Taking Total Responsibility for Your Life and Practice

Taking Total Responsibility for Your Life and Practice

Have you ever felt like you were out of control in your medical practice?  Like you no longer controlled how you got paid, what kind of patients you saw, and even felt like you were being told how to take care of patient?   

I start most of my Medical Practice Success Summits by asking, “What is the number one problem in your practice?”  I normally get all kinds of answers-  everything from employees, to cash, to competition.  After a pause, I inform the attendees that “The number one problem in your business is you.”  You must understand this.  If I replaced you with someone much smarter, more experienced, and motivated than you, they would be able to solve the problem(s).  Therefore, the problem is you.  It’s the same in my business; the problem is me.  John Maxwell calls this “the law of the lid.”  This “law” essentially states that an organization can only go as far as its leadership will let it.  A business is limited by the ability of its leaders.  This makes sense, doesn’t it?  The great thing about this is that it means that I am also the solution.  You are the solution.  For things to change, you must change.  Don’t wish that things were easier, commit to you being better.  That is great because it is the one thing you have control over; it is the one and only thing you completely decide.  

In 2006 I felt this same way- out of control of my practice.  I had just been, for lack of a better term, fired from my 10-year tenure as medical director of a busy trauma center ER.  This happened in spite of the fact I felt I had done all I could to make it a great place with great medical care.  In 1996, I was the first board certified Emergency Medicine doctor the hospital had ever had.  I worked hard to bring in a group of residency trained, board-certified doctors.  We recruited a great trauma surgeon out of UCLA.  I implemented nursing protocols and had each of my physicians sit on or chair a hospital committee.  I myself was the head of the medical executive committee and my partner was chief of staff.  

We decreased door to door times and triage to doctor times.  We improved patient satisfaction scores and had an amazing culture.  Despite all that, at the end of the day, the end was not in my hands.  I was not in control of the hospitals financials or the decisions they made.  The day they let me know they were ending the ER contract I had had for ten years, was devastating.  It hurt my ego and my check book.  I had tied up my self-worth with my position, sound familiar?

Sometimes the darkest days become our greatest blessings.  

I am convinced that life happens for us, not to us.  That day and the following months I did a lot of soul searching.  I decided that I would not let my fate be in the hands of a hospital administrator or anyone else, for that matter.  We would open our own clinic and failure was not an option.  I was convinced then, and am even more so today, that I would rather succeed or fail on my own rather than let my fate lie with someone else.

If you listen to doctors today, you can hear their frustration bubbling through.  They spent long, hard hours trying to get into medical school. Once they did get in, that is when the real work started.  They spent long days, nights, weekends and holidays, often to the peril of their own personal lives, in order to become physicians and take care of others.  A medical doctor  is still the most noble of all professions.  But today government, insurance agencies, hospitals, and lawyers are making it increasing difficult to be a physician and even harder to make money or be happy.  This has led to a bit of an uproar among doctors about the woes of this bureaucracy.  It is completely justified and makes perfect sense… unless it doesn’t.  The reality is that just because something is justified does not make It reasonable or in your best interest.  Every moment we spend lamenting about the good old days or bitching about how terrible it is today, is a moment we are not spending figuring out how to make it better.  Worse than that however, it takes all of our power.  Your happiness is directly proportional to how much control you feel like you have.  If Medicare, hospitals, and lawyers have all the control and you have none, that is why you feel frustrated.  The answer is to take total responsibility for every portion of your life and your practice.  You have to take complete ownership of the problem.  In each of the areas that are frustrating you, start with a list of what your options are.  Let’s use an example.  Let’s assume the problem is Medicare.  What options do you have?

  1. You could stop taking Medicare in your practice all together.
  2. You could learn to become an expert in the rules of Medicare.
  3. You could make friends with your Medicare rep and nurture that relationship.
  4. You could take Medicare but only if the patient has co-insurance.
  5. You could hire someone to deal with the things about Medicare you hate such as forms, phone calls, or regulations so you can practice medicine.  
  6. You could become involved in changing the Medicare rules.
  7. You could run for Congress.
  8. You could limit Medicare to a certain percentage of your practice.  

I’m sure the list is more extensive than that.   It doesn’t matter which you do or don’t do.  What matters is that you take control of the situation and create something you are happy with.  There are two things you should never worry about-  things you cannot do anything about and things you can do something about.   If you cannot do anything about the problem, then it is not really a problem, it is just a reality. Accepting reality rather than banging your head against the wall is key.  You may hate the fact that you were born short.  Complaining about it does absolutely no good.  You must decide if it is a problem or it is a fact.  If it is a fact, move on.  If it is something you can do something about, then the key is to spend about 10 percent of your time and effort defining the problem and 90 percent of your time and effort dealing with it.  

This is true in all areas of your business.  From your team members, to your hours of operation, to your locations, etc. - you must assume complete ownership.  You are 100 percent responsible.  This then allows you to be response-able which is able to respond to any situation.  

People often say that if they had more resources, they could be more successful.  Resources meaning money, time, talent, or personnel.  The reality is that other people with a lot less resources have figured out ways to make it happen.  The problem is never resources.  The problem is always resourcefulness.  If you are resourceful enough, you will find the resources. If you want a more successful practice, you need to go to work on you.   What is the one skill that if you had it, would change everything in your practice?   What are the two skills that if you were an expert at them would make all the difference? Once you identify them, then figure out how to make them happen.  What course do you need to take, what seminar do you need to attend, what book do you need to read? Can you find a mentor?  

Life Is a 360-degree mirror.  

We see exactly who we are.  We attract exactly who we are.  In order to create a better world for you and your business, it does no good to pound the mirror.  You must change the person in the mirror.  When you change, everything will change.  

Once you decide to become 100 percent responsible, one of the options you will have is to hire the talent.  By the way, I think this is a great option.  Surround yourself with people who have the skill sets you do not have.  I have done this, as has every successful person I know.  However, this comes with a HUGE caution flag.  You cannot hire someone to do what you should be doing.  You cannot abdicate to them your responsibilities.  You are still in charge; the practice is your baby.  If your name is on the bank note, they are not going to care when you say you turned that over to someone else.  So while I am all about hiring the right team, remember that at the end of the day, you need to delegate those responsibilities, not abdicate them.  You cannot surrender the success of your practice to your practice manager, or the hospital or an insurance company, or anyone else.  This has to be your responsibility.  

Understand what got you here, will not get you there.  The very practices, strategies, and ideas that got you to where you are in your life will not be the same ones that get you to where you want to be.  If they would, you would already be there.  You are going to have to elevate your game.  You are going to have to get the skills and tools you need to go to the next level.  You are going to have to become a better leader.  You are going to need to elevate your thinking and your actions.  

Becoming 100 percent responsible and taking extreme ownership of every part of your practice sounds overwhelming at first.  

The reality is that it is liberating.  You are now the person in charge.  You are now the reason for success or failure.  You must realize that the obstacle is the solution.  The very thing stopping you, which is you, is also the very thing that can transform your practice and business.  The thing that is stopping you is the thing that is the solution.   Decide today to become responsible.  Be all in.  No more excuses, no more blaming.   Now take a deep breath and let’s go.