April 2002

The One Percent Solution:
How to Achieve a Competitive Edge
By Jeffrey Lewin, DC

If there’s one constant when it comes to managed care, it’s change. One of the secrets to practice success in this ever-changing managed-care environment is stability. Stability comes from having an abundance of patients who come to your practice from a wide variety of sources. And the best, least expensive source of new patients will always be from referrals.

Successful practices, like all successful businesses, have one thing in common that is their lifeblood: customers. You may say, “I am a doctor and I have patients, not customers.” However, take a moment to consider that your patients are, in reality, buying health-care services from you. By this very definition, your patients are your customers.

As such, the experience these customers have from the time they enter the front door of your office until they leave will determine the value they place on the services they are purchasing from you. It will also determine how long they will continue to buy those services from you, and what they will tell others about the services they have bought from you - or if they tell others at all.

How can you and your team maximize the number of referrals you receive? The answer appears simple at first glance: Since you are in the business of delivering services to your customers, be sure your customers are satisfied with the services they receive. In reality, the answer is not quite so simple. The paradoxical reason is, many satisfied patients still don’t refer.

When asked, most chiropractors would respond that the overwhelming majority of their patients are satisfied with the service they receive. Yet, most chiropractors are keenly aware that only a small number of their patients are responsible for the majority of the referrals they receive. And an even smaller number of attorneys, medical physicians, and employers are responsible for the non-patient generated referrals. Why is this the case, if most of your referral sources are satisfied with the level of service you provide?

By making the level of customer service you deliver to your patients extraordinary, rather than just satisfactory, you will make it virtually impossible for anyone to entice your patients to switch providers. There simply would be no alternative. You will be successful in converting your patients from being just satisfied to being excited about your practice and motivated to refer. When your patients become excited and motivated, they join the ranks in your own personal army of limitless referral generators.

Consistent, Incremental Improvement
Your mission should be to create an experience that will make your patients excited and motivated to sing your praises to everyone they encounter. You can accomplish this by setting a goal to improve each and every area and department that makes up your practice.

Be sure you approach these goals methodically. What would happen to your practice if you suddenly made huge changes across the board in every area of your practice? The result would be a nightmare! How would your staff respond? How would you know that you are on the right track toward improving customer service? If you did not produce the results you were looking for, how would you begin to figure out which component of your sweeping changes was not working?

The way to monitor the effectiveness of any improvement is to make it incrementally and consistently. By creating an atmosphere that fosters consistent, incremental improvement in all areas of your practice, you will impart a sense of certainty to your staff, who will not only be more likely to accept your changes and innovations, but who will take ownership of them and your commitment to incredible customer service.

The Japanese have a word for the culture of commitment to excellence in customer service called “kaizen.” Loosely translated, kaizen means consistent and never-ending improvement. This culture of kaizen was an underlying factor in Japan’s economic and industrial success post-World War II.

When implemented, kaizen does not work by unleashing some kind of “magic” in a tidal wave of improvement. Rather, kaizen is effective because it creates consistent improvement one wave at a time. This process has also been called the “One Percent Solution.”

A Commitment to Improvement
Your practice is an accumulation of many divisions, departments, and functions. Each of these individual areas delivers an aspect of service that results in a patient’s experience of your practice. Together they add up to the total experience that defines whether your patients are merely satisfied with their care, or if they will sing your praises from the rooftops.

Commit to improving each of these divisions regularly and consistently, 1% at a time. Constantly ask yourself how you can improve each area just 1% each week. Ask yourself, for example, “How can I improve the appearance of my reception area just 1% this week?” The following week ask yourself the same question. By the end of a year, your reception area will have improved 52%! That is a dramatic change and will result in your reception room looking very different from how it looks today.

Make the same, consistent weekly commitment to improve 1% in the clinical areas of your practice, at the front desk area, in upgrading your level of documentation, and on and on. Carry over the culture of 1% improvement in the quality and timeliness of your reports, in the level of your professional relationships, and in your overall commitment to excellence week after week. Soon you will experience the thrill of setting new standards in customer service. You are constantly creating a new standard below which nothing is acceptable.

Remember that consistency is a key element in the equation. Without consistency, you run the risk of having to constantly react to the day-to-day challenges of practice without a plan. Begin by composing a list of all of the various divisions, departments, and functions of your practice. Set aside one hour each week to set your goals for improvement and to monitor the accomplishment of your improvements from the previous week.

At the end of a year of 1% improvements in all aspects of your practice, your practice will be greatly improved. Keep in mind that, like interest in the bank, all of your individual 1% improvements compound over time, and the resulting level of improvement will be much greater than 52%.

By cultivating a culture of 1% improvement in your practice, you will develop a competitive edge that will result in excited and motivated patients who send referrals streaming to your doorstep.

Commit to yourself that the ordinary is no longer acceptable and that only the extraordinary will do. Commit to raise not only the bar, but the floor. Commit to consistently embrace innovation in your practice. Commit to extend the “One Percent Solution” beyond the walls of your office, into every aspect of your life - and success will become a bountiful reality.

Dr. Lewin is the director of coaching services at Breakthrough Coaching. He can be reached at 800-723-8423, or via the company’s website at www.mybreakthrough.com.