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Golden Goals

You have to know where you’re going if you expect to get there.
Creating—then rechecking—goals can keep your practice focused.

By julie k. silver, m.d. Published May/June 2005

“If you don’t know where you are going, it’s unlikely you will arrive.” Or so says Robert Bacal, the author of Perfect Phrases for Setting Performance Goals. He tells the story of how Steven Jobs, the founder of Apple Computer, knew exactly where he was going. When he was twelve years old he called Bill Hewlett, the founder of Hewlett-Packard, and asked if Hewlett would give him some parts. Bacal goes on to note that, “If a physician takes more time deciding on a holiday destination than he or she spends on deciding on the ‘destination’ of the practice, that’s a problem.” If you aren’t convinced that you should spend some time setting goals, consider the following:

1) Goals help you to focus on what is important in your career.

2) Goals help your staff to focus on what is important in your practice and help them to work more efficiently and with less supervision.

3) Goals allow you to monitor progress and to better assess how your staff is functioning.

4) Goals ease anxiety—both yours and your staff’s. Knowing what is expected and how to accomplish it is reassuring.

So when was the last time you set goals for yourself and your practice? If you can’t remember, you are in keeping with most of your colleagues. Talane Miedaner, a personal coach and the author of Coach Yourself to Success, says, “By the nature of their work, physicians tend to put other people first. Setting goals is one way to help keep focused on your own life and what is most important to you.”

Creating and sharing goals

Before you begin to set goals, it is helpful to know what the experts recommend about this process. First, goals usually have two parts. The first part is the “what.” What is going to be accomplished? The second part is the “how and when.” How is the goal going to be accomplished and in what time frame? For example, you might set a goal that states, “Increase practice referrals from local physicians by 10 percent this year. We will accomplish this by sending a quarterly letter to physicians describing our new services.”

This is obviously a doctor-oriented goal, but you can also have staff-oriented goals that focus on how smoothly your practice runs and how well your patients are treated by the staff. As Bacal writes, “To succeed, organizations need to be able to coordinate the work of individual employees and work units, so that everyone is pulling in the same direction.”

The most important thing with respect to goals for others in your office is to include them in the process. Employees are much more likely to pursue a goal if they “own” it by having a part in developing it. Moreover, asking your employees to come up with some goals will give you a lot of insight about how things are going and where there might be problems.

In the book, Goals and Goal Setting, author Larrie Rouillard explains that goals which involve others usually include a three-step process. This process is an initial discussion that focuses on the “who, what, when, why, where, how, and how much” as well as the expected outcome. The second step is compromise between the parties who are setting the goals. Step three “closes out the compromise step and sets the ground rules for goal execution and the efforts to be expended for goal achievement.”

As you consider business and marketing goals, keep in mind your personal goals, too. You may be thinking about statistics and financial reports, but things that are less tangible such as how patients perceive your care is important. “Business targets are the most obvious goals, but perhaps not the most important,” suggests Bacal. “At least as important are goals that embody the values the physician wants to dominate the practice. For example, treating each patient humanely and with respect.” This is the main factor in word-of-mouth referrals.

Of course, word of mouth is one of the primary ways that doctors get referrals and much of this depends on how patients who have already been treated by a physician report their experience to others. Miedaner believes that word of mouth is the best marketing strategy. She advises, “To get patients talking about you, you need to deliver a ‘wow’ experience. One of the best ways to do that is to consistently underpromise and overdeliver. If it takes two weeks to get the results back, tell your patients that you’ll know in three weeks and then give them the results in two weeks. They’ll be delighted with the speediness of your service.” Of course you should be ethical in what you tell patients, but Miedaner justifies her statement by saying, “If you tell patients two weeks and there is a delay in the mail or the lab is behind schedule, then your patients will be disappointed even if you are only a day or two later than you said. The patient will hear the excuses, but blame you.”

Just as you should ask your staff what goals are important, so should you check in with your patients. Miedaner says, “Ask and you shall receive. All you need to do is to ask your patients what they need, what they would like, what would make their experience better and what services they would be interested in having.” Not only will this help you to form better goals, but also you will endear yourself to your patients because they’ll see you as a physician who truly cares about what is important to them.

