I was interviewed on a recent episode of the Practice Care podcast.
In the interview, PracticeCare host Carl White and I discussed the complexities of aligning compensation models with practice goals, emphasizing the differences between physician owners and employees. We explored the challenges of motivating employees within different compensation structures and address the issue of burnout among healthcare professionals. The episode highlights the importance of valuing employees and setting clear expectations to enhance practice sustainability and improve overall efficiency and profitability. Ultimately, the conversation stresses the necessity of a people-centric approach in managing healthcare practices effectively.
You can listen to or read a transcript of the interview below. If you have any questions or would like to discuss how we can help your organization with provider compensation and setting clear work expectations, please schedule a Practice Strategy Session.
Interview Transcript
PracticeCare Podcast Producer
Welcome to PracticeCare with Carl White. The podcast where we help practice owners in healthcare know just enough about the business side to make good business decisions and keep their practices independent. Now our host, Carl.
Carl White, PracticeCare
Although compensation seems like it’s all about the money, it’s not all about the money. Why not? Well, my guest today is a physician compensation expert, and he’s going to explain what that means. I’m Carl White, principal at Market Visory Group, which is a healthcare marketing agency. And I’m also the host of practice care. The mission for both is the same, and that’s to help private practice owners stay private. Not only is that usually what they want, but care is better when the provider owns the practice; because that’s when they’re going to have the most freedom to make the clinical decisions they think are best. Nobody else, no other owners are whispering in their ear what they think is important, what they think ought to be done. It’s just the provider making the decisions he or she thinks it’s best. Let’s just try to keep it that way.
Carl White
My guest today is Stu Schaff. Stu is an expert in physician compensation and physician engagement. For over 15 years, he’s worked closely with the leadership of more than 100 healthcare organizations across the U.S., like Dignity Health and Trinity Health, to develop truly impactful physician compensation strategies and plans. As a trusted advisor, Stu empowers medical group leaders to break the cycle of constantly having to react to dissatisfied physicians. His proactive approach is thoughtfully tailored to each group he serves, leading to improved recruitment, retention and engagement. Stu, on this frigid day in Chicago, in January, one degree is the high, thanks for coming on Practice Care.
Stu Schaff, Intentionate Healthcare Advisors
Thanks for having me, Carl.
Carl White
Yes, I’ve been looking forward to this one. It’s a topic that is just a thorn in a lot of people’s side. It’s hard for them to put their finger on the pulse of what’s going on. So, I’ve been looking forward to this one. Before we get into it, though, I want to start where I start with every guest. The bio I asked for was short. That’s what I just read. Tell us a bit more about you. How on earth did you get into this lane of, you know, the world of healthcare?
Stu Schaff
Yeah.
Carl White
It’s hard to find people who do what you do all day long.
Stu Schaff
Absolutely, it’s definitely a niche.
Carl White
Yeah.
Stu Schaff
So, I have been in the physician side of the business for about 15 years, and I fell into it. My family had a lot of folks who were in the healthcare industry, pharmacists, nurses, lactation consultants, so on and so on. You can imagine what the dinner time conversations were like.
Carl White
Like any other.
Stu Schaff
Yeah, but when I was coming out of college with a finance degree, I think I kind of backwards rationalize it to myself, thinking, you know, healthcare is a big industry, and it’s probably only going to get bigger. You know, unfortunately, for better or worse, people are always going to need health care. And, you know, I just happen to fall into this specialty of physician compensation right around the time that laws and regulations around stark and anti-kickback, these things that your listeners may have heard of, may dread to some degree, were changing. There was a lot of need around that. And, you know, I have become known as an expert in these things. I do a lot of speaking and a lot of writing on these topics, and a lot of work with private practices and other institutions like the ones you’ve named and it’s interesting. I’ll say that.
Carl White
Yeah, I’ll bet it is. I bet it is. And there’s a lot to unpack, and we’re going to get started in today’s episode. And I’ve got a few questions, and I said to you before we start recording, I’m not sure the best sequence to ask them. So, I’ll ask [you to] help me figure it out. One of the parts of the issue is there’s the physician owner mindset and the physician employee mindset, right? And so, compensation kind of follows and can, you know, reinforce both? But how do different models reinforce the different mindset? Because a lot of people, every owner out there, wants their employees to think like owners, act like owners, act like them. And I’ve been on both sides of that coin. It’s not so easy when you’re the employee to think like the owner, because you start to say to yourself, “I’m not paid like the owner”. So, talk more about that and, you know, how one reinforces one and how one reinforces the other.
