Why won't it work for me? (Proceedings)


We have all heard of the carrot or stick approach to horse training, or the 2 Ã- 4 approach of getting a mule's attention before training. While these ideas are entrenched in our heritage, they are not generally used; rather, alternatives are sought that will serve the same purpose.

We have all heard of the carrot or stick approach to horse training, or the 2 × 4 approach of getting a mule's attention before training. While these ideas are entrenched in our heritage, they are not generally used; rather, alternatives are sought that will serve the same purpose. In this seminar, we'll make you look at alternatives to the reward and punishment program of your practice.

"Behavior that is reinforced, rewarded, or recognized is likely to be repeated." - or the inverse - "Behavior that is not reinforced, rewarded, or recognized is likely to extinguish or diminish gradually."

By definition, motivated people usually need no additional motivation from the practice to perform; however, in some cases, - especially during tight labor markets as we see today - the qualities of the new employee are not exactly exemplary nor is their commitment to the practice usually that high. Although we need to continue to nurture our star performers, these "less than motivated" staff members are the ones we have to reach to make the programs and promotions work. That's something we wish we could change, but in most cases, we just have to make do with what we have.

Signs that Your Practice Needs Help

As veterinary professionals, we know the difference between signs and symptoms in healthcare delivery. Our patients never tell us their symptoms, we must observe the signs. In practice management, we often wait for someone to tell us the symptoms rather than watch for the signs that indicate a problem is emerging. There are signs that can be used as indicators which reflect that your practice is moving in the wrong direction. When the patient has the "ADGs" (ain't doing good), something must be done. When a practice suffers from the ADGs, we have to be able to diagnose the situation. Here are some danger signals:

     • PEOPLE start referring to telephone calls as impositions on their time rather than opportunities to promote the services of the veterinary practice.

     • STAFF develop an orientation toward the rules of the practice and the national literature rather than a value orientation that considers spirit, excellence, and contributions of the individual.

     • PARAPROFESSIONALS begin to have different understandings of words such as "responsibility" and "service."

     • PROBLEM MAKERS outnumber problem solvers. Problems are given to the veterinarian rather than being solved by the staff.

     • LEADERS start to rely on structures instead of people, they write memos and policies rather than discuss the challenge with the staff members.

     • EMPLOYEES lose respect for the proper use of the English language or the common courtesy of group sensitivities.

     • VETERINARIANS state that they do not offer full services because they know what their clients want and are not going to share what the patient needs because of cost factors.

     • A TENDENCY toward superficiality is exhibited. Doing enough to get by today is preferred over excellence for tomorrow.

     • PRESSURES of the day-to-day operations push aside concern for vision, risk, and healthcare quality.

     • STAFF MEMBERS quantify both history and their thoughts about the future, for the practice and personally.

These are indicators of problems looking for a place to happen. They are not unlike the vomiting dog. The signs could be a passing event that will be solved by the "tincture of time." Also like a vomiting patient, they can be an indicator of something deeper, a reason to initiate action quickly and in a positive manner. Work on your practice management diagnostic skills, it will provide for a healthier practice (and patient).

The Solutions

Premise Number 1

The ENTIRE staff must buy into the promotion or program. This is not going to be a traditional team-building seminar, however, it is useful to remember that a team must be centered around principles and not just a collection of people in the same place at the same time. You must build your team FLAG properly.

Followers -every team requires players, else you cannot call it a team - they must be willing to play by the rules established for the game.

Leadership -every team needs someone to make the hard decisions, set the pace, and provide the feedback on activities. It is not a team without someone to give direction - that's a committee.

Attitude - the attitude of concerned excellence must be seen at all levels, from the followers to the leaders, and the attitude must be positive to be successful.

Goals - any team needs to know where they are going, the end point where they can be recognized for making a successful score.

Premise Number 2

The staff's basic hierarchy of needs must be met.

          o The staff must perceive that the practice is a safe place to work - both from a physical hazard situation as well as from a security one.

          o Every person has a need for recognition of their individual contributions and abilities. Practice the three R's of staff nurturing - Recognition, Respect and Responsibility.

          o People want challenging work and not just menial tasks.

          o People need guidance and direction not just a set of instructions to blindly follow - that's called "sharing the vision" or giving them a view of the long range plans.

          o Of course, the basic living needs of the person must be met - a decent wage, a stable family and an outside interest in life.

          o It must be a FUN place to work; people have to look forward to going to work, not dread it.

          o Basically, JOB SATISFACTION must be present if a person is expected to give 110% for the team and practice.

