Have you ever considered that your medical practice has similarities to your patients?

Both medical practices and humans are systems made up of many subsystems, and each subsystem contributes to the overall health of the entity.

Just as experts in medicine are now taking a more holistic approach when assessing the health of a patient, experts in medical practice leadership now look at all the systems in the organization to assess the overall health of the practice. This approach is known as systems thinking, which helps practice leaders understand how all parts of a system are linked together.

In our bodies, each organ, bone, muscle and nerve plays a unique role within the body. A strong contribution from one component can’t make up for deficiencies in the others. It’s impossible to diagnose the overall health of your patients by examining merely one component.

This systems approach can be used when assessing the health of your medical practice. How healthy is your practice? How effective is your team?

The model I like to use in my assessment of medical practices is Marvin Weisbord’s six-box organizational model. I think of it as viewing the total medical practice system and its subsystems from an altitude of 35,000 feet.

The six subsystems are: purpose, leadership, rewards and recognition, structure, relationships, resources and helping mechanisms.

There is a seventh component that complicates the interaction of these six subsystems: outside environment. An organization such as a medical practice is an open system and cannot be static. It will be affected by what is going on outside the practice, such as insurance plans, an aging population and economic health.

Leaders must be proactive. Internal motivation for change based on being alert to market and other external forces allows an organization to dictate its strategy for managing change rather than letting those changes be forced on it from outside.

Overview of the model

Each of these six subsystems communicates to each team member what is important and how to behave, and each subsystem directly impacts patient care. The following sections provide some ongoing questions you should ask to ensure your team’s performance is aligned with your practice goals.

Purpose. What business are we in? What values should guide our operating processes and are critical to our culture and success? How are we going to treat each other and our patients? What are our short and long-term goals? Are the purpose, mission, values and goals aligned so that they are clear and do not contradict one another? The answers you find to these questions should guide your medical practice in setting strategies for the other components of the model.

Leadership. Who is connecting the vision, mission and values to the strategy, structure and systems? Who is developing our culture and empowering the team? Are all the leaders communicating similar messages through their actions and words? Is there continual coaching and continuous improvement toward the goals? Without the leadership to convey your purpose and connect it to the organization at large, your team risks losing sight of your goals and not building the systems needed to sustain success.

Rewards. Is there an incentive for doing all that needs to be done? Are we measuring the outcomes that tie directly to our mission and goals? Are we rewarding the values and behaviors that we want? For example, if we say that teamwork is one of our values, are we rewarding only individual accomplishments?

Structure. How do we divide the work? Do we have enough staff members to provide quality work? Are people trained to do the work they are assigned to do so that we can achieve our mission and values? Are the roles and responsibilities clear? Is the workflow design efficient and effective with the most appropriate people performing job assignments? Aligning your resources to the goals and purpose are a crucial piece to the larger organizational model.

Relationships. How do we manage conflict among people? Is communication open, authentic and plentiful to align everyone toward the goals? Is teamwork encouraged at all levels? Does the culture of the organization foster trust and collaboration among physicians, team members, patients and families?

Helping mechanisms (adequate resources and technology). Do we have adequate equipment and technology to achieve the goals? Is our equipment in good working condition? Do we have policies, procedures and processes that support achieving our goals? Do we have ample budget to achieve our goals? This model will require you to assess the organization’s capabilities beyond your people and facilities, and as a leader you will need to be honest about whether the job can be done properly.

Outside environment. Are there external forces that affect our ability to achieve the mission? Can patients pay for services? How has the internet changed patients’ access to health information? Who are the main competitors? Is there a parent company that affects the organization? Making sure your internal subsystems are in order will allow your organization to meet the external challenges more easily.

How effective is your team?

Periodic assessment to measure progress and the continuous improvement efforts of your systems and your team is important. In doing so, I recommend:

  • Thanking team members for participating.
  • Ensuring that any surveys distributed are anonymous.
  • Providing no retribution for scores and comments.
  • Sharing the results with those who completed the survey. If you don’t inform the team members of the results, they will not complete it the next time.
  • Creating an action plan to highlight areas where the practice is excelling and areas for improvement. 
  • Get the team involved; communicate the plan to your team.

Some categories are easy to improve. For example, one area that is often scored low is celebration. When asked for their input, team members frequently have ideas for celebrating successes. By celebrating success, you can raise morale, reinforce your mission and values, and create a culture that encourages success to happen more often.

Physicians and other health care professionals have been trained to think systemically as they assess their patients. By applying a systems-thinking approach to leading medical practices, it is possible to create a healthy, values-focused culture for your practice.

Dr. Susan Murphy is a best-selling author, business consultant and speaker in relationships, conflict, leadership and goal-achievement. Her newest book, Leading Successful Teams: A Systems Approach To Creating A Winning Culture, will be published in Fall 2024. She can be reached at [email protected] or visit www.DrSusanMurphy.com.

Note: This article was originally written by Dr. Murphy for the Medical Group Management Association and has been edited for Desert Health.

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