Stu Schaff
And I think that you and I, as business owners ourselves, could also attest to the fact that no matter how much you want them to, someone who’s not an owner of your practice will never have the same exact mentality that you will. That’s true in healthcare. That’s true really, for any business, right? So, just like, just to take a step back for a second, you know, when we talk with practices, you know, in the case of a private practice. If we’re talking to a physician owner of a practice, or somebody who’s running a practice alongside a physician owner, you know, they’ll come to us for a variety of reasons and say, you know, we need a new compensation model for our physicians [and] for our non-physician providers. And, you know, and then we go down this process of saying, well, what are you trying to accomplish? Nine times out of 10 they want their employed doctors to do more. And it’s interesting because…
Carl White
Like, more work per hour, or whatever.
Stu Schaff
Absolutely, yeah, absolutely. And, you know, the second question then is why is it important that they do more right? And in most cases, I’ll tell you that I have found that they feel pressure as a result of the fixed costs that they have. Whether that’s their rent, the employees that they have, who are, you know, non-providers, the physician employees themselves. Even the personal things that those physician owners have. Their personal mortgage, their car payments, their kid’s college education, things like that, you know. So as a result, they feel overextended, and they’re trying to figure out what is the way out of that, right. Not to mention that there’s this kind of background radiation, if you will. Society points to more as the default. The graph always has to go up into the right.
Carl White
True.
Stu Schaff
Right?
Carl White
Yeah.
Stu Schaff
So, you know, we’re talking about more profit, more revenue, more volume, more employees, more offices. I know that’s a big focus with what you all do in your group, right? You know, have you ever heard the expression if you’re not growing, you’re dying?
Carl White
Once or twice.
Stu Schaff
Yeah.
Carl White
Yeah.
Stu Schaff
And it’s not necessarily a bad thing to grow if you can do it sustainably.
Carl White
Yeah.
Stu Schaff
Right. So that’s the context that, you know, I bring up this difference between the physician owners and the physician employees, because that’s where we move the conversation. So, the physician owners’ incentives are clearly aligned with doing more, like you were saying.
Stu Schaff
Whether that’s volume, or revenue, or profit, or whatever it may be, in their role as owners, right? That’s, you know, because they can profit more in their role as owners. They tend to look at their physician colleagues, and I’m using that word purposely, their physician colleagues within their practice, and wonder why they aren’t doing the same. And that’s where we bring in this idea of there’s the two separate roles. And I keep using these terms purposely. You have physician owners [and] physician employees, right? And those are two separate roles, and it’s important to understand the difference between the two. So, there’s this economic difference between those roles, whether it’s an owner or an employee. You could be a physician on both. That leaves that difference in mindset. So, in most practices, employees are going to be paid a salary or a percentage of revenue or some combination thereof, right? I’m vastly oversimplifying things here, but that’s kind of the general model. And for those employees, there’s not typically any kind of like, profit distribution associated with that. I’m not talking about 401K’s, retirement and things like that, but we’re talking about what goes into a paycheck, right?
Carl White
Yeah.
Stu Schaff
And they’re, you know, talking about those components. So, a salary, there’s no financial incentive for that employee to increase revenue, to decrease expenses, right? And they’re going to default to their very human instinct to prioritize their comfort, right? In the short term over the long-term, good of the business, right? And that makes sense, right? That there’s not really a reason for them to do otherwise. And as much as you would like them to act like an owner, doing air quotes here, right? There’s just nothing to set that up and they’re not trying to hurt anybody or anything like that, right? So, a lot of practices have said, okay well, I’m going to align their compensation with the revenue that they’re bringing in. Okay. Well, you know, in that model, the more you, you know, all things being equal, the more you do, the more you earn for the practice. You earn for yourself, right?
Carl White
Right, right.
Stu Schaff
But the reality is not everyone is motivated by money to the same degree.
Carl White
Right.
Stu Schaff
And everybody is going to tap out at some point beyond which, family or other, you know, things that are, themselves, their own health, you know, are more important than money, right? So, everybody kind of has a ceiling on that. There’s no, like, unlimited level. I would say the same is true for owners as well.
Carl White
Yes.
