Turning Around a Once Successful Practice
That is Faltering
A medical group has been expanding for a decade at a steady
rate and now maintains several offices in a tri-state area.
As a result of exploding malpractice rates, decreasing managed
care reimbursements, and shifting expectations from their
community hospital, the medical group is reeling. The same
problems are developing in all offices.
- Medical staff are objecting to higher work demands and
- Requests are increasing for additional vacation time and
- Morale is slipping.
- Issues that were never important are now of monumental
- Staff meetings, formerly amicable sessions over lunch,
range from quick to non-existent.
- Gossip is frequent.
- Distrust is evident.
- A founding member of the group leaves.
Initial process and findings
Gail Fisher surveys group members by interviewing a cross-section
of people in the medical group. From these interviews she
develops talking points to interview a larger group of staff
She finds a general sense of distrust, dissatisfaction, and
impending doom. Group members fear for their futures. However,
all have a distinct memory of the initial excitement, creativity,
and pioneer spirit that marked the practice's earlier days.
Ms. Fisher delivers this information to management and then
shares it with staff. Together, they form a planning group
is formed that is charged with developing an approach that
will ensure that staff members know their concerns are heard
and their recommendations considered for future changes.
The planning group considers how to help the practice retain
the best from its beginnings, while taking current realities
into account. Working with the planning group, Ms. Fisher
holds a 1-1/2 day forum with all available staff members at
- Staff members partner to interview one another about which
aspects of the practice and staff they value, their aspirations
for the practice and themselves, and how they believe positive
staff behaviors can be enhanced.
- The group discusses current medical realities, how staff
are affected, and how staff can be "proactive"
instead of internalizing dissatisfaction and making cynical
and derisive comments.
Much to the partners' surprise and satisfaction, the staff
lists many positive attributes about the practice and their
colleagues. The entire group takes the time to assess the
practice's greatest asset - themselves as staff - and how
to best utilize their skills and expertise.
Ideas generated at the forum offer a transition to a hopeful
future. Energy is apparent. Staff meetings resume and are
again structured to address the challenges that confront them.
In place of gossip, there is renewed appreciation of one another.
Subversive behaviors disappear since there is a new willingness
to express dissatisfactions as they occur.