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Dynamic Chiropractic – May 9, 1990, Vol. 08, Issue 10

Achieving Desirable Practice Performance

Implementing "End-Results Strategy"

By Brian James Porteous, DC, QME

Are your staff members challenged by their jobs? Do they show enthusiasm in performing their everyday tasks? Or, do they seem to drag around the practice, moving at only two speeds -- slow and stop?

Even employees who enjoy their jobs experience down periods. They become dissatisfied and bored. They get "in a rut." How do you respond to one of your employees who is experiencing lack of motivation? Do you ignore the problem? Or, do you deal with it?

Doctor, it is your responsibility to refocus staff who lack motivation. Help them find new excitement in their jobs by concentrating on end-results strategy.

A singular theory: End-results strategy is easy to understand. The things that get rewarded get done. In most chiropractic practices there is a mismatch between the behavior a practice needs and the behavior it rewards. In coping with getting the work completed each day, many practices fall into a trap. They reward the wrong activities and ignore or punish the right ones.

Contemporary business strategy states: In dealing with people, you don't get what you hope for, what you ask for, what you wish for or what you beg for. You get what you deserve.

Key thought: When you reward for the right behavior, you get the right results. When you fail to reward the right behavior you will likely get the wrong results.

Most chiropractic practices experience difficulty in defining the end-results they want or need. They fail to concentrate on the things that make a difference. It is impossible for a doctor to reward what he wants done, if he himself is unsure of what needs to be done.

Creating the right incentives and the proper rewards to achieve identified results is another area of indecision. So doctors know what end-results they want. However, they fail to recognize the importance of rewarding desired results.

Five key ingredients: To help people become inspired about their jobs, follow these end-results strategies.

  1. Help your employees set specific work goals. Ask them to evaluate areas of personal strengths and weaknesses. The end-results any employee achieves depends on maximizing this individual's important strengths and compensates for weaknesses.

  2. Establish systems that enable employees to measure their progress. Have your employees keep productivity records that chart their achievement toward specific goals. (Graphs -- yes, they really work.)

  3. Excercise management control. Most employees are not self-starters or self-achievers. They need constant inspiration and direction from management (Doctor, you are management.)

  4. Measure performance against established goals. An employee must take ownership for his performance. Require each employee to write a self-evaluation at the end of each week. Make the employee responsible for his own evaluation.

  5. Provide meaningful rewards. An effective reward must have value. If a reward for accomplishment isn't significant to an employee, achieving the goal won't be important.

Summary. Sometimes, this end-results strategy method is difficult to implement in a chiropractic practice. Many doctors fail to take the time to identify where end-results strategy is needed. Once the areas are identified, establishing the targets for accomplishment requires realistic how-to-achieve planning. And, a rewards program must be implemented.

Example: In most chiropractic practices the collections over the desk or the number of office visits are measurable functions. In many chiropractic practices, a profitable, full-time associate must produce four to six times his pay, including taxes and benefits. Based on this fact of management, it is possible to determine how many dollars a doctor must produce each day. When the doctor achieves this goal, he is entitled to a reward. If he exceeds this objective, he has earned and deserves a greater reward. If he is unable to achieve the minimum objective, he is either over-paid or should be replaced.

Having a production objective for each employee, plus an appropriate rewards system for achieving and surpassing the objective, generates production consistency.

Important -- in setting up your end-results strategy follow this guideline: State all goals in terms of results to be achieved, not activities to be performed. For example, challenging an associate to work smarter or harder to increase his production is an activity. Producing $1,200 in service per day is a result.

Remember this key point: As the doctor-manager you aren't managing your people; you're leading them. This means establishing the end-results you want to achieve and rewarding the behavior that produces these results.

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