The most notable authority on goals is Zig Zigler. He mentions repeatedly in his book, See You at the Top, it is impossible to get where you are going if you don't know where that is. And you significantly increase your chances of achieving them by writing your goals down and creating a specific plan of action to reach them. This may include things like gaining more education, hiring people with specific knowledge or talents, or identifying specific people you need to know in order to reach your goals. However, without defining specifically what you want, the chances of obtaining your goals reduce significantly.

Assess your practice. Obtain an accurate assessment of your current status and then set goals for where you will be in one year. Knowing where you are starting from helps you set more realistic and obtainable goals. Once you have your goals, break them into steps and prioritize them. Work on the hardest and most important steps first. Work on them day-by-day, week-by-week, and month-by-month. As Jim Parker use to say, "plan your work and then work your plan." Most people would agree that leaders generally know where they are going. But leaders are also very aware of where they have been and where they are at the present time. Knowing where you have been, where you are now and where you want to go are all vital in goal setting. If you are not conscious of where you have been, you may end up creating a new version of the past. Knowing where you are now means knowing your practice statistics. Going where you want to go relies on knowing where you are starting from. If you search the internet for directions to a specific destination, you cannot obtain the directions without providing the address of the starting point.

Grow Your People

While you are setting your plan in motion, assess your staff. Assessing their performance will help you assess your skills as a leader. Did you hire well? Were you accurate in reading the people you hired? Are they performing as expected? If not, did you train them correctly? Anyone who has been successful has had help. In Jim Collin's book, Built to Last, he states that every successful company had to, "get the right people on the bus and find the right seat for them on it." Too often, in a chiropractic clinic, we tend to hire people we like and then try to figure out what they are good at. Unfortunately, generally speaking, that does not work.

Initially, you need to define the roles in the office and create job descriptions for those roles because then it is easier to hire personalities to fit those roles. After you have found the right person, then it is time to "invest" in those people. The philosophy we try to follow is to do three things with everyone in our company: help them grow professionally, help them grow personally, and help them grow financially with increased incentives. Without all three, your people can burnout.

As you are growing your people, continual feedback is very important and it has to be specific and continuous. Most issues arise in work relationships because of disconnect between employer and employee. The employee is told to be helpful to a patient. However, do the doctor and staff have the same definition for being "helpful?" You, as the leader, must define what being helpful really means. Then, continued feedback must be given through periodic performance evaluations to ensure their activities match your definitions. Some other questions you may want to ask yourself are: Have you motivated, compensated and rewarded your staff appropriately? Do you have clearly established boundaries for your employees? Have you hired friends, relatives or patients that are not truly qualified? Employee hiring, training, motivation and discipline are some of the hardest skills to master for the doctor. They require study, a few hard knocks and patience as they evolve over time. The second article in this series focuses on staff, so stay tuned.

Final Thoughts on Leadership

Do you command or earn respect? There is a huge difference between the two. The doctor who cannot lead well will have to command respect. He will only obtain respect through threats, intimidation, bullying or discipline. He is the boss and can fire an employee if he wants. Employees only learn to respect the power of position and not the doctor as a person/leader. The doctor who leads well will earn respect. He does the things necessary to grow and manage the practice for the benefit of his patients, his employees and himself. He earns a position of respect and power in the minds of his employees through his actions and accomplishments. Leadership was addressed first in our series because it is the hardest business factor for the doctor to evaluate and change. Sometimes we meet the enemy, and it is us.

Assessing your leadership skills requires being introspective and honest with yourself. The points raised in this article are only a few of what you might need to master leadership in your practice. You must have the willingness to admit and improve upon your own mistakes. You must have the determination to study leadership and improve your skills. Work through this first. Then, continue to read this series and work through the four remaining factors. It will improve your practice; and, you have more than 48 hours to do it.

Dr. N. Ray Tuck Jr. is the chairman of the American Chiropractic Association Board of Governors.
Click here for more information about K. Jeffrey Miller, DC, MBA.