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155: Effective Strategies for Delegation in Healthcare Practices

August 28, 2024
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Episode Summary

Is delegation in healthcare just about offloading tasks? Think again. On this episode of Practice Freedom, Mark unpacks the often misunderstood concept of delegation within healthcare private practices.

Episode Note

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Is delegation in healthcare just about offloading tasks? Think again.

On this episode of Practice Freedom, Mark unpacks the often misunderstood concept of delegation within healthcare private practices. This episode is a deep dive into the two-part delegation process: identifying and reassigning work and then continuously managing it to ensure it meets the desired standards. We touch upon the balancing act between leadership and management, addressing common challenges in creating a self-sustaining, high-performing practice. Learn from Mark’s insights and strategies designed to elevate your practice to new heights.

Accountability is the bedrock of effective management, and we explore this concept using Pat Lencioni's renowned model. Discover how to bridge the gap between expectations and outcomes by fostering a culture of open dialogue and engaging in those tough conversations that many shy away from. We'll guide you on prioritizing tasks effectively and making the most out of your Level 10 Meeting™.

Tune in and transform your practice management approach today.

In this episode, you will hear:

  • The two-part process of identifying and reassigning work, followed by ongoing management
  • Balancing leadership and management roles to create a high-performing, self-sustaining practice
  • The importance of accountability in management, using Pat Lencioni's model: trust, healthy conflict, commitment, accountability, and results
  • Addressing gaps between expectations and outcomes through regular assessment and open dialogue
  • Prioritizing tasks for maximum effectiveness during the Level 10 Meeting™
  • The need for continuous feedback and engagement to refine practices
  • Encouraging honest, objective, and subjective assessments for better management and team alignment

Resources from this episode:

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Episode Transcript

0:00:02 - Mark Henderson Leary

Welcome to Practice Freedom. What if you could hang out with owners and founders from all sorts of healthcare private practices, having rich conversations about their successes and their failures, and then take an insight or two to inspire your own growth? Each week on Practice Freedom, we take an in-depth look at how to get the most out of both the clinical side and the business side of the practice, get the most out of your people and, most of all, how to live the healthy life that you deserve. I'm Mark Henderson Leary. I'm a business coach and an entrepreneurial operating system implementer. I have a passion that everyone should feel in control of their life, and so what I do is I help you get control of your business. Part of how I do that is by letting you listen in on these conversations in order to make the biggest impact in your practice and, ultimately, live your best life. Let's get started. Welcome back, practice Leaders. 

It's another quick hit episode digging into a topic that is always fresh. Talked about it a bunch, bunch, and I might be repeating, but if so, you probably need to hear it again Delegation, delegation. What does that mean? Even? And so, before we dig into delegation, just don't forget that if you're stuck, please reach out Love to help get you on the path to that culture, that business that you love being a part of and you're proud of. It's delivering high value, super profitable. It's giving you the life you want. If you're stuck on how to get there, please reach out. I'd love to talk about what a next step, or a first step, could look like for you. Practicefreedomcom slash schedule. 

So delegation what is delegation? Is it giving somebody else your work and not doing it anymore? Maybe has that worked for you? Probably not. I say that I don't know. Some people have a talent for it. I know people like a good friend of mine, patrick, who I worked with, worked for, sold my business to his business, and understand he is a master delegator in many ways and he and I had an in-depth conversation recently. But the point about what I'm saying is that you know he was always. He had a family cultural dynamic that taught him how to delegate very well, served him still serves him fantastically well. 

But most people that I encounter struggle with it for a lot of reasons and I think it starts with the definition. I think we think I know I did the delegation meant I'm gonna give somebody a job to do that I no longer have to do and done. There we go, and now somebody else does it. No, I don't do it. And now things are good. And if you ever tried that, you probably work that great. So why, what are we missing? And I think one of the key elements and it's a lot to this is a kind of a mind-blowing moment. Hope this comes out in an understandable way. 

That delegation is two parts it is identifying and reassigning the work and then it is the management ongoing of that. Yikes, right. So now, in fairness, it's not always the case If it's a job you're doing, if you were, say, the CEO of your business and you have historically been answering the phones, well, I mean, as I say this, even maybe this isn't holding up either. I'm thinking that you know a lot of times that there are things you've been holding on to that someone else needs to do, that perhaps someone else can manage and, like you, literally handed up, stop answering the door or something. You don't need to check in on that again, that might be the case, but still, I mean, if you're answering the phones, for example, and you're taking support calls, and you shouldn't be taking support calls, that isn't to say that you aren't going to want to make sure that ongoing, that whoever is answering those support calls is doing it at the level you want. 

It's that management piece that is so tricky, because I think most people think that management is intuitive and easy and as it turns out, it's a discipline, and leadership and management are different, as it turns out. And so those a lot of us are great leaders and terrible managers. That's a thing. Did you know that? Did you know you'd be a great leader and terrible manager? You can, and in absolutely spectacular ways you do this. You know that great leadership can come in the form of casting a great vision. It can be your infectious enthusiasm. It could be your indomitable optimism. It could be, you know, your willingness to try things and your excellence in your craft, setting the bar so high. That can be great leadership. Lots more to it, but that could be. That's a good example. 

