Team EQ: Your Edge in Practice Development

By Shelley Simon, RN, DC, MPH, EdD

I've yet to meet a chiropractor who wasn't interested in increasing new patient referrals, especially internal referrals that are a direct result of high-quality service provided in the office. This interest often keeps practitioners on a nonstop search for the right formula, the perfect script, a "new" marketing strategy, and motivated employees who "get it" that part of their job is generating referrals. Growing a successful practice in today's competitive and information-saturated environment requires an edge. This edge includes having a clear marketing message and broadcasting that message, with the help of a high-performance team. What's a high-performance team? It's the team that, individually and collectively, demonstrates understanding and ownership of your marketing message through their actions and attitudes.

Building a team that is engaged and enthusiastic about practice growth requires that everyone - including the doctor(s) - share, responsibility for the success of the practice. Easier said than done, you might be thinking. Yet, it is not really a mystery. Successful practices that consistently deliver quality service also tend to take care of and develop their staff. When a staff performs as a true team, everyone understands the goals of the practice and works toward them with clarity, synergy and a shared sense of purpose. In practices noted for team harmony, employees feel good about what they are doing, they enjoy coming to the office, and patients respond positively to the staff's energy and commitment.

If having this kind of high-performing team appeals to you, but you've not been successful at creating one, the missing element may be team emotional intelligence - team EQ, for short. One of your jobs as leader is to encourage in your staff a sense of accountability for the well-being of the team and practice as a whole. Good leaders know how to balance their focus on productivity and task-oriented behavior with attention to developing people and their relationships with one another. You can have a staff that functions with high EQ - individually and at the team level - by learning about, fostering, modeling, and being a champion for developing and practicing emotionally intelligent behavior.

An EQ Primer

By now, most people have heard about emotional intelligence. However, before we get into team EQ, a few words about EQ in general. The core elements of personal, emotional intelligence are: the capacity to recognize and understand one's own feelings and the feelings of others; the ability to be self-motivated; and the competency to manage one's emotions. Both research and experience demonstrate that EQ is linked to personal achievement, professional success, and even physical well-being. The good news is that EQ - unlike IQ - can be raised and cultivated through practice.

According to author Daniel Goleman, who popularized this concept, the two overriding categories of EQ are personal competence (self-awareness, self-management, how you understand and manage yourself) and social competence (social awareness, relationship management, how you behave with and influence others). Working in health care requires the ability to handle stress, complexity, and conflict, while at the same time maintaining positive relationships. EQ competencies are critical for individuals and teams alike.

Take Your Team to the Next Level

Here is a short list of qualities that high-functioning teams tend to exhibit. Use this list to assess and then develop your team by improving EQ competencies.

  • Team members are clear about purpose, expectations, and common goals.
  • Roles are clearly defined and the group shares a common language.
  • The team follows clear ground rules about how members work together to accomplish goals (including delegation, fairness, and behavioral rules).
  • Feedback is encouraged and conflicts are addressed as they arise.
  • Decision-making, authority, responsibility and accountability are shared within the group.
  • Team members rely upon and respect one another; they rarely blame or point fingers.
  • There is confidence at the group level that difficult or challenging problems can be solved.
  • Members practice flexibility in dealing with one another, patients and others, both inside and outside the practice.

Unique Elements of Team EQ

The cultural norms within a practice (that is, the usually un-stated rules about how a group works together and how they feel about what they do) are what often determine whether staff functions at a high level - as a team - or simply as a loose collection of people who happen to work together. Goleman says that collective emotional intelligence is what sets top-performing teams apart from average ones. Research conducted by Vanessa Druskat and Steven Wolff (as reported in the Harvard Business Review) suggests groups that demonstrate high-collective EQ outperform, by a margin of two to one, teams that do not.

How a group sees itself, how its members function together, and how roles are defined all shape a team's collective EQ.

While similar to individual emotional intelligence, team EQ is distinct and has unique core elements. These include:

  • Emotional awareness: the ability to identify and understand tendencies and emotions as they surface in one's self and in other members of the team.
  • Emotional management: the ability to manage emotions and moods appropriately and constructively in given situations to achieve team objectives.
  • Internal relationship management: the ability to get along and work effectively with others and be flexible, even in challenging situations.
  • External relationship management: the ability to connect and communicate effectively with patients, vendors, referring practitioners, etc.

Having practiced for eight years in Pennsylvania, Dr. Sean Hopkins has come to appreciate the value of having a team with good EQ. "When I think about EQ and its contribution to practice or team success, the first thing that comes to mind is coordination of efforts," says Hopkins. He notes that prior to learning about and applying EQ principles, he had a difficult time seeing much team effort in his practice. "My concerns were not necessarily my staff's concerns," says Hopkins.

By investigating the needs and wants of his team and working toward improving EQ at the individual and team level, they ended up with, according to Hopkins, "more continuity, improved employee interactions, and a more productive workplace. Feelings of culpability, annoyance, suspicion, and confusion evolved into comfort in roles, confidence in interactions, cooperation of efforts, and passion about our work. Personally, I feel that learning about EQ can change a practice from average to outstanding in just a short period of time," concludes Hopkins.

How Is Your Team Doing-Really?

Practitioners and staff often cannot accurately see some of the habitual behaviors and attitudes that hinder their effectiveness at the group level. Here are four brief scenarios that illustrate teams with low-collective EQ. These may bring to mind similar situations or patterns that are present in your practice.

This Is a Meeting? A team gathers for its weekly meeting. From the very first agenda item, people interrupt one another, shoot down ideas before they can be considered, ignore the team leader's attempts to keep the meeting on track, and accomplish little, if anything, over the course of an hour. Lack of self-awareness and empathy for others makes it almost impossible for this team to accomplish its goals - inside or outside of the meeting.