Stu Schaff
But that’s, you know, that’s important to understand. When you have a blend of those things, which is pretty common, as I mentioned earlier. You know, having a salary, a percentage of revenue, model, things like that. You know, there are, you know that those issues that I’ve already talked about with each of those components exist, and you know, the blend can create other kind of weird things. You might have a level at which you earn instead of a threshold, if you will. And some people call it hovering overhead, right, in their practices.
Carl White
Yeah.
Stu Schaff
Or a lot of people of those are set too high, and that ends up actually being demotivating. Imagine being in a track meet and being a high jumper and you know, the bar is set at a level you think, there’s no way I could ever reach that, or you’re probably not even…
Carl White
So why try.
Stu Schaff
Exactly. So why try. Exactly. Yeah so, those things can be really tough. There’s another kind of model that we see sometimes. It’s challenging, and you tend to see it less with employees and more with groups of partners, which is what you might call a P&L model, or a revenue less expense model, which has the potential to get closest to having that alignment from a financial perspective among those providers. But it can get really, really complicated, especially in terms of how expenses are allocated. And you know, when there’s a mismatch between how that model works and the actual control that a person has, for example, you know that an individual partner is not necessarily going to be able to change the terms of a lease right, which might be getting allocated partially to them, right, and that can again create this sort of demotivation. And on the flip side, if you gave them too much control, it would be just total chaos, where you have essentially a confederacy of different providers trying to work on the same practice. You don’t want to have them arguing over preferences and the lease and over staff and other things like that, right? There is no one size fits all. There is no magic bullets. And so, what we’re trying to do is we’re trying to help practices find a model that meets their specific needs with all of those things in mind. You know, it coming back to saying, well, you have this group. Maybe an owner of the practice, or maybe multiple owners of the practice, and maybe you have another group of physicians coming in. Or perhaps your group is set up such that there’s never going to be a path to partnership, right? There’s variation in that as well.
Carl White
Yeah.
Stu Schaff
So, what makes the most sense for the group and what you all are trying to achieve? And it’s all about those people, right?
Carl White
Yeah. And, man, so much to unpack in there. I mean, at the end of the day, it sounds like, you know, motivation is the big deal, right? So, it’s a strategy to get, well, it’s a strategy to achieve a goal. But if you’ve got, you know, a bunch of employees who you need to achieve that goal, if their motivations aren’t lined up to yours, then already you’ve got a bit of a problem to solve, or a bit of a pickle, I suppose. I remember, for example, former clients, a number of practitioners in the practice. And her thing was hourly meetings, right? So, it was counseling and so and so. What she would say is, look, if somebody cancels work, the phones are there, like anybody who’s clinically appropriate, who could benefit from you know, a visit, call them up. And she had these incentives. And why wouldn’t you do that? And some made a lot more money than those who did not, and she could never crack the code. And it wasn’t her. It’s a complicated thing. And so, you’ve got, you know, that variable. What if I just want to come in, do great work and leave, and I’m not primarily motivated by money. There’s a lot of people out there. That’s not a bad thing. So, it makes you want to step back and say, all right, you’re a physician owner. How should you be thinking about compensation? And what can you really, you know, how do you do you even, do you screen for people? Like, I just want the money motivated doctors to employ, to work, because they’re all motivated. You know what I mean? Like, I don’t even know if it’s possible, but like, how do you, how should they be thinking about compensation?
Stu Schaff
Yeah, you know. And before we really dive into that, just to respond to something that you’re saying. One of the things that I tell everybody that I work with is that it’s really critical that we try to manage via management, not manage via compensation, right?
Carl White
And go into that, that’s a powerful statement.
Stu Schaff
Yeah, sure. Thank you. So, what a lot of organizations in healthcare, I found in my career try to do is, they try to say, look, this is a powerful thing. If you do X, you will get Y. So, to use your example, you know, to borrow from what you said, why wouldn’t you do X? Because don’t you want Y, right? But it’s, it’s kind of the wrong question, in a sense. Instead, just like a lot of the other parts of the healthcare industry and pretty much any other business, we need to be thinking about making clear what we expect, right? Supporting people in meeting those expectations. Making it clear what it means to exceed those expectations and what the benefit of exceeding those expectations is. And also having this understanding that not everybody is going to exceed expectations. What you want is for people to meet expectations, right, and aligning your business around them. This whole idea of like, more, more and more, add in an item, it’s not something that is sustainable. It’s not something that the people who make up your practice, the practice is nothing more than people, right? It’s not something that they can just continue to operate in that way. It’s unrealistic and unsustainable. So, we end up talking a lot about setting those expectations, how you support those expectations, that difference in the mindset. And all of that together then informs what makes sense for compensation. So, another thing that we say is compensation should reflect the way that books are practicing. It shouldn’t drive the way that they’re practicing, right? So just to make that a little more explicit.
