By Arthur Geary
This is the first in a series of articles examining the discipline of execution in business. The next article will address strategies for bridging the execution gap.
Taking action on your business plans in a disciplined, effective way enables you to create a more powerful practice. The first step is understanding the biggest obstacles to putting your plans in action.
Do You Suffer from the Execution Gap?
I define the execution gap as the difference between business goals/expectations and results. The gap occurs when a business sets goals or strategy and makes decisions without integrating the essential elements of execution in an organized process.
An early sign of the execution gap is lack of rigorous discussion. In the eyecare practice I was president of, my management team and staff knew I expected them to generate their own ideas to improve upon my plans. Meetings in which my course of action was challenged, thereby becoming more realistic or actionable, was par for the course. Asking staff to help you make plans action-ready is essential. If you do not include the ideas and feedback of your staff (the ones charged with implementing your plans), your grand visions for your practice have much less chance of getting put successfully into action.
In eyecare practices, as well as many other small and mid-size companies, the owner/founder or a dominant CEO sets the business strategy and mandates implementation and results. In the case of the doctor/owner, having a “take charge” personality usually makes them a good clinician. In many cases, the doctor may be starting a new practice or buying a small existing one. In either case, there is typically limited staff, and what staff exists has limited business experience and expects the doctor to provide direction. In this scenario, several habits begin to form that contribute to and sustain the execution gap.
Four Roadblocks that Prevent Effective Execution
1. Management by directive. This develops from a belief by the doctor or staff that the doctor will provide all direction. This belief creates a habit or style of management by directive. As the doctor/owner, you may believe, and many of your colleagues may have reinforced, that the staff is there to serve and cater to you to provide high-quality patient care. Can you operate a successful practice or business in this fashion? The answer is yes, but as the business grows so will the “gap,” unless the “discipline of execution” is embraced. This is especially important in healthcare because the “gap” may eventually diminish the quality of care provided.
2. Staff passivity. Management by directive trains staff to accept whatever directive is given regardless of how they may feel about it or what problems they may foresee or encounter from its implementation. This can be a much bigger issue for medical and optometric practices than other types of non-healthcare businesses because of the education, skill, experience and maturity of the typical practice-level employee. It takes a confident leader to encourage staff to respectfully, professionally and appropriately challenge directives and to offer alternative solutions. An insecure leader will interpret a staff member questioning a directive to be insubordinate or challenging their authority. Likewise, if you are a doctor or CEO with a history of public, anger-induced or reactionary responses to assertive employees, you are training your employees that passivity is the safest conduct. It is also likely that, whether you realize it or not, the preference for passivity is probably influencing your recruitment of new employees. Beware, in this environment the practice may have a “family feel” to it, but lack the cohesiveness of a team effort that develops when you have “buy-in” to the plan and everyone takes ownership for the results. As a consequence, as the practice grows the gap usually widens. Over time the practice culture of ingrained passivity by the staff and the lack of personal accountability will increase the difficulty of embracing the discipline of execution.
3. Setting your organization up for failure. This often occurs when the doctor/owner attends periodic seminars, information sharing group meetings, trade shows or similar gatherings. Usually, at these meetings the doctor/owner is exposed to new ideas, new products, new concepts, updates, management and business building tips or programs. Typically, the new information is excellent and the doctor/owner comes back excited about what they’ve learned. Too often, they come back with a handful of ideas, programs, tips or equipment that they are convinced will take the practice to the next level. Naturally, they want these plans implemented “yesterday!” I like to call this the “Latest and Greatest,” or the “Shot Gun Approach.” I speak from experience when I say this is an easy trap to fall into. Why this is a problem? In their excitement about what they’ve learned, the doctor is focused on the anticipated result, while giving inadequate thought to the implementation. This leads to the ready, fire, aim trap. Usually, the doctor will return to the office, announce the great ideas, have a passing conversation about the implementation and set the target date. Or, they will announce a handful of initiatives to be implemented simultaneously without consideration of their staff’s ability to adapt to them all. Out of this habit is born much of the disappointment over results that don’t meet expectations.
4. No rigorous process for challenging or vetting ideas, systems, programs, or initiatives; their associated assumptions and plans for implementation; and the frequent testing of expectations against results with the understanding that adjustments will likely need to be made. Central to this process is an environment that fosters open communication. This habit often develops as an outgrowth of the first four habits. However, breaking or avoiding this habit is absolutely critical to developing the “discipline of execution.” This rigorous process is at the heart of execution. It is the catalyst that allows your business to go from point A to point B, producing results that meet or exceed expectations. But it is often at odds with the decision making style of doctors, because it also requires a commitment of time. In most businesses today staffing is lean and everyone is busy, so a “run and gun” or “shoot from the hip” style of decision making is common. Also common, is that the entrepreneurial owner will take pride in making decisions quickly as a sign of how nimble their company can be. This is a personality trait of many entrepreneurs, such as ODs, and may be valuable early in the business development cycle, but as the business grows the “gap” will usually widen to a point where it becomes intolerable.
Recognize this is Just Step One
Understanding these four roadblocks to execution is the first step to creating a practice primed to implement plans and reach long-term goals. But it is only a fraction of the battle. The next article in the series will examine strategies for bridging the execution gap.
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Planning the Three Stages of Optometric Practice
Arthur Geary, founder and CEO of Execution in Business, Inc.,is a senior executive and leader with a broad range of experience from start-up to Fortune 500 companies in eyecare, insurance, finance and securities, medical software and commercial construction. To contact him: ageary@executioninbusiness.com
