Change before you have to - Jack Welch

Change is hard because people overestimate the value of what they have and underestimate the value of what they may gain by giving that up – James Belasco and Ralph Stayer

Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies – Grouch Marx


These are all great quotes. I particularly like Groucho’s; he had that right, and it applies to changes in business, as well. The tail often wags the dog – we decide we have to change for the sake of change, and then start looking for trouble, etc., etc.

What is it that drives us to change?

Sometimes it’s trade shows – you come home from a meeting and, “There are going to be some changes around here.” That’s the “Groucho” approach. Now, I’m not putting down trade shows, but you should make sure that you have a legitimate, well-thought out need to change. The vast majority of those giving practice management seminars are wonderfully well qualified to help you through any transitional changes in your practice.

Change should be dynamic and ongoing. Your team should be actively engaged each minute of each day in “continuous improvement”.

  • How can we do this better?
  • What if we moved that over there?
  • There must be an easier way!
  • Why are we doing things the way we do?

You’ve been there. You come into an organization and see a routine; you ask, “Why are you doing things that way?” “I don’t know, we’ve always done it that way.”

Maybe you’ve heard the story of the woman that always cut the legs off of the turkey and laid them alongside it to roast. One day her son asked her why she was doing that. He said that, in all the depictions of Thanksgiving he’d ever seen, the turkey was roasted with its legs attached. She said that she didn’t know, her mother always did it that way, so, he asked his grandmother why and she said that her mother always did it that way, so, he asked an aged great, great aunt about it and she said, “Our mother did that way because her roaster was too small to put the lid on with the legs attached.”

Strategic changes are a bit more heavy-duty than continuous improvement. These are paradigm shifts for the business. It’s dissatisfaction, greater needs, or an overall dissonance that leads to these types of changes:

  • We need to generate more revenue.
  • We need more patients.
  • We are bringing in an associate.
  • We are moving to a new office/location.
  • We are going to bring in new technologies that will be a paradigm shift for the practice.

I’d strongly recommend engaging a qualified consultant to assist you with these kinds of changes. I am not that consultant, but, we can and will in this blog discuss how you arrive at the need for change, and will discuss in future blogs how to address the human elements of those changes. 

As I mentioned in my last blog:

C = f (D x V x P) > Co


C = Change
D = Dissatisfaction with the Status Quo
V = Vison of an Ideal Future State
P = Pathways for Accomplishing the Change.
Co = The Cost of Change

(Harris, Copyright, 1996 by Thomas E Harris, PhD)

We can also say,

D = (Cop + Pp) >V

D = Dissatisfaction with the Status Quo
V = Vison of an Ideal Future State
Pp = Perceived Pathways for Accomplishing the Change.
Cop = The Perceived Cost of Change

You may become discouraged when you see a future state that you desire and you believe that the cost and pathway will be more expensive and/or more difficult than your vision justifies.

All of these variables must be taken into account when contemplating a change. We’re not just talking about rearranging the furniture. (My mom used to say that when you start rearranging the furniture, it means that you’re dissatisfied with life. I guess her equation would be Rf = DL > SL)

If you are dissatisfied, ask:


  • Is this an itch, or is the status quo sending you around the bend:
  •      Financially?
  •      Professionally?
  •      Emotionally?
  •      Personally?
  •      Socially?
  • Do you have a clear vision of an ideal future state?
  •      Define that state.
  •      How would things look, function, feel?
  • What changes would be required to achieve that future state?
  •      Define the pathways to achieving it. (Get professional help with this, if it’s a strategic/paradigm change)
  • Determine the stakeholders (Whom will it impact and who needs to be involved?).
  • Determine the costs:
  •      Financial
  •      Time
  •      Human

I’ll leave the determination of the need to you and the processes to you and your consultants, but the stakeholder/human factor I will be addressing starting in the next blog.

In summary, if the need/desire for change are greater than the costs to achieve change, then a well-ordered systematic approach will be required to determine the who, what, when, where, why, and how.


Works Cited

Harris, T. (Copyright, 1996 by Thomas E Harris, PhD). The Leadership of Change. University of Alabama