But the management component is what happens when we start encouraging or enrolling other people into this, especially if you have to have more than one person doing work that you used to do. How does that continue to grow correct, improve and ultimately become self-sustaining in the likeness of the vision of a leader. That's the management piece. The leader is going to set the bar for excellence in a macro or micro level, in general terms. So sometimes it's the same person, right? So sometimes the leader managers the same person, and so the manager might be setting a bar for excellence, but the leadership discipline, or say it another way, the setting the bar for excellence, that's the leadership, the making sure that we are doing, that is the management, ongoing. 

Now, management can be heavyweight. It can be training, onboarding, it can be, you know, those early stages of learning and developing a process to be self-sufficient. That ultimately is very lightweight. It doesn't have to be, and no part of this am I espousing micromanagement, no part of this. This is the proper balance of management. But the point of this and we can, and I certainly do, dig into leadership and management the point is to include it in the definition of delegation. It is part of the role. And so thinking about I don't know, maybe this is too detailed, but this is how my brain works, right. So one of the big epiphany for me was realizing that accountability in a function, following Pat Lencioni's model of the five dysfunctions of a team, or more accurately, in this case, the five healthy functions of a team trust at the foundation, healthy conflict above that, clear commitment above that and accountability sitting on top of that, which then leads to the results that we predict and the results we agreed to down there in commitment when we did that. And this major epiphany for me is that, well, the three things kind of came together. 

Accountability what is accountability? Accountability is so often described in terms of like just harsh consequences, like if people don't show up, they're on time, I'm going to yell at them, and if they whatever, I'm going to fire them. That's certainly in the chain of events of accountability, but really it's not the missing ingredient. I don't think of accountability. Those consequences can be hard conversations, those can be commitments and things like that, but really the accountability where it breaks down once we decide to delegate, once we put somebody in a role and this is where I see this being really valuable. This delegation idea of I'm going to take a portion of my work and give it to somebody else is no less applicable at the time when we already know we have a leadership team with these three or four or five seats in it, and I'm going to put Sally in the head of clinical operations or patient experience, or new patient growth, or sales marketing operations, finance, whatever. I put this person in that role. That's the initiation of delegation. We are not done. The initiation of delegation, we are not done. 

This management piece, is it working, man? I just I realized, even amongst a lot of very good managers, we kind of check out after that assignment is made. All right, you're the head of sales, good, go, now I don't have to do this. And this relief comes over us and it's so, so, feels, so good. Especially the first day, the first couple of days, it's like you got this. The first day, the first couple days, it's like you got this. Oh, I got this, like I don't have to do anymore. No, you don't do anymore. Unbelievable. So where does accountability fall in this? 

So what we've done in pat lancione's model, we started with trust. I, you know, I think I need some help. Okay, fantastic, let's have some hard conversations. Who's the right person? This person, not that person. Oh, there's three people who want to do it. Okay, no, we've chosen one. Great, now we're committed because we know what the plan is. This is the person that's going to do it. This is what the expectations are, this is how we're going to move forward. We got the plan and everybody says yes, we're on board, and we put the person in Darn, we're good to go. 

What happens next? So what does that mean? It means that we have to look at what's unfolding in front of us and measure the gap this is my phrase measuring the gap between what we thought was going to happen and what did happen. And what we can be certain of at this point is that it's not going to go exactly as planned because, as great as we were, we probably were a little off in exactly the commitment, the timing and the expectations, and there was a few missing things. You know, there was some delays and some leftover stuff from before, you know, just conceptually. So we got to error correct. So what we're expecting, that happened, that didn't happen. Oh, I thought these prospects were going to close, or I thought this was going to happen. I thought the survey was going to happen on a different day, and so what that means is there's going to be gaps and things are not going to be gaps and things are not going to be as expected. 

The accountability really boils down to that is simply are we taking account? It's literally the definition right. What does an accountant do? An accountant counts the money and tells you where it is. They don't make money. They give you the reports that you can act on. Someone else acts on those. Maybe the business administrator, maybe the integrator, maybe the head of sales, maybe the head of operations are going to take these numbers and fix them. But the accountant, the accounting person, they take account of that and all they do is count it. And so accountability is almost nothing more than that. Because in the context of this, if you think of accountabilities, including the hard conversations I won't fault you for that. 

But the model we're working here is Pat Lencioni's model. That talks about trust, healthy conflict, commitment, accountability and results. And when you look at it in that lens, all we have to do to create accountability is just take account of what's going on and put it in a pile, put it in a list, and EOS I would say, add it to the issues list and we'll take account of things. Like we had committed to the plan that everyone was going to be here on time and yet three of you were late. That's accountability we have now. We've put it on our issues list, we've written it down, we have called it out. It is now known. We don't have to do anything with that. We only would do something with that if we thought it was valuable. 

