Strategy – more than a plan

Is a business plan enough?

Business plans are important tools for any owner, and in my role as a QIP practice surveyor I have seen many such plans – some brilliant and some in need of work. Not a lot of work, as most are pretty close to the mark and just need firmer time frames and outcome measures. But none of them was a strategic document. None projected a longer term vision of the business or demonstrated a purposeful system of achieving it. 

Strategy

It has been said that strategy is more than a list of goals and actions to achieve them – more than a plan. Strategy is more deeply rooted in the DNA of the business, the owner and the organisation. It is the combination of behavioural patterns, customer management, competitive advantage and the philosophy of adding and delivering value.

Well, so say the academics in the field of strategy. Like Mintzberg who listed no fewer than ten ‘schools’ of strategy, or Sun Tzu (‘The Art of War’) whose work has been commandeered by business coaches and consultants often with good effect. And of course Michael Porter, a more recent guru who insists that strategy is focused on a unique mix of offerings that enhance competitive advantage.

If you would like to develop a strategy for your business that provides direction and perspective in turn generating a purposeful business plan, HR plan, marketing plan, earning plan and exit plan you will need two things. Firstly, an open mind toward how to analyse, structure and drive your business; and secondly, a day with me to guide you through the process.

Developing a strategic plan is not simple, nor is it absolutely necessary to have a narrow strategic focus. In fact, the best strategies are often flexible, responsive and able to adapt to changing circumstances. Too rigid a strategy can be counterproductive when the internal or external business environment shifts unexpectedly. 

That said, it is still useful to have a point on the horizon on which to navigate your progress.

Some can develop their own strategy in-house, using the collective knowledge and wisdom of the team. Others go outside and engage consultants or advisors to steer them. More often there is a blend of these two methods. The end result is the measure of success. Not the actual plan that is constructed, but the achievement of the milestones inherent in the plan that show you are making strategic progress.

Take a moment now to envision your ideal business in around five or so years. In your mind take a walk through and see the layout, talk to your team members and maybe your new business partner, get a feel of the culture of the organisation and the marketing signals given out by the quality of fittings, people and service. Write it down, distill the essence of the outcome you want, including your role, time commitment and investment in this business. Afterwards you can back track on the key elements and what needs to be in place in three years to enable the five year plan. Then what needs to be in place in one year, six months, next week. These steps are your key performance indicators of strategic success or need for adjustment.

How can I help?

Two of my workshops include strategic planning. One is an introduction as part of a multi-stream day. The second is a full day devoted to developing a strategic plan for your business.

Remarkable Practice

Three topics across a one day workshop: strategy, marketing and leadership. We look at fee setting strategies and other important starting points before moving onto the other two streams. Ideal for newcomers to private practice or those looking for a boost to their business enthusiasm.  Check the event list at www.redsok.com for when this event is next scheduled.

Remarkable Strategy

The aim for you at the end of this workshop is to have a strategic plan to enable your business to outperform in terms of market share and profitability.

My strategy is for you to leave the workshop with:

  • A clear understanding of how strategy arches over every business decision you make, service you deliver and product that you make.
  • Knowledge of where your specific competitive advantage lies and how to maximise it.
  • Ideas galore to transfer to your business plan to ensure your strategic intent is reflected in your activities and outcome measures.
  • Examples of implementing strategy in your finance, HR, team building and leadership activities.
  • Finally, a renewed enthusiasm for your business and your ability to actively manage it to success.

Is all that possible in one day? Probably not, but you have to start somewhere.

Check the list of events at www.redsok.com to see where and when Remarkable Strategy is next hosted.

How do Clients Judge You?

One of the best feelings in our work is when a new patient answers the question, ‘Why have you come to see me?’ with ‘Because I was told you are the best’. This has two great benefits, firstly my ego gets a stroke (although my wife may suggest this is neither a benefit nor necessary), secondly it indicates the patient is more likely do well with my treatment because they already expect to do well.

However it begs a second question of the patient: ‘Best at what?’  A question I was never brave enough to ask for quite some time (or subconsciously avoided to preserve the ego stroke), and when I started to ask the answers were sometimes unexpected.

It appears I was ‘best’ at each of the following for various patients who then found it useful to tell others:

  • attractive staff
  • running on time
  • privacy of treatment room
  • worked at the Olympics
  • warming the ultrasound gel
  • variety of gym gadgets
  • getting a result
  • interesting memorabilia display
  • no stairs
  • explaining the treatment program
  • availability of parking
  • excellent coffee shop next door

Shock and horror!  Many of my ‘recommendations’ had absolutely nothing to do with my professional expertise or competence and everything to do with the ambience, convenience, consideration, accessibility and neighbours of the business.

It appears that patients use a different yardstick to judge (and thus recommend or pillory) health practitioners than we use to judge each other. I am impressed with colleagues who have mastery of theory, knowledge and techniques whereas patients judge us on their experience rather than ours.

Of course they do. How could they do otherwise? Our clients rarely have an understanding of the treatment evidence base or current trends in health care for specific conditions. So they judge us on what they do understand: customer service, respect, honesty, integrity, fairness, cleanliness, hygiene, eye contact, manual contact, tolerance, value and coffee.

A quick search of the literature  shows a vast array of complex assessment tools to evaluate ‘quality’ of patient care. Almost all give a strong weighting to the outcome of care – was the goal achieved? Yet patient satisfaction is not the same as patient outcome. Nor is it the same as the patient experience. It appears clients can be very satisfied despite a poor outcome provided the experience was positive, supportive and client centred.

The sensory environment has also been studied with factors such as music, aroma, air quality, furnishings and layout being assessed in relation to hospital patient outcomes. As yet the quality of studies lacks rigor (link to Cochrane Library).

The American Medical Association states that ‘patient-centered communication is key to quality care’ and not only reduces errors but also can ‘achieve better health outcomes’ (link).

In another article, Dr Oliver Kharraz identifies the relationship (likeableness) of the practitioner as a significant factor in whether the client will follow the advice provided (program adherence).

I think this is more critical for practitioners who provide a process as opposed to providing an event. Let me explain, the concept of selling goods versus services is well understood. However I believe in medical care the service can be further divided into those that are events and those that are processes.

Events include vaccinations, surgery, provision of an appliance (orthosis, plaster cast, etc), completing a procedure (dental filling or extraction, blood test, endoscopy, etc). Each of these has a clear end point and a yes or no outcome.  Did it happen or did it not?

Processes include weight loss programs, blood glucose management, neurological rehabilitation, soft tissue recovery, fitness programs, aged care and so on. These tend not to have a clear start/finish cycle but are more elastic and depend on patient adherence for desired outcomes.

Physiotherapists are process therapists. Most of our clients require more than one session as we build their programs and progress them through the recovery. Spinal manipulation for mechanical displacements (wry neck, facet subluxations) are the exception and practitioners who work solely in this area are (I suspect) judged on immediate outcomes as a result of the manipulative event.

So what is the take home message here?  Simply this, as we are a process profession, we need to make sure the process is very, very good. We cannot rely on them feeling ‘cured’ each time they attend (a great event when it happens). Our science based treatments take time and adherence to have their therapeutic effect and it is the elements of process that enable sufficient exposure to the therapist for the treatment to make a difference.

Patients will recommend you based on the process of you delivering the treatment. So take some time to evaluate the patient experience in your business – from referral to discharge. Every single, seemingly insignificant element of the patient journey is important to the patient experience. Ask them what you are doing well and what you could improve on. Put aside your professional ego and listen closely.