Setting the stage

You’ll have an easier time focusing on your goals and what you need to do to get through each day if you discourage interruptions whenever possible. I was talking to a pediatrician friend of mine who told me, “Remember when you read me that statistic that it takes several minutes to recover from an interruption and how interruptions, though seemingly inconsequential, eat up your time and drain your energy?” I remembered the conversation and I was interested to hear that ever since that day she had gotten her staff to interrupt her far less, resulting in a much more focused and cohesive workday.

Miedaner believes that evaluating your time is critical to success. In a section of her book titled “Make Time When There Isn’t Any,” she writes, “When you can’t figure out where all the money goes, it helps to do a spending log for a month and see exactly where it is going. The same goes for time.” Miedaner also recommends doing one thing at a time. She counsels readers, “Rushing around trying to do ten things at once is not efficient. Give yourself permission to do one thing at a time. In reality, that’s all you can do. You might as well accept it and focus on doing one thing consciously and well.”

Once you have figured out your top three to six goals (it is best to start out with just the most important ones) and committed them to paper, remember that even the best laid plans won’t happen unless there is follow-up. Goals that are written down but never seen again have little chance of actually coming to fruition. In order to save time, you can designate someone in your office to check the goals and what progress is being made on a regular basis. Then
perhaps every other month or so, he can fill you in.
This way you can save time but still be involved and troubleshoot a bit.

I don’t blame you if you already feel so overwhelmed that the prospect of going through the motions to set goals seems unbearable. If so, try setting just one or two goals that you can easily accomplish and control. If you want to change the course of your practice or your career and you are looking for some advice, Miedaner recommends hiring a personal coach who can help you to focus and succeed in your endeavors. She says, “Even people with less extraordinary careers find that life can take over, but this is doubly so for physicians, who are often on call and have to interrupt their personal lives to handle emergencies. Then, before you know it, a whole year can pass by and you can’t even remember what your goals were to begin with.”

Or, as the great “philosopher” Yogi Berra once said, “If you don’t know where you are going, you might wind up someplace else.” g

Julie Silver, MD is an Assistant Professor at Harvard Medical School and the author of several books including Chronic Pain and the Family. She is also directing the new Harvard CME course, “Publishing Books, Memoirs and Other Creative Non-Fiction” (for more information go to http: //cme.med.harvard.edu/.)

