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Peter Marincovich, PhD, CCC-A, owner and lead audiologist at Audiology Associates in Northern California, recently wrote an article published in which he emphasizes the value of trust and communication between doctors, staff, and patients. After incorporating this care philosophy into his practice, Dr. Marincovich and Audiology Associates have achieved better relationships between staff with almost no turnover, as well as excellent patient satisfaction.
Dr. Marincovich founded Audiology Associates in 1984 and he is currently celebrating 30 years in business. Dr. Marincovich explains his philosophy on creating the perfect audiology practice, “Trust and communication—making a human connection—are essential ingredients for any successful relationship. Trust within a business environment must begin with top management and then permeate the organization. Having a well-conceived plan designed to build rapport and camaraderie among staff and patients, through an organized process to improve interpersonal communication, pays dividends in terms of employee longevity as well as client loyalty over time.
The plan we eventually adopted resulted in measurable improvements in patient satisfaction, going from 81% to 97% within five years. It reduced staff turnover from 8% to less than 3%—and to zero in the past two years. It also produced greater staff/patient connectivity, and higher patient retention rates measured by follow up records at our three locations in Santa Rosa, Mill Valley and Mendocino. These improvements did not occur overnight and required a concerted effort to learn more effective ways to interact and communicate. So, how did we get here?
About eight years ago, after establishing my practice some 22 years earlier, I felt something was missing. We were doing things over and over again the same way and expecting different results. Staff turnover was high and patient satisfaction was less than desired. We were not where we needed to be as a team. I also realized that things were not going to change unless I changed and became aware of what I needed to know. In an attempt to resolve these issues, I attended leadership training workshops, read more than 30 books and listened to management CDs in my car.
‘Beyond the Language of Trust’ was chosen as the headline of this article because it builds on one of the many books I read entitled, ‘The Language of Trust: Selling Ideas in a World of Skeptics’ by Michael Maslansky, Scott West, Gary DeMoss and David Saylor. This book focuses on effective ways to communicate with clients, customers and patients on their terms to gain their confidence. While these recommendations are excellent, they address only half of the equation.
Our goal was to go beyond external guidelines to include internal communications as a prerequisite to building effective team and patient relationships. Our plan evolved over several years through many team meetings during which we defined our vision, mission, as well as team values—and my values—that led to a revitalized culture.
I wanted to take it to the next level and really understand what I should be doing and, in the process, help our team become more effective. This approach involves helping the team seek out new opportunities and career paths, while giving them tools they need to succeed. As a leader, I also had to know when to get out of their way and let them do the things you brought them in to do—by making them better decision makers.
Our team has fully embraced this philosophy. They see my passion and know it comes from a good place. Furthermore, they knew that in order to give back to the community and improve patient experience they needed to grow. This led to a creative way of engaging and empowering the staff, while significantly enhancing patient satisfaction.
Good communication takes effort. You have to work at it. It starts with developing an honest, interactive communication process among team members. One reason why people don’t speak their minds is because it is often easier and less threatening to say nothing, or because they fear repercussions or possible rejection if they do.
Throughout my career I’ve found that effective communication begins with mutual respect, transparency and communications that both inspire and encourage others to do their best. Information is something you give out, but communication is what you achieve by getting through and engaging the receiving party. To embrace open communication as part of your culture, you have to talk about it, praise it, nurture it, and reward it. And, as a leader, you have to become the living embodiment of effective communication and deliberately demonstrate it everyday.
As I learned to become more proactive, I found that what I needed to do for myself was to have clarity of purpose and then establish systems and processes that would produce the same desired outcome for the team as they helped inspire in me. As our team developed, we focused on producing a simple visual communications chart to use a linear model to show paths of communication. We also learned to ask questions, ask referral sources, ask each other and equally important, ask our patients. Finally, after systems and processes were in place, I became committed to ensuring clarity by repeating, reviewing, creating stories and just talking about what was important.
