Your Practice Mission and Staff Ownership: Making the Connection

By Shelley Simon, RN, DC, MPH, EdD

Perhaps the most common and chronic complaint I hear from chiropractors is that their staff lacks a sense of ownership in the mission, goals and business results of the practice.

Doctors often feel that no matter what they do, they can't get their staff to be consistently accountable to providing superior service, embodying and sharing the value message of the practice, doing their part to bring new patients to the practice, or whatever else might constitute the mission and purpose of the clinic. "They don't care about the practice like I do," is the common refrain.

I have some bad news. You will be chronically disappointed if you continue to hold the unrealistic expectation that your staff will one day care about your practice as much as you do. You have a financial and emotional investment in your business and profession that staff members simply do not and will never have. Once you accept that reality, it's much easier to get down to the business of doing what you can to engage your staff in adopting an attitude of ownership, even though both you and they know they are not owners. Think of your goal not as getting staff to embody the same level of ownership in your business as you do, but rather developing a shared understanding of your expectations and creating explicit standards for daily performance that align with your mission.

Mission as a Path to Ownership

Just as it is with every other aspect of your business – providing quality service, showing respect for patients, being consistent with your marketing message, being financially responsible – when it comes to creating and putting a mission into practice, it's up to you to lead by example. The idealistic expectation for staff to assume high levels of ownership in a practice may stem from the doctor's lack of leadership or frustration with practice outcomes. An inconsistent message (saying one thing, doing another), expecting employees to engage with patients in a way that the doctor is unwilling to do, or relying on staff to produce results that are the doctor's responsibility are all examples of poor leadership that can result in employees who adopt a "Why should I care if the boss doesn't?" attitude.

In addition to the day-to-day basics of being a strong leader, it's important for the doctor to demonstrate leadership by establishing the culture and setting the emotional tone for the practice. This can be done, in part, with a well-thought-out mission statement that is more than something to frame and hang in your reception area, publish on your Web site, or review when practice statistics are down.

In my experience consulting in chiropractic offices, it's less common than most doctors realize to have a staff that genuinely understands, much less feels accountable to, the mission of the practice. In a confidential assessment questionnaire, I will often ask the staff to rate the degree to which they agree to the following statements: 1) I understand the mission and vision of the practice. (2) I understand how our goals and projects support the mission and vision for the practice. It is not at all unusual for the majority of employees in an office to answer "disagree" or "strongly disagree" to either or both of these statements. And all the while, the doctor has been under the assumption that their staff was on board with the declared mission statement of the practice.

Sometimes staff say that they do understand the basic direction the practice is moving, but then comment on how frequently the focus changes. Others say they understand the mission and vision (because the doctor has repeated it a gazillion times), but are uncertain about how it relates to procedures, protocols and projects. While this may not be the situation in your practice, it is more common than you might think. For a mission to truly come alive, the gap between the statement and practice reality needs to close. That is the ongoing work of practice development and growth.

In one practice, the doctor already had a very detailed and constructive mission statement, common to offices that have participated in practice-management seminars over the years. Asked to repeat that statement, the staff either didn't know about the mission or had a vague understanding of its meaning. And so, we set to work. When the doctor was finally able to identify the true purpose of the practice, it came down to a very simple-to-grasp-and-enact statement: "To create and maintain raving fans for modern chiropractic." He knew he'd nailed it as soon as it was read back to him because it captured the essence of what drives the practice and gave language to the true reason for its existence.

Now the concern was getting the staff to "own" this mission, which turned out not to be a problem, in part because they were invited to participate in a staff retreat where they explored the mission and discussed how it was relevant to their daily lives at work. The staff recognized the mission statement as one that they could embrace, live up to and go home each day knowing they were functioning as a team in a way that reflected the power of the statement. Because the mission was encapsulated in a simple yet powerful phrase, they could identify experiences that patients would need to have to become raving fans.

Even with their ideal mission statement agreed upon, the office realizes that they must commit renewed attention to updating policies and procedures, continuous quality improvement initiatives, and ongoing staff training in order to successful narrow the gap between the statement and their daily reality. And so, the work continues with renewed commitment and focus.

Constructing a Mission Statement

Many doctors have adopted other practice's missions because they think, "Well, why not? I agree with it." Recently, a doctor I'd worked with for a long time was reviewing his mission in the wake of some staffing changes. He, too, wanted his staff to grasp the mission and asked me quite sincerely if I would forward him some examples of other successful chiropractic missions so he could see what "worked." He knew what my response would be, which was, "Um, no." It's your mission. Take the time to construct one that has meaning to you.

The purpose of a mission statement is to provide a foundation for your vision and a grounding for your daily existence. It tells you and your staff what your real work is, whom your customers are, the nature of the services you provide, and how your team functions. Too often, mission statements are dry, long, abstract and overly philosophical. In addition, doctors will sometimes create statements that are exceedingly global and so abstract that there is a huge gap between what their mission states and their current reality.