Carl White
Yeah.
Stu Schaff
You wouldn’t want a physician or another clinician to make a decision for a patient based on money, right? You know, anybody listening, that is, you know, is saying, Oh, I would never, right? Of course.
Carl White
Yeah.
Stu Schaff
Of course. None of us want to do things like that, but that’s kind of how these models end up acting in a lot of situations. You know, I have had clients, for example, just a couple examples. Off the top of my head, I had clients where they had a productivity-based model. So, you know, one example of that is revenue based, or you could also do it based on volume. In this case, it was based on volume. And we had a surgeon who had an incentive, and that incentive was capped. He was motivated by money, right? But you better believe that the second that that physician hit the, you know, that cap, to which there wasn’t going to be any more incentive. No, he didn’t slow down. He went on vacation for the rest of the year. Great for physician access, right?
Carl White
Yeah.
Stu Schaff
Not really. Yeah, so you know, right? And that clearly wasn’t the intention. This is a very motivated surgeon who wanted to do a lot of surgeries. But he’s looking at his model, and he’s changing his practice based on the reality of what it means to his life, right? So, I can work really, really hard, and then I can take off two months, right? Which is absolutely not what’s going on, or what we want to do. Instead, what you want to do in that situation is say, well, how can we best work with that surgeon to recognize that not only is he meeting the expectations for the access for our patients, but is in fact exceeding them based on things that are within his control, right? And how do we, I’ll just say, reward him right, for continuing to do that? Right. With recognition that not all of his colleagues are willing to do the same thing, right. So, there’s countless examples of those kinds of things, but ultimately it’s setting those expectations that is really the first part to getting this right. And that goes back to really just saying, what are we trying to accomplish. And to go back to your question about, like, how you can, you know, screen for that and things. I mean if I had the answer to that well I’ll be on my private island. Because that’s the trick, right? I think the key to success, in that sense, is to be clear on what you are trying to accomplish. To be very forthcoming with those things early on and to consistently reinforce them, right? And that’s culture, right? So, it’s building a culture that reinforces those expectations. And it’s kind of a self-fulfilling kind of thing. And you know, you have to be willing to cut when people are, you know, are not making those right decisions. Like if you have a situation where you can say, look, I’m going to hire slow and fire fast. You know, bless you. Because, like that’s the ideal. It’s just very, very challenging for people to do that.
Carl White
Yeah, So, you know, how should physician owners be thinking about compensation? It sounds like it’s not the first thing. First it’s what financial targets do you need? What’s realistic? Number one. Number two. What’s the culture? Compensation is one way to, you know, to reinforce and reward the behaviors that you’re looking for before money even gets talked about, is that a fair way of putting it?
Stu Schaff
That’s true. That is true. And I would also say, I would add something that puts a little bit of a different spin on it, which is, an employee in your business gives your business their time and their effort. And let’s not forget that practicing medicine is a lot cognitively and emotionally, right? It’s a very tough job. They’re giving a lot, right? Compensation is what you give them in exchange for that. Right? It’s not just necessarily the paycheck. You know, you have a salary, you have a bonus, you have benefits, of course, but what about acknowledgement? What about growth opportunities? What about feeling valued and trusted and empowered, respected, having a sense of purpose. Those aren’t as easy, I understand, as writing a check could be. So, it can be a tough sell for some of our clients, you know, especially because they’re operating in such complex environments already. And they’re so overstretched because of those cognitive and emotional challenges of practicing medicine. And then you add on the cognitive and emotional challenges of running a business in medicine, right? So, it’s like, tough squared, or maybe even cubed. In our practice, we are encouraging practices to put everything on the table. Medicine is complicated enough as it is, and when you’re faced with a business issue, you can’t afford to just do things the way you’ve always done them, because that’s the way you’ve always done them, right?