Why Can't We Achieve Our Goals? This team thinks it has goals, but in truth, its so-called goals are vague and its action steps toward achieving them are poorly executed. Team members won't hold one another accountable (or even be accountable themselves) to follow through on their assigned tasks. When, month after month, nothing gets done, no one knows whom to hold responsible. This team lacks a sense of purpose and direction.

What, Us Argue? This amiable team avoids conflict at any cost. Team members so concerned with being nice and so worried about hurting anyone's feelings that they avoid addressing interpersonal issues, even when those issues are glaring and ongoing. Team members will talk behind the back of someone who is causing them angst, but would sooner have a root canal than confront that individual directly. Problems simmer, resentments build and productivity suffers, but nothing is ever resolved.

What's In It for Me? Members of this team think of themselves first and foremost. They are competitive instead of collaborative; suspicious rather than trusting. They will go out of their way to help a fellow staff member or patient only if there is reward or recognition in it for them personally. Efforts at team-building are viewed as "just more work for me," rather than something that would benefit them and their co-workers.

The common thread in all of the above scenarios is that the individuals function habitually and independently rather than collaboratively, creatively and interdependently. They demonstrate little awareness or empathy for those around them and they lack resonant, congruent behavior. They are likely bored, overloaded or both. If you see your team here, consider it an opportunity to put on your leadership hat and work toward improving team EQ.

Leadership Sets the Tone

As the leader of your practice, you have the influence and the responsibility to set an example for the harmony, collaboration and optimism that will result in high patient satisfaction and practice growth. You can model what good EQ skills look like by demonstrating consistent behavior, reinforcing positive behaviors to make each team member feel valued, managing your emotions appropriately, and leading with a visionary, democratic style.

Benefits of Developing a High-EQ Team

  • Stronger group identity.
  • Increased effectiveness and efficiency.
  • Better performance, even when under pressure.
  • Higher levels of flexibility, confidence, trust and optimism.
  • A more collaborative, satisfying work environment.
  • Ability to proactively solve problems; increased creativity.
  • Lower staff turnover.
  • Greater accountability for positive outcomes.
  • Higher motivation and initiative.

Dr. Scott Kirchner practices in Minnesota. He has made great strides in understanding and communicating with his staff as a result of taking a close look at his own EQ. "By becoming more aware of how and why I think and act, I have learned about myself and others. Rather than assuming the worst or looking for what's gone wrong, I've become more curious about why others behave as they do. I have found myself asking better questions," says Kirchner. His heightened level of self-awareness, Kirchner says, has dramatically improved his relationships, and staff productivity has changed for the better. The best part is, "We are having fun now!"

It pays to create and sustain an environment in which your team feels safe openly discussing the "emotional temperature" of the group. Problems and challenges can only be addressed when they are out in the open. Team members must be willing to regularly evaluate their tendencies, re-examine their shared habits, and review the big picture, in order to stay focused on the ideal vision of good team EQ. Set aside time at each staff meeting for this level of discussion and encourage impromptu discourse to keep the channels of communication open.

Dr. Janna Gresham's situation illustrates the importance of team EQ during a time of transition. Having purchased a practice in Kentucky, Gresham was immediately faced with replacing a key front-desk person, cross-training other staff members, and implementing new management procedures. Realizing the importance of involving everyone in the transition process, she established daily feedback and meetings to understand the staff and to help them realize their value, both personally and professionally. On successfully integrating into her new practice, Gresham says, "A successful transition is a continuous juggle between the emotional and the practical, a tenacious balance between self-awareness and social awareness. Regular staff meetings and open team discussions have helped lay the foundation for a synergistic, dream team."

Encourage personal EQ development within each of your staff members by providing resources and opportunities for continuing education and training in this area. Individual responsibility, accountability, and the ability to recognize and manage one's own emotions go a long way toward turning a group of staff members into a high-functioning team. This is every bit as important as training staff to use the computer system, negotiate for payments or follow scripts.

An Ongoing Endeavor

Developing and maintaining good team EQ is a process that requires ongoing attention and commitment. It's not a "one time and we're done" proposition. As staff members retire or move on and you hire new ones, the dynamics of the team can (and frequently do) shift. If you have a core set of cultural norms and explicit guidelines in place that are positive and reflect and promote good team EQ, new staff members should be able to adapt to them quickly.

The need for ongoing attention to team EQ became quite evident over the past year in Dr. Lisa Stein's well-established practice in California. During the midst of a practice-threatening insurance crisis, Stein's office manager of seven years became pregnant with twins, the office manager's job-share partner was diagnosed with a serious illness, and Stein's associate announced that she was also pregnant. "We have had to maintain amazing compassion for one another, as well as for ourselves, while keeping the health of the practice at the forefront," says Stein. "We had to learn - and we keep on learning - how to communicate honestly, compassionately and effectively." The group has remained committed to the practice and to each another. "We've noticed that when we don't exude love and compassion and cohesiveness within the team, our patients pick up on that stress. Patients don't come to our office to feel stress - they come to be cared for," says Stein. No doubt this group will weather their challenges and be stronger for it.

Your edge in practice development begins with you - with your interest in developing yourself and your team in a way that will allow your practice to exhibit an extraordinarily high level of emotional intelligence. Yes, it takes time and resources. It requires persistence and attention. It demands conscious commitment. And the end result - a cohesive team, more referrals, and greater practice satisfaction - is more than worth the effort.

Click here for previous articles by Shelley Simon, RN, DC, MPH, EdD.

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