condition that your patient complains about or allowing patients to arrive 45 minutes after their scheduled appointment the main reasons for daily backups? If so, what policies can be initiated to better handle these simmering situations before they flame up? Benjamin Franklin’s common sense strategy, “an ounce of prevention is worth a pound of cure”, comes to mind. Focus on what is really important vs. what is the worst-case scenario.
  3. Communicate and Delegate Responsibility, to others in the practice so that they can take control of certain situations and run interference for you. Not every situation needs your immediate attention; so instead of dealing with every unexpected hot spot on your own, ask for help. Let staff handle them based on your well-thought out standard operating procedures by communicating (via training) these pre-determined decisions and preferred problem-solving techniques. Then, discuss outcomes with them (debrief) to assure that the best approach was followed. A successful consequence of delegating is a great outcome as a result of planning/training…and you were never even aware of it.