Carl White
Yeah, yeah. We’ve had, you know, a fair number of guests who talk about like culture and mission. And if there’s a common conclusion from them, it’s, look, we don’t pay the highest, but our retention is amazing because our culture is strong, and we screen well for it. Like we don’t think about money first, we think, are you a fit with our culture. People’s turnover is lower, and it’s as if small businesses are competing against very large players. That’s how they compete. Work life is better. Expectations are clear. All the things that you’re talking about. And I’m thinking of one in particular, where a couple of providers left and they came back because where they went to they’re like, oh yeah, this isn’t what I thought. I left for the money, but I left them to come back, because I just like it here. I realized I’m making enough money. So listeners are probably like oh I don’t know where to start. Figure it out and go listen to some of these episodes because I’m telling you there’s tangible savings both in turnover and in just compensation cost, because most people don’t need the highest dollar, and they start to realize there’s a cost for that higher dollar. And I don’t, you know, then I don’t want to pay it. So, you know, what you said before we came on and started recording, it’s like putting a band aid on cancer and I love the saying, because, you know, just implementing a new compensation model doesn’t usually solve the underlying problems. Hence, like putting a band aid on cancer. Did we kind of hit what you meant by that, or is, you know, if you lead with comp but forget all those other things it’s just a matter of time before it crumbles. Is that kind of what you mean?
Stu Schaff
Yeah. So, first of all, I want to give credit to my brilliant wife who came up with that saying. So, thank you, Lauren. You know, think back to what I said at the top, where I was talking about the questions that we ask folks when they’re coming to us, about why they want their businesses to do more, or excuse me, their employees to do more. And you know, when you’re talking about being overextended, building a better mousetrap in the form of a new compensation model, generally speaking, isn’t solving that underlying problem that the owner has. Being overextended. It’s possible that they might end up seeing marginal gains, but there’s also risks, right? You know, if you end up setting the bar too high, like I alluded to earlier, that can be demotivating, and you might end up seeing people say, you know, I’m not going to do the same work for less money or more work for the same money. It’s just not worth it to me. We’re talking about smart people here, right? And it’s very easy to misalign this stuff, especially if you’re not doing it all the time. And you know, there’s an even larger issue lurking in the background here, which is burnout, right? People are talking about burnout a lot, and I’m very glad that they are, because it’s been lurking there for a long time, and it wasn’t really until 2020 that it started to get maybe more of the spotlight than it deserves now.
Carl White
Which is kind of sad, right? Look what it took.
Stu Schaff
Yeah, you know, physicians, clinicians, being scientists, first and foremost. There’s been a lot of discussion about what it means to be burned out trying to define it and all that. The conversation is maybe now getting around to, you know what to do about it and that’s where we’re trying to help. But like this idea, whenever I see you know headlines about folks in healthcare being burned out and disengaged, or leaving their jobs or completely leaving, you know, healthcare, that scares the crap out of me, because, you know, from a selfish perspective, I’m thinking about, when I get sick, who’s going to take care of me? Who’s going to take care of my family, right? And so, you know, you have to, I talked a lot about context, right? In addition to this stuff about the difference between employees and owners, you know, and all that, you have the fact that these are people whose batteries are drained, and you know, you need to think about that more broadly and look at those other things before you can really think about trying to use compensation as a tool to fix the problem. There are probably other things that you can do to make a bigger difference toward that goal that you have, while improving the practice. I have a lot of clients who are larger groups, I work with small groups and larger groups, but it’s a little bit more obvious in the larger group just because the sample size is bigger, where you have maybe a few people who are outliers in the up into the right direction, right? They’re very productive, they bring in a lot of revenue, and then you have a whole bunch of people who are on the, you know, hanging out on the lower side. Generally speaking, people don’t hang out at the average. There’s maybe a couple.
Carl White
It’s true.
Stu Schaff
The average is created by people on the low end and the people on the very high end, right?
Carl White
Yeah. It’s true.
Stu Schaff
So what I have found, and I’m working on getting more data to show this out, but I’ll just say anecdotally, what I have found is that there is a lot of value in trying to do things to kind of rise the tide for the boats that are on the lower end of the spectrum, as opposed to putting all the focus on the people at the top end of the spectrum, right? Because if you already have a model that’s say, you know, focused on revenue or something, and you’re just trying to find a different tweak to it to make things better, you might impact the people who are already outliers, who are already motivated by the money. You’re probably not going to affect these other people. But if instead, you get a lot clearer about the expectations, you work with them to help meet the expectations, and then you start kind of rising that tide, there’s probably a lot more, I’m mixing metaphors here, but a lot more juice to be squeezed out of the folks at the lower end while keeping them happy, making everybody you know, happier, and making the whole practice a lot more sustainable. And that’s true whether you’re talking about a larger practice or if you’re talking about a smaller practice. Arguably, I would say, depending on, you know, who we’re talking about in a smaller practice, it might even be easier for you to get your arms around that, because you can actually go and have conversations with these people, right?
