A Pediatric Practice Suffering from Growing Pains A Case Study in Organizational Development

by: Tom Pearce, President, iLead Training & Consultant

Our client, a private pediatric practice, has been recognized annually by the local paper as the best pediatrician practice in town.  The five physician practice served over 23,000 patients in 2011 and would be considered by all to be a model practice.

By late 2011, issues began to arise, mostly due to the rapid growth of the practice over the past three years.  Since its inception in 2002, the practice had grown from two providers to five. As a result of their growing pains, the principal doctor retained Tom Pearce of iLead Consulting & Training to help him smooth out some of the rough edges in his expanding practice.  There were several ongoing obstacles in the practice during this time:

  • Provider turnover:  Through no fault of their own, the practice experienced the turnover of four providers in six months.  There were resignations, terminations and people moving on to focus on different specialties.

  • Inconsistent hiring practices:  As the practice rapidly grew, people were hired for various reasons.  Some were a great fit for the practice, some were not.  This lack of consistency led to 100%  turnover of staff in 2011.  The constant training and retraining of staff took its toll on the morale of the group.

  • Inexperienced administrators in key roles:  Several administrators started in their positions when the practice was much smaller and open fewer hours during the week.  As the practice grew, the challenges become more complex.  One key player, despite her sunny disposition, skills and talents, found her confidence waning.  Facing burnout, she decided to leave the practice to pursue a totally different career path.

In order for the practice to retain its status as the best pediatric practice in town, the principal doctor recognized that the practice needed to change.  In addition, it was his goal for the practice to become an employer of choice by creating a healthy work environment.

The iLead team met with the doctor and his CFO, the group developed a four-point plan designed to transform and re-energize the practice.  The plan included the following steps:

  • Conduct an employee survey:  The entire staff was surveyed in order to identify the specific issues that needed to be addressed.  The results revealed that the top three issues within the practice were:  1. Provider and staff communications, 2. Customer service and 3. Employee turnover.

  • Conduct employee interviews: The next step was to interview each staff member looking for ways to improve in each of the three key areas.  Employees were encouraged to speak openly and honestly about issues which were holding them back from doing great work.

  • Make hard decisions: Once the interviews were completed, it became clear that the practice would not move forward until people who had very poor work-performance were separated from the organization.  Great care was taken to give notice and ultimately separate each of these employees.  As a result of these tough decisions, several staff members decided to follow suit.

  • Recruit right person, right fit, right time:  In order to quickly and efficiently find talent to replace the providers and other talent a process was created to recruit not only for the necessary skills, but also for the right fit for the practice.  The mantra became, “right person, right job, right time.”  The principal doctor and his team wanted to find people who would uplift the group and not bring the team down.  Within just a few months, all the critical positions were filled including the practice administrator as well as key provider openings.  Two top performers were promoted and one senior-level employee had her job refocused so that it was a better fit for her professional interests.

  • Create a meaningful rewards structure: Through a series of coaching sessions and discussions with the CFO, employees were hired and contracts were renewed with an eye toward rewarding the right behaviors.  Contracts were structured to encourage creativity and productivity.  Pay structures were designed to balance the needs of the practice with the needs of the individual to grow and develop.

  • Provide team-building and leadership training: Once the new team was in place, the iLead team began training with an eye toward improving customer service. The training included sessions on team building, improving customer service and effective communications.

  • Write performance reviews focused on building a positive work climate:  As of this writing, the focus continues on placing the right person into the right job at the right time.  Employee performance reviews are given in the spirit of compassion and tough love.  Ultimately, there will be more employee turnover, but it will be managed, thoughtful and respectful.  Those who stay and thrive will be given opportunity to increase their salary and their professional challenge.

Working together, the practice leadership and the iLead team re-energized and refocused this team.  In less than six months, the practice successfully transformed from experiencing an uncertain future into a thriving and healthy practice.  The results – better communications, more disciplined staffing processes and compensation practices which motivate desired performances and a positive work climate.  In March, 2012, the practice was once again recognized by the local paper as the best pediatrician practice in town.

For more information on how iLead Training and Consulting can turn your organization around, please contact Tom Pearce at tompearce@iLeadusa.com.

Tom Pearce