For example, they may describe an ideal scene in which chiropractors are the leaders of the health care professions and the wellness revolution, while patients transform their paradigms on health and adopt a chiropractic lifestyle. Even the doctor who authored the statement lives with this dissonance, all the while wondering why they don't feel more inspired by and connected to the mission and why the patients and staff don't "get it." For the staff, these lofty mission statements mean little, because they're viewed as "pie in the sky."

Upon hearing your mission, if your staff says, "That's great, but what does it really mean to me?" then you have some important work ahead of you. Here's a process to help you arrive at a statement that will inspire you and your staff to move forward. As you work on your mission, spend some time with the questions below to get the creative juices flowing.

• What are we known for?
• What do we care about?
• How are we perceived by patients, colleagues, and within the community?
• What do we deliver?
• How do we think of ourselves?
• Whom do we serve?
• Why do we come to work each day?
• What kind of impact would we like to have?
• What makes us unique?

Once you've brainstormed the elements you want to be represented in your mission statement, the bulk of the work is done. Now, formulate it using a sentence stem exercise. Here is one example, but you can create your own, depending on how lengthy or brief you want your statement to be. (Hint: Brief is usually better.)

• We exist to __________ [primary purpose and business you are in]
• For ___________ [your customer, who you serve, your niche]
• In order to __________ [deliver what service/product]
• With __________ [outcomes or the difference you make]
• And __________ [with key distinctions about how you go about your work and/or what makes you unique]

A Few Examples

Learning about mission statements lends itself to using examples. First, let's look at several that, while valid, are relatively forgettable and don't meet the criteria for an effective mission statement.

• "Our mission is to provide high-quality, convenient, cost-effective care for patients who need and value our service." (Too operational; too boring)
• "The mission of XYZ Chiropractic Clinic is to provide value-driven services, to create healthier lives, to promote wellness and to restore the physical, social and spiritual well-being of the community of [our city] and our outlying neighbors." (How would any practice measure this? Too many concepts)
• "Our mission is to help families and individuals of all ages express greater degrees of life, human potential, function, health, and well-being through enhanced neural self-organization, subluxation reduction, and spinal integrity, regardless of the presence or absence of symptoms or conditions." (Too much jargon)
• "The Mission of ABC Chiropractic Center is to adjust as many families as possible in order to express and maintain their optimal health potential – naturally without drugs or surgery – with the highest quality chiropractic care; and to exceed above and beyond each patient's health expectations so that they will in turn refer others." (Too much of a battle cry)

For contrast, here are some mission statements that hold up nicely:

• "To partner with our patients in creating healthier lives."
• "To stabilize the nervous system to help your body heal itself, restore function, and perform at its optimum level."
• "To be a positive force and resource for our community's health through family-based, state-of-the-art chiropractic care."
• "To be the best in the eyes of our patients as we help them achieve their health goals and full potential."
• "To inspire patients with an alternative, vitalistic approach to health and to provide effective support to help them make positive lifestyle choices."
• "To be an example of the benefits of chiropractic and a healthy lifestyle."

And just for fun, here are some examples of non-chiropractic mission statements that are truly great:

• Facebook: "To give people the power to share and make the world more open and connected."
• IBM: "Our goal is simply stated. We want to be the best service organization in the world."
• Wal-Mart: "To give ordinary folk the chance to buy the same thing as rich people."
• Google: "To organize the world's information and make it universally accessible and useful."

Assessing Your Mission Statement

After you craft your mission statement, take a step back and assess it objectively. Does it capture your heart and mind? Does it clearly express value for your patients? Is it succinct and memorable? Does it feel empowering and energizing? Is it conversational in tone, jargon free, and easily translated into standards and protocols for performance? Is it action oriented? Does it feel authentic and unique to your practice? And is it crafted in a way that will be a bit of a stretch for you and your staff to live up to?

Live with your statement for a few weeks before sharing it with your staff (unless they were involved in the process) and before publishing it or otherwise making it public. Give yourself time to determine if you can live with and live out your statement on a daily basis. Be willing to make revisions and edits until you know deep down in your bones that you've got it right, that it's spot on in terms of what your practice stands for.

Your Mission Statement in Action

Having a great mission statement, in and of itself, will not automatically make your staff feel as though they "own" the practice, but it is part of an overall leadership strategy that has the potential to raise their level of commitment, as demonstrated by their dedication and enthusiasm. You can certainly post your mission statement around the office and write it at the top of staff meeting agendas, but a more meaningful use is to reference it when the going gets tough, when you and your team are faced with an important decision, or when you are working on practice branding and promotion. In doing so, you drive home the point with staff that the mission statement of your practice is intended to be taken seriously.

When staff members make the connection that your mission statement is designed to be lived out on a daily basis, they will naturally begin to feel a greater sense of ownership in your business. When you are serious about your mission, your team will be, too.

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