Carl White
Yeah, yeah. You know, it’s a good point. So just imagine we always want to be up and to the right. I mean, where my head started to turn to is, is your first stop trying to get more out of your people? So, what do I mean by that. Are you as operationally efficient already as you could be? Is there some, you know, bloat and waste or whatever that you could. Because every dollar of expense that you save goes right to the bottom line. Every dollar saved in expense is pretty much $1 of profit. Whereas another dollar paid to somebody is not $1. So, are you really as operationally efficient? That’s to me is question one. Question two is, if you do this, and you actually get more productivity out of your people, can the operation handle? You know, just make sure that if you get the phone ringing more, that the machine, the operating machine, can actually handle it. How much more could you grow? I mean, there are some places where they’re just going like crazy. And so, when I want more, look, man, we’re already working 12 hours. Like there aren’t more hours in the day to squeeze. Like, is that in place, you know, before you turn on the growth engine, just make sure that if 15 more people called you in the next 10 minutes, you could handle it in the way in which you want to. And maybe there’s an answer in there, or a couple of answers, you know.
Stu Schaff
Yeah.
Carl White
So, yeah.
Stu Schaff
Absolutely. And I think those things are important. The only thing that I would really add to it is that I believe that the root of all of these problems that we’re talking about is in, not treating people like people, not thinking of them as people first, right? And I don’t mean that necessarily in a malicious way. It’s that we’re sort of jumping to these non-depersonalized things, right? So, what I would maybe put before some of the questions that you’re talking about, which I think are very, very important, is to get very clear on things from the people’s perspective. So, I’ve alluded to a few of these. So, when I talk about clear expectations, I mean a few things. One is, you want to have a very lean set of priorities for your clinicians, for your providers, I mean, really, for everybody that you work with, right? Because you can only, the brain can only handle so much, right, and again, like medicine is so cognitively and emotionally challenging to begin with, that the more you add in, the less likely that any one of those things will get done, right? Or put it a different way. If everything’s a priority, then nothing’s a priority, right? So, lean priorities, right? The second thing is a sustainable workload, right? Because people need to have the ability, at the end of the day, their battery is down. They have to be able to recharge for the next day. They have to be able to, after a week, to be able to recharge for the next week, right? And so on and so on. So really have a good understanding of what people should be capable of. If you’re thinking about your employees, they may think they’re capable of less than you do, and the reality is probably somewhere in between, right? And then the third aspect of those expectations is what you’re kind of expecting from them in terms of output. So maybe talking about volume, we may be talking about revenue. We may be talking about clinical quality. If you’re really sophisticated, you might be talking about the cost of providing that care, right? So, if you’re talking about, like a value-based model, or things like that. And those things have to be, I have a finance degree, so I’m going to use a finance term here, it needs to be zero based, right? It needs to be based on the reality and specifics of your practice.
Stu Schaff
So, one thing that I see a lot is, you know, we’ll say, okay, well, my surgeons are not as busy as the benchmarks. Capital B benchmarks, right, say that they should be. And you look into it a little bit and you’re saying, oh, well, they can’t get enough time in the OR, right, because there’s just not blocks available to them. There’s no way that they could ever meet that, right?
Carl White
Yeah.
Stu Schaff
Or, you know, we’re set up to have our, you know, APPs do certain visits, and the way that the allocation of billing works, they’re not getting credit for, right? So, there’s all these different challenges associated with it. So, what you need to do is look at what’s going on in your practice and make sure that the expectations reflect what’s realistic in that context. Right? Once you do those things, and you have a really clear understanding what the expectations are, and you’re talking about that frequently, and you’re showing people where they are relative to expectations, you want to make sure that management is supporting people and removing all the roadblocks possible that could keep them from meeting those expectations. And that they are, you know, that you’re paying fairly for what it means to meet those expectations, right? And only then can you figure out what it means to exceed expectations, right? That’s kind of the formula that we work people through. And again, there is no one size fits all. It has to be completely dependent on the context of your situation. Layer on to that, the kind of cost savings that you’re talking about and everything. But it has to be grounded in the people in your practice, because the second you step away from that, that’s where the ugliness kind of hides, right?