Premise Number 3

They must have adequate training on the expectations as well as the task. We'll spend several hours discussing training and training programs, so we won't repeat the concepts here. Just remember, that without a clear explanation of the project, the outcomes, and the tasks, the team wil never succeed with implementation of the program or promotion.

Premise Number 4

Don't stifle creativity! Creativity is usually associated with the arts and given very little latitude in veterinary practices. When veterinarians are taught how to cut in surgery, a step-by-step procedure is learned. When the technician is taught how to do laboratory procedures, each step is tested in sequence. We even train the receptionist to reply to callers according to a set script. It seems that creativity is not beneficial to the professionalism of most veterinary practices, or at a minimum, they want to decrease the potential for it occurring. This will not be true in the 1990s.

In the real world of business, managers who are skilled at tapping the creative juices of those around them make it to the top faster than anybody else. Each of our paraprofessional staff members are really managers in training, in client relations if nothing else. Usually, the most effective staff members become managers. Managers who are seen as highly successful have targeted and overcome the most common myths about creativity, which are still rampant in corporate America. Here is a review of the common myths we hear in veterinary practices and how these myths can be turned into productivity enhancers:

     • Only a Small Number of People Are Creative, and They Are Weirdos. Actually, most people can be creative at some time. Trouble is, most veterinary practice managers have not developed that special ability to hear them when they occur. Just think of that receptionist who first said, "We need to use a military discount during our slow times to compete for their trade." Those practices that listen to the creative ideas generally profit, especially if they use public recognition and rewards as incentives to identify those that spoke up first. Those practices which embrace this myth are doomed to the status quo.

     • Creativity Is Intangible and Uncontrollable. This myth is true and false, you can't make people produce brilliant ideas on demand, but you can nurture a creative spirit. Regular brainstorming sessions can be developed by using a "challenge of the week" at each staff meeting; keep the focus targeted just on the current problem on the table, make discussions free-and-easy in a give-and-take atmosphere. Keep some structure, lest the sessions get out of hand, but avoid regimentation or anyone voicing value judgements on specific comments.

     • You Only Need Creative Thinking in the Creative Fields. This myth is based on the thought that research facilities, ad campaigns, and new product development are the only science areas that can embrace creativity. In fact, any idea that suggests a new and better way of doing something is creative thought. The best thing about creative thought, one idea can set off a creative chain reaction with the practice team. Developing a more efficient method that is recognized by the veterinarian as a great idea leads to internal competition to get more recognition by the veterinarian, and the practice can gain at every turn if the management is tuned into the creative juices that flow.

     • Creative Thinking Is Play, Not Work. Anyone who believes this myth should not be in a management position. Try to give 30 minutes of intensive, uninterrupted thought to creative ways of differentiating your veterinary practice from others in the community, then see how drained you really feel. The answer is always: plenty! One of the best strategies is to list the benefits of good creative work for all members of the practice team; convey the message that creative work will be rewarded.

     • Creative Thinking Is Risky and Leads to Unnecessary Change. This is the most dangerous myth of all, since it causes the practice believers to seek the status quo. In times of creeping inflation and increased competition, this type thinking can make any practice into a dinosaur within the veterinary medical community. Creative risk taking should be built into the practice policy; reward risk taking. Do this and the winds of creative change will take on tornado force within your veterinary practice.


There are always those individuals who will not respond to encouragement, to suggestions, or to the possibility of a reward. They may lack the interest, the energy or the capability to do so. These people are called exceptions. Don't allow them to disprove your positive effort.

Look forward to the first mistakes. They mean something new has been attempted. Promote the individual effort and acknowledge it publicly, regardless of success rate. Honda only allows middle management to veto 10 percent of all staff suggestions. The remaining suggestions have to be implemented. The improvements are seen in very cost-effective, quality vehicles. Your vehicle is your practice. How do you plan to promote quality and innovation? Your upscale thinking and positive attitude will provide you with the answers.

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