Using the Rule of Thirds to Change Your Practice’s Culture

When I support practices, I usually meld together many different management theories to come up with a plan that will be customized for every office. The Rule of Thirds is a rule often used in photography but aptly applies to one theory of management that I heartily support (adapted from Patrick Lencioni).

Every team can be divided up into thirds, whether you have five team members or one hundred.  You will have one third of your team members in each of the categories in the table below.

Either you as an owner, or your office manager, may likely feel that you are spending 80% of your time convincing your naysayers because they don’t follow protocol, they create conflict, create confusion and decrease morale. In reality, no matter what you do for them, they will never be happy and will always find something to be unhappy about.

The more serious side effect of your spending most of your energy on your Naysayers is that your Undecided could very easily be swayed and become a Naysayer as that is where all attention is landing in the office. Even more serious is that your Supporters will either become a Naysayer as that is the entire conversation in the office or they will leave because they don’t want to be caught up in the politics.

A better approach is to assume that everyone is a supporter, if you do this you will find that half of your Naysayers will become positive and half your naysayers will leave because they don’t fit in. All of your Undecided will become Supporters as well because they crave the stability, clarity and positivity that you will be providing.

I know this sounds good in theory but how can you bring this change into your practice? Change best comes from the top by way of being an example to others. Your team won’t change their behaviour if you don’t, your culture needs to be developed over time to hold change.

  1. If a team member doesn’t follow protocol, just let them know that you expect different next time and then drop it. Don’t talk about it to others, don’t bring it up at a morning meeting. This goes back to the theory of criticizing privately and praising publicly.
  2. At your daily meetings, always praise your team members by name of who did their job well the day before. I know that it’s their job and they are getting paid for their tasks, but they still need to have your recognition. If someone doesn’t deserve recognition, then don’t provide it.
  3. Establish a “No Complaining Rule” this will keep the positivity of the practice in place. Team are allowed to voice a complaint only if they can also provide a solution. An example of this is could be “ Dr. ____________ patients are getting upset because we are always running behind, usually it is because you are chatting at the end of an appointment. Is it possible for me to give you a sign behind the patient to let you know we are at the end of the appointment?” You can also make it into a fun activity, anyone who complains without a solution needs to put $2 into a jar that will be donated to charity when it is full.

Culture change takes time and patience, it is dropping bad habits and retaining good ones for an extended period. Sometimes we can’t even see the areas where we need to change, it may be a tweak it may mean something bigger. There are many ways to institute culture change into your practice.   Connect with me and I will help you find the one that is best suited to your team.

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