@ 2005 UO Inc. www.uoworks.com 800-888-2047










				Golden Goals You have to know where you’re going if you expect to get there. Creating—then rechecking—goals can keep your practice focused. By julie k. silver, m.d. Published May/June 2005 “If you don’t know where you are going, it’s unlikely you will arrive.” Or so says Robert Bacal, the author of Perfect Phrases for Setting Performance Goals. He tells the story of how Steven Jobs, the founder of Apple Computer, knew exactly where he was going. When he was twelve years old he called Bill Hewlett, the founder of Hewlett-Packard, and asked if Hewlett would give him some parts. Bacal goes on to note that, “If a physician takes more time deciding on a holiday destination than he or she spends on deciding on the ‘destination’ of the practice, that’s a problem.” If you aren’t convinced that you should spend some time setting goals, consider the following: 1) Goals help you to focus on what is important in your career. 2) Goals help your staff to focus on what is important in your practice and help them to work more efficiently and with less supervision. 3) Goals allow you to monitor progress and to better assess how your staff is functioning. 4) Goals ease anxiety—both yours and your staff’s. Knowing what is expected and how to accomplish it is reassuring. So when was the last time you set goals for yourself and your practice? If you can’t remember, you are in keeping with most of your colleagues. Talane Miedaner, a personal coach and the author of Coach Yourself to Success, says, “By the nature of their work, physicians tend to put other people first. Setting goals is one way to help keep focused on your own life and what is most important to you.” Creating and sharing goals Before you begin to set goals, it is helpful to know what the experts recommend about this process. First, goals usually have two parts. The first part is the “what.” What is going to be accomplished? The second part is the “how and when.” How is the goal going to be accomplished and in what time frame? For example, you might set a goal that states, “Increase practice referrals from local physicians by 10 percent this year. We will accomplish this by sending a quarterly letter to physicians describing our new services.” This is obviously a doctor-oriented goal, but you can also have staff-oriented goals that focus on how smoothly your practice runs and how well your patients are treated by the staff. As Bacal writes, “To succeed, organizations need to be able to coordinate the work of individual employees and work units, so that everyone is pulling in the same direction.” The most important thing with respect to goals for others in your office is to include them in the process. Employees are much more likely to pursue a goal if they “own” it by having a part in developing it. Moreover, asking your employees to come up with some goals will give you a lot of insight about how things are going and where there might be problems. In the book, Goals and Goal Setting, author Larrie Rouillard explains that goals which involve others usually include a three-step process. This process is an initial discussion that focuses on the “who, what, when, why, where, how, and how much” as well as the expected outcome. The second step is compromise between the parties who are setting the goals. Step three “closes out the compromise step and sets the ground rules for goal execution and the efforts to be expended for goal achievement.” As you consider business and marketing goals, keep in mind your personal goals, too. You may be thinking about statistics and financial reports, but things that are less tangible such as how patients perceive your care is important. “Business targets are the most obvious goals, but perhaps not the most important,” suggests Bacal. “At least as important are goals that embody the values the physician wants to dominate the practice. For example, treating each patient humanely and with respect.” This is the main factor in word-of-mouth referrals. Of course, word of mouth is one of the primary ways that doctors get referrals and much of this depends on how patients who have already been treated by a physician report their experience to others. Miedaner believes that word of mouth is the best marketing strategy. She advises, “To get patients talking about you, you need to deliver a ‘wow’ experience. One of the best ways to do that is to consistently underpromise and overdeliver. If it takes two weeks to get the results back, tell your patients that you’ll know in three weeks and then give them the results in two weeks. They’ll be delighted with the speediness of your service.” Of course you should be ethical in what you tell patients, but Miedaner justifies her statement by saying, “If you tell patients two weeks and there is a delay in the mail or the lab is behind schedule, then your patients will be disappointed even if you are only a day or two later than you said. The patient will hear the excuses, but blame you.” Just as you should ask your staff what goals are important, so should you check in with your patients. Miedaner says, “Ask and you shall receive. All you need to do is to ask your patients what they need, what they would like, what would make their experience better and what services they would be interested in having.” Not only will this help you to form better goals, but also you will endear yourself to your patients because they’ll see you as a physician who truly cares about what is important to them. Setting the stage You’ll have an easier time focusing on your goals and what you need to do to get through each day if you discourage interruptions whenever possible. I was talking to a pediatrician friend of mine who told me, “Remember when you read me that statistic that it takes several minutes to recover from an interruption and how interruptions, though seemingly inconsequential, eat up your time and drain your energy?” I remembered the conversation and I was interested to hear that ever since that day she had gotten her staff to interrupt her far less, resulting in a much more focused and cohesive workday. Miedaner believes that evaluating your time is critical to success. In a section of her book titled “Make Time When There Isn’t Any,” she writes, “When you can’t figure out where all the money goes, it helps to do a spending log for a month and see exactly where it is going. The same goes for time.” Miedaner also recommends doing one thing at a time. She counsels readers, “Rushing around trying to do ten things at once is not efficient. Give yourself permission to do one thing at a time. In reality, that’s all you can do. You might as well accept it and focus on doing one thing consciously and well.” Once you have figured out your top three to six goals (it is best to start out with just the most important ones) and committed them to paper, remember that even the best laid plans won’t happen unless there is follow-up. Goals that are written down but never seen again have little chance of actually coming to fruition. In order to save time, you can designate someone in your office to check the goals and what progress is being made on a regular basis. Then perhaps every other month or so, he can fill you in. This way you can save time but still be involved and troubleshoot a bit. I don’t blame you if you already feel so overwhelmed that the prospect of going through the motions to set goals seems unbearable. If so, try setting just one or two goals that you can easily accomplish and control. If you want to change the course of your practice or your career and you are looking for some advice, Miedaner recommends hiring a personal coach who can help you to focus and succeed in your endeavors. She says, “Even people with less extraordinary careers find that life can take over, but this is doubly so for physicians, who are often on call and have to interrupt their personal lives to handle emergencies. Then, before you know it, a whole year can pass by and you can’t even remember what your goals were to begin with.” Or, as the great “philosopher” Yogi Berra once said, “If you don’t know where you are going, you might wind up someplace else.” g Julie Silver, MD is an Assistant Professor at Harvard Medical School and the author of several books including Chronic Pain and the Family. She is also directing the new Harvard CME course, “Publishing Books, Memoirs and Other Creative Non-Fiction” (for more information go to http: //cme.med.harvard.edu/.) Back to top @ 2005 UO Inc. www.uoworks.com 800-888-2047