Carl White
Totally agree. Thank you for clarifying that. When I said what I said, I was thinking of, involve the people. Because, you know, if you say to somebody, I want you to be 20% more productive, if they have a finger on the pulse at all, they’re going to know instantly whether it’s even doable or not, right. Because they know. They’re the ones living it every day. Some of the best solutions about whatever kind of improvement it is, if you can get the people to say, how could we improve this, what do you think would make. Then great things come, and there’s all the right buy in. And then, you know, everybody wins. But you’re right, without the people, if you just impose it on them, you want it to fail, impose it on them.
Stu Schaff
Yeah, and generally speaking, most people got into medicine because they actually wanted to practice medicine. They wanted to see patients. They wanted to treat patients. Not because they wanted to sit there and collect the paycheck. So, assuming, cynically, that people are just kind of slacking off just because they don’t have the same mindset that you do, is not good. Yeah, it’s not suboptimal.
Carl White
To be diplomatic. Exactly. Stu this topic, like a lot of other topics, we could, you know, keep going and going. But in the interest of kind of bringing us home, there’s two questions I ask every guest to wrap up an episode. And the first one is, it’s kind of a loaded question. Anything you think I should have asked you, but I just don’t think to ask you, that could be in the context of what we talked about.
Stu Schaff
I mean, we could talk about things forever.
Carl White
I know, I know, I know. But anything that kind of jumps to mind, you know. [Maybe] there’s one point that we should have made but didn’t. It’s okay if it didn’t.
Stu Schaff
Yeah no, I think this is a pretty good overview of a very complex topic.
Carl White
Ok, yes, good for us. And the other wrap up question is, so we’ve caught listeners attention, and they’re enthusiastic about having a look at the comp model, or thinking about it more, but they just don’t know where to start. Look you do this all day. It’s a complicated topic, as we justly, sort of, you know, argued here. Any place you can think of, you know, they could just get started, to get kind of get going. People get excited about something, but they don’t know where to start. Any place you could tell them to get started on this, to start to peel the onion.
Stu Schaff
Yeah, absolutely. We’re developing a whole lot of resources for practices, so I would recommend that they come to our website. Intentionate.com and check that out. I would almost always recommend that if people are interested in discussing this, that they discuss it in the specific context of their practice. And I’m willing to have calls, one-on-one calls with any of your listeners about their specific practice and the challenges that they’re facing. We do complimentary 30-minute calls with folks all the time. So, at that same website, they can reach out and schedule a call, and we would be happy to talk about their specific situation, which I’m purposely emphasizing, because that really is the key.
Carl White
Yeah, it sounds like part of it is maybe to a certain degree, stop comparing yourselves to others, right? Just figure out what your own benchmarks are, what good looks like for you. It’s kind of freeing to be honest with you. If you could say, you know what, my story is my story and I don’t know anything about anybody else’s story, really. So that kind of comparison would be foolish. So just free your mind of all that and, you know, set your own benchmark. I like that.
Stu Schaff
Sage advice Carl.
Stu Schaff
Yeah, well, I just repeated what you said. Stu, thank you. Thank you very much for taking some time to come on Practice Care, bringing some attention to this topic. It’s complex to say the least. I think we’ve done a good job of bringing some clarity to it. So, thank you. Appreciate it.
Stu Schaff
Thank you and thank you to all the listeners for doing really important work.
Carl White
Yes. and Stu Schaff. We’re going to take all the contact info that you provided and get into the show notes for this episode. And a couple of other points before we wrap up. First, if you’re someone like Stu or someone like me that seeks to serve private practices, or if you’re a private practice owner, either way, you’ve got some experience on the business side of private practice that you think other private practice owners would benefit from hearing from please, we want you to come on Practice Care and tell the world about it. In the show notes for Stu’s episode and every episode, there’s a link, couple of clicks. It’s quick. Tell us what’s on your mind so we get you scheduled as soon as possible. Finally, please subscribe to Practice Care. Just search Practice Care, one word. We’re on Apple, we’re on Spotify, Google, YouTube, just about every platform and player. We do a new episode every week, and the easiest way to stay up to date is to subscribe. Thanks very much, and until next time.
Podcast Producer
Thank you for listening to Practice Care with Carl white. Make sure to subscribe and follow so you don’t miss another episode. You can find our guest contact information in the show notes. Stay tuned for the next episode.
