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The cost of disengagement in the practice


A practice with disengaged employees risks bleeding cash, says Amy Koon of the medical practice management firm Keystone Medical. In this article, Ms. Koon highlights key steps necessary for creating employee engagement.

Disengagement in the workplace is bad. And it’s common.

Amy Koon, chief operations officer at the medical practice management firm Keystone Medical, says her company experienced growing pains when the Spokane, Washington-based firm signed on more practices and added personnel. Some employees were fired up and excited about the work, while others only did as much work as necessary.

In early 2016, Gallup released data suggesting the same:  About two-thirds of American workers are either not engaged or actively disengaged in their jobs.

The apparent lack of engagement and subsequent consequences to Keystone Medical’s clients and bottom line, led Koon and colleagues to dig into what was going on and try to fix it.

Koon presented her findings and solutions for dermatologists, cosmetic surgeons and others at the May 2017 Aesthetics and Medical Dermatology symposia in Coeur d’Alene, Idaho.

“We researched and went over this for about two years and tried a bunch of things. Then, we had some really successful results and started sharing them with our dermatology clients,” Koon says.

The principles, she says, can be implemented anywhere teams of people work together. And, teams are different, depending on the practice type. Team members might be providers staff, front desk and back office people, for example.


Koon says the first challenge for many practices is to realize employee engagement needs attention. “Most of our offices want to talk about how they can increase revenue, or what kind of lasers they should get or procedures they should do,” Koon says.

While those are valid questions, employee disengagement is common. It can eat away at a practice’s bottom line, regardless of a its reimbursement, technology or service offerings.

Practices, according to Koon, cannot fully fulfill their revenue potential with poor team management and disengaged staff.

“We talk about what is the actual cost of employee turnover - when employees don’t stay and you’ve invested in training time and benefits. We show practices that when they have inefficient, poorly executed workflows, there’s a toll to revenue,” Koon says.

Having a poorly engaged or disengaged staff results in increased payroll costs and errors, which contributes to liability and malpractice. The lack of engagement contributes to diminished productivity and patient flow, which obviously impacts revenue and product sales, she says.

“These contribute to poor patient and customer experience, which impacts patient retention and reputation within the community, which, over time, starts to erode that revenue for the practice,” Koon says.

NEXT:  What People Want




Research, analysis and experience have shown Koon and colleagues that employees - regardless of position in the practice - are looking for two things in the workplace.

“They’re looking for a sense of purpose that what they do during the day matters. They’re also looking for mastery; a feeling they’re doing things well and they have the resources and ability to do those things well,” she said.

So, how does a practice put those things into motion? Koon recommends these steps:

STEP 1 Clarity and Alignment

“Before you can really start to work on employee dynamics - whether they’re super positive or super negative - the first thing is creating clarity and alignment from the top down within the organization,” Koon says.

Every practice needs to define its core purpose, which is similar to a mission statement, but with specific components. The core purpose should be something grand and impactful that’s not industry-specific, Koon adds. “For example, when Keystone set out to do this we decided that our core purpose for existing as a company is that we ‘empower’ people.”

The purpose statement must be clear because it will influence everything from hiring, strategies and operations, to how the practice spends money and profits. “This is not a marketing slogan. You’re looking for something that is super clear, so when you communicate it to your team, everybody is on the same page with what that purpose is,” Koon says.

Next, the practice needs to define core values. “We encourage practices to keep these core values clustered to three or four. Keep in mind that this will be your rule book for hiring and firing and for evaluations. They also need to be aligned with the existing values from the top down,” she said.

NEXT:  Communicate, Invest and Persist


STEP 2 Communicate

Research shows it takes about seven times for information to really sink in. “It’s important to keep repeating the core values and core purpose over and over again,” Koon says. “We have a joke at our company that if I call you in the middle of the night out of a drunken stupor, you should be able to tell me our core purpose and values.”

STEP 3 Invest in Your Team

Once you’ve laid the foundation for the organization and started communicating the core purpose and values, it’s time to invest in your team, but first, define investing.

“We identify how they can authentically add value to the team and to the company. I say authentically because this is not an exercise about helping people to feel good about themselves. This is taking a genuine inventory of people’s proclivities and natural strengths and passions, and finding tangible and specific ways those can be applied to day-to-day business operations to add value,” she says.

Secondly, candidly identify friction points, which can be identified as weaknesses. Talk collaboratively about potential friction points, identifying them and discussing how they can be minimized.

Third, consistently invest in personal development opportunities for individuals and teams.

“The reason that’s point three and not the starting point is that, once you’ve defined the mission and purpose of the organization and what those key core values are, each step builds of that. A lot of people forget to use those core values to weed out the individuals who really aren’t a good fit in the organizations,” Koon says.

STEP 4 Persist and Prioritize

The last point ties it all together:  Persist and prioritize. Set a long-term strategy on prioritization of and persistent communication about core purpose and core values. Then prioritize creating and maintaining the health of your team and its members. Make sure you take time to create a long-term strategy and incorporate it into your daily, weekly, monthly, quarterly and annual operations and strategies, she says.


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