The first step involved meeting with each team member and discussing goals as part of organizational development. We focused initially on individual staff goals. We identified career path interests and talked about how they envision reaching their goals. The last step was to integrate their personal desires and aspirations with financial aspects of the practice and how this understanding can help them achieve their objectives. By communicating to my staff that I value their involvement in Audiology Associates to do good not only for the company, but also for themselves, I effectively sent a message to the team that I care for them in a meaningful, helpful, value-added, leadership way.
The second step involved having everyone complete a self-assessment identifying strengths and non-strengths. Strengths and weaknesses surfaced, and I learned what my staff fears. Some individuals like to communicate, others less so, and I learned to take a more nuanced approach in my attempts to communicate with each individual person. In addition, I learned more about their behavioral characteristics, their perceived limitations and what motivated them.
I also learned to use different communication modes for different staff members based on listening to their responses and being intentional about learning exactly who I was working with as I gleaned their perceptions of the process. I’ve learned that some of my staff benefit most from a sit-down meeting with a formal agenda to review. It’s not that everybody doesn’t benefit from this approach, but some other staff members communicate best in more casual ‘water cooler’ conversations and chats on the fly.
Together, we created our vision, mission, values, tenant and our credo as a collective group. The entire process took about a year and was well worth the effort. The hardest part, and probably the most significant, was in determining our values. Once our core values were determined, we discussed further how these values translate to our practice. My staff and I developed metrics, benchmarks and goals for the practice as a whole. To this was added a process for discussing each month where we are in relation to our goals. When this was completed, we shared the final product with the entire team, discussed the overall plan and obtained their buy-in. Not only did open communication add clarity, it also produced contingency conversations with options if alternatives were required to achieve initial objectives.
In result of our team efforts, patient appointments are now set up in the office with various members of the staff assisting with different aspects of the process. Job descriptions are coordinated with state requirements. We call it our 30/30/30 system. I divided many 90-minute appointments into three, 30-minute segments. During the first two segments assistants and support staff see patients and provide initial services. The final 30-minute segment is reserved exclusively for the audiologist. This not only frees up one hour of audiologist scheduling time, but it engages the staff and helps them expand their capabilities beyond the formal job description. Team members are directly involved with patients at varying levels and they become a larger part of the hearing health care delivery process.
The success of the 30/30/30 system led to a redesign of the office. Our lab was previously situated in a somewhat closed-off area separate from the rest of our workspace. Now the lab is the center of the office with open access to patients, providers and other staff moving about more freely.
When it comes to benefitting the patient, our exclusive MA5P METHOD™, (personalized Assessment, Active listening, Adaptation, Assistive technology solutions, Aftercare and hearing loss Prevention), reconnects patients and dialogue with them about ways they can achieve a lifestyle that may not have been possible without these comprehensive clinical services. In addition, we established Key Performance Indicators so we would have an ongoing system for evaluating where we are as a business and how well we are communicating with each other and our patients.
A side benefit of working through the various aspects of developing an effective communications plan allowed us to focus on our team, and the assembly of teams within the team. We identified our entire staff as giving us a strategic advantage. We conducted administrative, tactical, strategic and developmental meetings with team members. Individuals participating in these teams were identified as coordinators, leads, captains, ambassadors as well as those with aspirations to move up within the practice.
All of this planning and careful implementation led to the development of our new communications culture we call Beyond the Language of Trust—which has become a culture among our own internal decision makers and staff members. In leading our employees through this process, I also gave them tools needed to succeed, and trust them to make informed decisions in keeping with our overall strategy and business plan. At the same time they now trust me. However, the most important outcome is that they trust me to trust them.”
Peter Marincovich, Ph.D, is certified with Clinical Competence in Audiology (CCC-A) by the American Speech-Language-Hearing Association. Dr. Marincovich founded Audiology Associates in 1984 and is currently celebrating 30 years in business. Audiology Associates offers three convenient Bay Area locations in Santa Rosa, Mendocino, and Mill Valley. Dr. Peter Marincovich spearheads the practice with a holistic approach that focuses on patient centered care and hearing loss prevention, the latest diagnostics and comprehensive rehabilitation. For more information about Audiology Associates and Dr. Marincovich, visit us at http://www.audiologyassociates-sr.com/ or call 707-523-4740.