With a growing business in place, many chiropractors decide to expand their influence within their community in one of two ways. Some choose to start or buy a satellite practice and employ an associate to run it. Other chiropractors may wish to step back from the running of their own practice over time. These chiropractors will employ associates in their existing practice with the intention of having the associates take over most of the day to day practice running.
The ideal is to have the associate chiropractor step up and manage the practice or satellite practice, empowering themselves to be the boss of ‘their own’ practice. Chiropractors who have done this will know the frustration that can occur when they continually have to micro manage. This generally happens as many chiropractic associates have never run their own practice. They have learned the skills of being a chiropractor, though still have little experience or knowledge in the running of a practice. Essentially, they are unconsciously incompetent about running a chiropractic practice, and they don’t know that they do not know how to.
For them to become competent in the running of a practice, where they can run it without having to think that hard about it, they first have to realise where they are starting from. They need to become aware that they are unconsciously incompetent in this area.
The 4 step process from unconscious incompetence (they don’t know what they don’t know), to conscious incompetence (they know what they don’t know), to consciously competent (they know what they know though they have to think about it to get it done), to unconsciously competent (they know it and do it without having to think about it that hard) is a process that everyone goes through to master a new skill. When the associate was learning to adjust, they went through these very same phases, and many are now approaching a level of unconscious competence clinically. This can have the principal chiropractor incorrectly assuming that the associate has the skills necessary to run and manage a practice.
The first step is to make the associate aware of what they don’t know. This will move the associate to a level of conscious incompetence. A good way to accomplish this is to have weekly meetings at the practice as a minimum, going through all of the behind the scenes work with them. If the principal chiropractor keeps on micro-managing the new practice, the associate will never have a chance to move to a level of conscious competence in running it. Handing over responsibility for different tasks over time will allow the associate to reach a level of conscious competence and over time a level of unconscious competence.
It is necessary for this to be a process over time, not throwing the associate in the deep end with the total running of the business. It is also important for the principle chiropractor to recognise that the new associate may make mistakes over time in the learning process. Recognising and accepting this while continuing to support and encourage the associate is similar to encouraging a child who is learning to walk. When a child falls you would encourage them to keep on trying, knowing that over time they will become consciously competent and ultimately unconsciously competent walking.
With the associate making errors, negative feedback, especially if strong, will have the associate stay at a level of conscious incompetence, as they will be mindful of making decisions in the future. Thus, the goal of having the practice run by an associate will not become a reality.
The ultimate goal is to empower the associate, and the feedback model is an excellent way to give the necessary feedback when errors are made. Here are the steps to making it work:
1. Action – What is the specific action that needs feedback?
2. Impact – What is the specific impact that this is going to have on the practice?
3. Ownership – What specific ownership can the principal personally take for why this situation or mistake has occurred?
4. Desired outcome – What is the desired outcome for this moving forward? This is worked out together.
The 3rd step is the most important step in empowering the associate. Being humble and taking personal responsibility in some way for why the mistake has occurred will keep open communication between the principal owner and the associate, and keep the pathway to associate empowerment on track.
The goal of having an associate run practice or satellite practice can be a reality if you work at it. The same process can be used to employ an office manager to run your practice or satellite. Don’t expect it to happen quickly, it is an empowerment process that takes time, and the freedom this can give you is definitely worth the time and effort.
Dr Malcolm Rudd is a Mentor, Coach for The Centre For Powerful Practices, and is based in Perth, Western Australia . Malcolm has had a career in Chiropractic for over 18 years, and has created a highly successful associate