The Fully Engaged Goal Driven Practice

Coach game plan

How to Have Sustained Motivation

How engaged and driven are you in growing and improving your business?

How about your team?

Would you say Very Engaged, Not Engaged, or Actively Disengaged?

Employee Engagement

Each year, Gallup grades the engagement level of both employees and managers in the U.S.

Gallup defines employee engagement as the level of involvement and enthusiasm employees have toward their work and workplace.

In 2025, it was 31%.

Managers were also surveyed. They usually rate higher, but they also rated at 31% in 2024.

Being Engaged, Goal Driven, and Successful

A team that is fully engaged is a team that wants to see patient successes. They also work hard to generate more patients through referral procedures and promotions. They stay inspired by the office’s purpose.

According to Gallup, comparing high-engagement vs. low-engagement teams, high-engagement teams had: [2]

  • 21% higher profitability
  • 17% higher productivity
  • 59% lower turnover

lower absenteeism, fewer safety incidents, higher customer ratings

It’s The Manager

Gallup’s core findings were that the manager accounted for at least 70% of the variance in team engagement (Gallup, State of the American Manager, 2015, since reaffirmed [1]).

In most practices, the doctor is the manager. But in a busy, growing practice, it’s hard for a doctor also to be an effective manager, business owner, property manager, and everything else. That’s why we’ve always recommended bringing on or assigning a qualified person — often part-time — to take on the manager role.

It’s also why we offer the Goal Driven MBA course for practice managers. (More on that in future emails.)

Increasing Engagement

Look at yourself and your team as athletes playing in a health care conference.

Are you winning?

That’s the question Jim Loehr and Tony Schwartz asked when they studied elite athletes for their book The Power of Full Engagement.

Their conclusion: performance depends on managing energy, not just time. Like athletes, people perform best by alternating focused effort with deliberate recovery.

Recovery time for your office could include:

  • Monthly team meetings that discuss how the office is doing statistically, patient successes, promotional plans, team member wins, and a fresh angle on why the practice exists.
  • Short weekly meetings.
  • Daily case management meetings.
  • Individual coaching of employees and professional development.

These are not just meetings – there are review and revival sessions. They are huddles, chalk talks, and reviewing game films.

Why? Because you want to win.

The best teams do this.

You should too.

Stay Goal Driven,

Ed

References

  1. Gallup Business Journal, 2015. Drawn from Gallup’s report State of the American Manager: Analytics and Advice for Leaders (2015).
  2. Harter, J.K., Schmidt, F.L., et al. Q12 Meta-Analysis: The Relationship Between Engagement at Work and Organizational Outcomes. Gallup, Inc.

The Time I Asked a Doctor The “Who” Question?

woman multitasking in a chiropractic office

What is the who question?

It was at a large seminar. Maybe Parker, maybe a state convention, I don’t recall for sure. I was talking with some doctors I knew in the hallway when one of the sessions ended. The doors opened, and the doctors who attended the presentation began pouring out of the conference room. One of them joined us.

He eagerly discussed some new promotional projects he heard about in the session. He also said that he learned some new approaches to scheduling and billing. I was interested, so I asked him some questions. Once hearing about the ideas, I said that they sounded good.

But then I asked the WHO question: “Who is going to implement these new projects?”

He looked at me, suddenly changing his demeanor as if I had insulted him by asking him such an obvious and stupid question, and he walked away.

True story. But hey, that’s what we do at PM&A: ask the tough but obvious questions.

Time and time again, we have seen doctors and staff come back from seminars with useful information that never gets applied. And there is a reason for this.

THE MISSING “WHO”

The missing WHO is your manager.

Many practices do not have a functioning manager. And for those offices that do, their manager is usually not operating as fully as they could.

Every practice, whether large or small,  has a set of departments or roles. Minimally, these include:

  • front desk
  • billing and collections (patient accounts)
  • and the clinical services of the doctor or provider.

Beyond these, there is a boatload of other tasks that fall outside of the front desk, billing, and doctoring. Who does these? Who organizes these? Usually, the business owner, who is also the doctor, does.

Dealing with these tasks can take up valuable time and energy. And this is expensive. It costs more than most business owners realize. What is a clinical hour worth? $500, $1,000, $2,000. Having the doctor spend time on non-clinical or non-growth-oriented leadership projects is expensive!

There are so many benefits for a practice to have a manager that I have long considered why doctors and business owners don’t create and invest in this position. Even on a part-time basis, it makes practical sense.

I think these are some of the reasons:

  1. Reluctance to delegate: Starting a practice as an entrepreneur, many practice owners are accustomed to handling all aspects of their business themselves and may find it difficult to relinquish control over certain tasks and responsibilities.
  2. Lack of awareness: Some practice owners may not fully appreciate the potential benefits and return on investment that a skilled manager can bring to their practice.
  3. Misconceptions and uncertainties about the role: Is the manager our billing assistant, our accountant, or a glorified assistant? Can my spouse or daughter be the manager? What are their job duties?
  4. Overestimation of current efficiency: Business owners might believe their current operations are running smoothly enough without a trained manager.
  5. Concerns about team dynamics: when someone takes on the role of manager improperly, they can disrupt the team’s harmony.

And especially,

  1. Where can I train my staff member to be a skilled manager?

Because of these reasons, and a few more, we have launched our manager training program. I encourage all practice owners to create the manager position in their practice and then support it. If you are ready, I encourage you to consider our manager training program.

Our program starts the week after Labor Day and is filling up. Let us know if you are interested, and let’s talk soon.

Ed

“Based on our largest global study of the future of work, Gallup finds that the quality of managers and team leaders is the single biggest factor in your organization’s long-term success.”

It’s the Manager, by Jim Clifton and Jim Harter