Going back into that model With trust and vulnerability. It's. It's like hey, does it really matter? How about this? Did we set the early, the time too early? Is that why everybody's late? And or is it you guys were lazy or I wasn't clear what was it? And so, into that healthy conflict, let's have some conversations and now we can come back and say you know what, it is too early. You know there's too much traffic. We, we didn't plan well enough based on how far people were gonna have to drive. If we did it 30 minutes later, no problem. Or you know what? We were just not being disciplined and we need to do better. Oh, okay, yeah, so just send the message that that was his first strike. You know we got to be on time moving forward. 

So that whole cycle of accountability starts with just putting it in a list, calling out the differences. Hey, you were supposed to close three deals, you only closed two. Hey, you were going to give me this document. Hey, you were going to do some homework. Hey, you're going to do these things, and or we thought it was going to be five and it's 10. Accountability can go both ways the calling out that, like you know what's going on here, you're over-performing, we need to put that into the feedback loop. And then we go back to the system and say like all right, so what of these things in the accounting? Because that's really true. Right, you get a P&L from your loosely saying the accounting, the finance, so you get this P&L. There's hundreds of numbers there. Very few of them are where you thought they were going to be, which ones need to get addressed, which ones are critical, which ones matter, and so that's part of the process. 

So, once we've called it out, we then go back and sort of create that confidence to say I'm gonna, of 10 things that we talked about that were not exactly as expected, let's open up the door and talk about them and address them, and then respond appropriately and act with courage into clarity of this is okay, here's the new plan. We're gonna adjust the meeting or the new plan is. We're going to adjust the meeting or the new plan is we are going to repeat the plan as written before, with consequences associated with it. And then, of course, if that plan is not met, again, the accountability side will say hey, you know what, here we are again, measure this and we flow it back into the system and say, all right, that's what we said. So we're at strike two, that's where we're at, and so accountability just starts with and I guess I know I'm kind of getting geeky on this why am I doing this? What's the point of this? 

I think that the great management doesn't necessarily start with the guts, courage, toughness. It starts with the honesty. The objective honesty, I say, and also subjective honesty. I realized I went through that, as my mind is. It's very often very simply objective honesty. You said you're going to be on time. You're not. You said you're going to make this many calls. You didn't. We thought we would have the deals done by now. We don't. That's objective to some extent, but subjective also works. I thought I'd like you more than I do. I thought your attitude would be friendlier than it is and subjectively I don't like it and I think that that is very understated management. 

If you have a leadership team that reports to you, a management team that reports to you, a direct reports report to you that you are accountable to the results of that team and that you don't have to love every minute of it. It might be people who rub you the wrong way with a weird habit and you wish they didn't have that habit. But if you look at them and you think, yeah, but they're really doing great work and they fit into the culture and I'm glad to have them, that's not what I'm talking about. But if you look at these people on your team and you think, yeah, you have the right to say I don don't like this. And if I'm going to win on the field, like any good head coach, I need players that can win and the players they make me feel happy to show up here every day to do this work and give it all I got. And I need that and nothing less, and that's probably a great way to describe it. You know you want players to show up that make you feel like you're happy to be there and like. You know some of those people might challenge you in ways you don't like, but you're like, you know we can win and I like doing this and I don't want to change this team because it works. 

You have the right, the obligation, to call that out and so, in that accountability layer, you just got to be putting it on the issues list. Like do I have a people issue here? We can talk about people analyzer Probably I got good episodes. If not, I'll put an episode out. Reach out if you know what the people analyzer is, but the tool to figure out exactly whether these people should be on the bus or not. 

But you absolutely that accountability starts with the honesty. This is what I expected. This is not what I expected. This is what happened instead, and if you're running on an EOS, you should be putting these into the issues list and you should bravely be picking up these issues as people issues and getting to the bottom of it, or whatever output issues, and honestly saying what are we going to do? Making a plan and following through with those hard conversations that lead to agreed consequences? Because I don't think accountability is about those consequences. That has to do with the commitment and it has to do with the healthy conflict that you've got that leads to accountability that ultimately leads to results. 

Anyway, I thought I would talk more about some other things in there, but I just riffed on that one point about accountability and through delegation. So to summarize this overly complicated explanation of simple concepts. That delegation has two parts and it has the initiation, which is a choice of what to delegate, and the assignment of that person, which is so amazing. But don't underestimate that feeling of gratification and that desire to check out if you're even if you're, especially if you're not a great manager, but if you're a good manager, you still might have the tendency like solve, problem solved, back to the hard stuff that I can really put my energy on. But you cannot let go of the observation, the management component, which really just thinking about, if it's only one thing, it's hey, that's what I thought was gonna happen, that's not what I thought was gonna happen. 

Put that in the list and let's go back to our level 10 meeting and let's address those things assessing what matters and assessing what doesn't, and making sure we're getting what matters most. Hopefully that's helpful. Give me some feedback. We love your feedback. If you're stuck, please reach out. Practice freedom commcom slash schedule. In the meantime, give us some feedback and we'll see you next time on Practice Freedom with me, mark Henderson Leary.

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