Seriously. It really is that simple. It’s all up to you.

It’s called personal accountability. It’s taking ownership of what results from your behavior, the choices you make and how you act. As I recently learned from a practice, the absence of the group value of personal accountability can be a limiting and destructive factor in a group setting.

Two similar groups merged about three years ago. The group has weathered several financial issues. Business has grown and new opportunities are available. But it’s not a happy place to work. Significant tension exists among the partners, which the staff senses daily. There is still discussion of “our” group and “their” group throughout the organization. The groups merged, but in reality they didn’t – at least not in how they function.

Accusations and finger pointing abound. Communication, in whatever form, is reacted to rather than responded to. There are hurt feelings, rumors and a real lack of cohesion toward a single vision for the practice.

And that’s the big issue. There is no single vision for the practice. Each physician with whom I spoke has a different view of how decisions should be made, where the practice is going, and who should or should not be in charge. The result: no personal accountability by any of the physicians. “He caused it.” “It’s her fault – did you see this text she sent me?” “Do you want to know what somebody told me about …?” No personal accountability whatsoever.

While this is not easily fixed overnight, practices can take steps to improve the situation – not just symptomatically but by addressing the root cause: lack of personal accountability.

Work on these areas:

1. First and foremost, there must be a unified and clearly articulated group vision. Without this as a backdrop, no group can overcome the dysfunction described above. How do you define success? What does it really mean to the group, as a group? Establish the group vision, then determine a mission and values, and develop a strategic plan, and you breath new life into the practice. Add strong physician leadership, close collaboration and cooperation with administration, and there is a foundation for moving forward and realizing success.
2. Compulsive, transparent communication must exist in all directions: If you want to develop a climate of trust, there must be open, transparent communication. Say what you’ll do, and do it. It’s important to be responsible in communications – responsible for what is said and how it is heard. That’s right – both sides of the equation. It’s often said that the biggest myth about communications is the notion that it actually happened.
3. How many psychiatrists does it take to change a light bulb? One, but the light bulb has to want to change. The same goes for your group practice. But it’s our role to assist our team in understanding why it’s important to change, how to change, what things look like on the other side of change and what happens if we don’t change. We must help this process along. We must teach, coach, mentor and assist as needed.
4. Create an environment that supports collaboration and conflict resolution. Address conflicts when they occur. It’s not useful to push them aside and let them fester. Encourage the breakdown of silos between departments and staff through task forces, work teams and other similar structures that support collaboration. In order for the team to be successful and for each person to accept personal accountability, they must feel that they are part of a team operating with honesty, transparency and integrity. All must be aligned toward one vision.
5. If there is to be personal accountability, there must be organizational honesty and integrity. The team must be able to count on the organization to do what it said it would do, when it said it would do it. And if not, communicate, communicate and communicate. It’s okay if we can’t deliver, but it is not acceptable if we don’t let the team know in advance.

Personal accountability matters. It is really up to each and every member of the team: physicians, administration, clinical support staff, ancillary staff and office staff. In fact, each of us owns our personal accountability. Shouldn’t we guard, honor and nurture it?

Learn more about the consulting team or contact Ken at khertz@mgma.com.