Practice owners can change their "practice flag". It is more than a slogan, like "Sharing the care" or "We care for your pet as if it was our own." It should be based on a systematic approach to quality healthcare delivery, embracing clear standards of care, ensuring continuity of care, and using the veterinary extenders to their fullest capacity. Veterinary extenders are simply those people, or things, who give the veterinarian more time for patient care, whether they are forms, policies, computer-assisted education devices, or veterinary technicians, who provide quality patient and client care. Let's look at the elements that need to be included in a quality practice "F-L-A-G":

 Followers: Every team requires players, or else you cannot call it a team. They must be willing to play by the rules established for the game.

 Leadership: Every team needs someone, or a group of people, as leader to make the hard decisions, set the pace, and provide the feedback on activities.

 Attitude: The attitude of concerned excellence for client-service and patient care must be seen at all levels, from the followers to the leaders, and must be positive to be successful.

 Goals: Any team needs to know where it's going and the end point, where they can be recognized for making a successful score.

Followers

Believe it or not, psychologists tell us that fifty percent of the American work force has a personality that prefers predictable, steady, and routine work. Another sixteen-point-three percent of the American work force prefers lifestyles that are very concise and structured, and a work place loaded with policy statements and procedure manuals. See Appendix D, Veterinary Management in Transition: Preparing for the 21st Century, for an in-depth discussion of behavior types and their expected practice and social interaction profiles.

A practice manager has a two-in-three chance to select a process-oriented follower, when people are hired to be on their team. By definition, these type followers must have a leader to be effective and comfortable within their work environment.

The follower needs to know what the expectations are, where the practice is going, or simply, what determines competence. They do not like rapid, unpredictable, operational changes. The basic issue in healthcare delivery must be competency. Training, and recurring training, is required for peace of mind. They need to have a clear "flag" to rally behind, usually the "vision" of the leadership. The performance range cannot be evaluated as excellent, outstanding, good, fair, weak, or poor. Competency is excellence in healthcare, and nothing less is adequate. Every text in human healthcare delivery says a single standard of performance is necessary and, within our consulting programs, that is called "competency". See Building the Successful Veterinary Practice: Programs & Procedures, Chapter 6, and the VCI® Signature Series Monograph Staff Performance Planning & Goal Setting, with the forms on the accompanying CD.

If a staff member is below competency, training is "needed". If the staff member is truly incompetent, the person needs to be de-hired, which means fired for inability to learn, even with multiple retraining and referral opportunities! Above competency, which must already be excellence, considering the forensic nature of healthcare delivery, is a category we call "ready to train others". This category recognizes the training ability of the best followers to help improve their team members' performance.

Leadership

Members of a veterinary practice staff want to believe they are in a caring profession. They want to be recognized as being the best in healthcare delivery. When staff members know they share the practice philosophy, that they are meeting these needs, they know they follow the practice standards (flag) of the owner or veterinarian. These philosophies become the core values of the practice and apply to everyone. When decisions are made by employees, using these core values, only accolades should occur. No one should ever feel the standards or values are inconsistent. These are the "flag" characteristics of a quality practice and are the keys to practice leadership and team building.

Sharing the dream and vision is one method to build a common team effort. Being fair is impossible, since fairness is in the eyes of the beholder. The good leader ensures that staff is treated in an equitable manner. Stars will be treated differently from the rookies just joining the team. Receptionists can become client relation specialists and excel, but are still are limited to duties different from technicians, such as inpatient and outpatient nursing staff. And owners have privileges not available to associates.

"Equitability" is most often defined in the work place as predictability, being able to depend on the veterinarian for support of the practice standards, even if it upsets a client. If the doctor learns to say, "I'm sorry, it was my fault, we initiated that program to help the majority of our clients," OR "I'm sorry we hadn't planned for your situation", then the staff will feel supported by the leader. As the boss treats the staff, so will the staff treat the clients. The leader's vision and dream will be supported when the team is led by example. See Building the Successful Veterinary Practice: Leadership Tools, Appendix B, where fourteen leadership tools are outlined, which should all be understood and in use on a daily basis by every practice manager and leader.

Attitude

The simple rule in leading a team is, "Whether you think you can, or whether you think you can't, you make it come true." The positive attitude builds on the strengths for which each individual was originally hired. We don't hire people for their weaknesses. The positive attitude says team members were hired to solve the problem, not wait to see what the rest of the people are going to do. The positive attitude is patient advocacy, a quality of care issue, speaking for the needs of the pet, and letting the clients get involved in the economic decisions and whether to access that level of care for their pets.

A great practice attitude is remembering that the only team members who stumble and make mistakes are those who are moving and trying something new. This is a characteristic of learning. Those who never make mistakes and never stumble are standing still and playing it safe. This is not a practice growth posture.

The "uncommon leader" will see a mistake and identify it as a training shortfall of the practice. Traditional managers just try to assign blame for the mistake. When building a team "flag", catching people doing things right is more important than catching them doing things wrong. When they are seen as doing something wrong, a good leader knows it is a training shortfall, so they turn it into a teachable moment, and everyone gains from the new knowledge being shared. Effective teaching starts with "discovery," and most often that discovery manifests as lack of knowledge Hence, the teachable moment occurs. They want to learn something!

Goals

Everyone wants practice growth, but there are many who do not realize that clear direction and defined limits are needed for orderly team advancement. While many practices say they have not had the time to define clear, concise, and embraceable objectives, they have concurrently made the time available to train new staff members on a recurring basis. High staff turnover is often symptomatic of a staff who does not identify with the practice standards. During the search, hire, and training of the replacement for the lost trained staff member, it is estimated to cost the practice in excess of $25,000 lost revenue during the transition.

With each training cycle required for new employees, the time taken to build the standards (flag) usually gets shorter, because of:

 Subject familiarity.

 Degradation, because of word-of-mouth concept transfers, similar to the telephone game we played as children, where by the last pass, the beginning phrase sounded nothing like the original phrase.

 Staff shortages.

The foundation of "standards" and "goals", during delegation, will be the core values, those beliefs and attitudes that are inviolate, by anyone, even the boss. Clear core values allow others to make decisions based on those inviolate standards, and they know their protection from "blame" is always based on the decision to use the core values of the practice. After the inviolate core values are established, the consistent standards of care emerge. These are "needed" actions, usually for the patient, sometimes for the doctor or practice, and everyone states the need in the same manner, each time the condition is encountered. Clients can still waive, defer, or make an appointment, rather than act immediately, but the provider cannot alter the need from the established practice standards. There are no exceptions in the offer.

Every team must have a goal. All team sports have expectations that are clearly defined, from what they wear, to the size of the playing field, to how they are to treat others, while they try to score. The team captain and the coach tell the team what is expected, and how they are to work together, to make the score. Some teams need more direction than others. Great goals and team building can start with these sport analogies, but they also go beyond these boundaries.

A practice team must be in for the long haul, not just a four-hour game of youthful endurance. A good leader keeps the goals and objectives clearly defined and in front of the team. The purpose of the goal, when well explained, is to add the power to the motivation. A great leader also puts himself into the team's shoes and tries to see the challenges from their perspective. The alternatives are selected from reality and the strengths of the team, not dreams and wishful thinking.