…and fire quickly.

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I have never met a leader or a practice owner that regretted firing somebody that was a poor fit for their team. While I have not had to let many of my teammates ‘find other, more suitable employment’ one example comes to mind.

DOFIStacy (not her real name) was a pretty good DOFI. DOFI stands for ‘Director of First Impressions’, a title shared by all of our front desk personnel. All the patients loved her and she took care of the data entry and scheduling portion of her job well enough. The downside was that she was often late and her ‘sick days’ tended to fall on the Friday before a 3-day weekend. I must have put up with a half-dozen ‘throat hurting’ and family emergencies (I think her grandmother died twice) and way too much aggravation before she finally pushed me over the edge. After a very dramatic sick call, she posted some great pics from the lake on Facebook! We let her go the next day, only to find out that she had been stealing co-pays from patients for on and off for over a year.

Lesson learned! I should have let her go as soon as I figured out that she had an integrity problem. Here are a couple of relevant quotes to help us remember to make the decision to remove people from our team more quickly.  I find that it helps to think of ‘firing’ as rectifying my own mistake in hiring the wrong person.

“The moment you feel the need to tightly manage someone, you’ve made a hiring mistake” (Jim Collins)

“Don’t beat yourself up if you get hiring wrong some of the time. Just remember, the mistake is yours to fix.” (Jack Welch)

So if you find yourself tightly managing someone or smelling a culture mismatch, move into addressing the problem without delaying to see if it will rectify itself. If its a problem with competence, you should be able to address it and see improvement. Chris McChesney of Franklin Covey said it best:

“If they can’t do it, they are in the wrong seat. If they won’t do it, they are in the wrong organization”.

Jobs Applied: Engage Face to Face

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“There’s a temptation in our networked age to think that ideas can be developed by e-mail… that’s crazy. Creativity comes from spontaneous meetings, from random discussions.” – Steve Jobs

While he valued face to face engagements and meetings, Jobs had nothing but disdain for the typical corporate ‘death by powerpoint’ session. What he looked for was live engagement and problem solving.

The hectic pace of physical therapy, with what sometimes seems like every moment taken by scheduled patient care makes it difficult to create time for face to face engagement. While we occasionally make time for clinical education activities like journal clubs, it is easy to replace face to face engagement for leadership activities with phone or email communication.

Creating regular face to face engagement is difficult in organizations like our private practice, with 17 facilities spread across a few hundred miles. In even larger companies with hundreds of facilities, face to face engagement between executives and local team leaders is even more rare.  My short stint working with US Physical Therapy (we were temporarily partners after an acquisition) showed me the reality of this.  The executive I reported to had about 260 direct reports.  We met face to face perhaps twice each year.

Face to face engagement… which we affectionately term 121s (one to ones) between a leader and those they lead is a key leadership task. In my opinion it is a key component of the cadence of accountability we should try to maintain with our teams. One of the most difficult but most rewarding activities we have undertaken as our practice has grown has been to maintain a regular regimen of contacts between our leaders and those they lead. Here is an example cadence that has worked well for me:

  1. Weekly – small group, very focused video teleconference focused on activities being completed to meet our most important goals.  We do 3 of them to allow small groups so they take no more than 20′.
  2. Monthly – face to face 121s between leaders and those they lead.
  3. Quarterly – Summits with key leaders meeting to share results, insights and progress toward meeting goals.
  4. Annually – Strategic planning with a small, focused group and then subsequent meetings to share aspirations and strategies with the entire team.

I believe that your average ‘meeting’ is a great way to avoid working. That said, focused face to face engagement and communication between leaders and those they lead is essential to building a great team.

Jobs Applied: Tolerate Only ‘A’ Players

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Steve Jobs, despite all of his redeeming features, was famously ‘impatient, petulant and tough with the people around him”. He also delivered results, while maintaining a loyal cadre of high achievers that stayed with him much longer than was typical of the computer industry at the time.

“CEOs who study Jobs and decide to emulate his toughness without understanding his ability to generate loyalty make a dangerous mistake”. – Walter Isaacson

Jobs believed that part of his job was to unfailingly deliver the brutal truth, rather than sugar coat failures. His belief was that many organizations employ managers who are so polite and forgiving as to become ineffective, allowing mediocre employees to feel comfortable and thus encouraging them to stay.

Jack Welch, famed CEO of GE had a similar style and philosophy when it came to an intolerance for mediocrity. Indeed, Jim Collins, in ‘Good to Great‘ found that one of the key features of great companies is that they were good at ‘getting the right people on the bus’. Along with that inevitably comes the need to get the wrong people off of the bus. GE famously utilized a performance feedback system that systematically ensured that the bottom 10% of employees were terminated or rehabilitated… slowly raising the bar for all employees.

Leaders and managers in physical therapy practices attempt to hire the strongest clinicians, with an attitude that lends itself great customer service and teamwork. This gets more difficult in tight job markets or when timing limits our choices. The adage of ‘hire slow, fire fast‘ is often harder to do than we like, and it goes without saying that the best time to ensure we have the right people on the bus is during the hiring process. We occasionally hire someone that isn’t a good fit (a C or D player). These are difficult enough to deal with.   Even harder than the obviously insufficient are those that are ‘OK’, the B players.26325920_s

By tolerating ‘B players’ we prevent the opportunity for an A player to join our team. True – we can develop B players into A players… but when you determine that they are a B player with no potential, they can set the bar for everyone around them. A team member’s status as a A or B or C doesn’t have to be defined only by phenomenal clinical skills, or amazing personality or steadfast work ethic… although it could mean any or all of those things. We should employ good clinicians with great empathy and a strong work ethic. We should employ great clinicians with good customer service skills and great ability to teach others. We should employ resilient, gritty grinders that never complain and make sure that the work gets done. But we should never tolerate mediocre clinicians with an OK attitude that give us no reason to complain.

How we deal with professionals that ‘meet standards’ or are ‘good enough’ determines whether our practice is doomed to mediocrity or if it has the capacity to be great. Tolerate only A players.