Practice Transformation

Nature is a metaphor for inspiration in many venues including Practice Transformation.

A caterpillar is one of the most dramatic and well-known transformation that occurs in nature.

Source: Shawn Beelman Photography

One of my favorite stories about transformation comes from Martha Beck, the famous Harvard educated life coach who is a regular columnist for O Magazine.

Martha wrote an article for O once called Growing Wings. She talked a little about the famous symbol for change, the chrysalis, pondering what goes on inside. Wouldn’t you expect to see to see a caterpillar inside a chrysalis go through some sort of linear process until it reaches the ultimate stage of becoming a butterfly?

It may be what we’d like to think, but it’s not true. Martha Beck points out in her article that what really happens inside a chrysalis is something she descries as “bug soup.” In that bug soup mixture is the formula, a secret sauce of sorts, for true transformation. It doesn’t sound like a pretty picture at all.

Kind of like change.

When it comes to change, we’re a lot like someone watching a chrysalis. What we see from the outside looks nice and neat.

What people think success looks like

Photo source: Wishful Thinking Blog

But what’s really happening on the inside is bug soup.

Success, what it really is

Source: Wishful Thinking Blog

I wish I knew the source of this quote, but since I don’t, I’ll just paraphrase it.

Don’t judge your insides by other people’s outsides. What you’re seeing is the cocoon. Inside we’re all a little more messy than that.

What, you may ask, is the rather long-winded point I’m trying to make?

Change is hard, but the results in the end are well worth it.

Practices around the country are taking on the difficult process of becoming Patient-Centered Medical Homes (PCMH). I read recently an article about a PCMH pilot program taking place in Kansas. The article quoted Gregg Wenger, M.D., a family physician in Sabetha, Kan., who is participating in the pilot project.  “Everyone has some example of something they could do better, whether it is following up on (hemoglobin) A1cs or whatever. When you’re busy and things are working, it is hard to make your clinic work better.” Dr. Wenger followed that up by saying something we all know; there’s  always room for improvement.

I’ve heard people criticize the NCQA PCMH recognition program as a “check off the box” process that does little to bring about real change.

I disagree.

Maybe that’s because I’ve seen real change happen in practices as they go through PCMH recognition.

Change doesn’t have just one way way of happening. You can see from the picture above, it can get messy.

Some may prefer to go through a rigorous, two-year practice transformation process, choosing PCMH recognition as the crowning glory of that effort. Others prefer to fine-tune their practice processes real-time as they go through PCMH recognition application.

Some may call that a check-off-the-boxes version of change. That it’s not “real.”

I say, whatever it takes to help people make change? Well, that’s what’s real.

Here are a few tips to help you keep change real in your own practice:

  • Something to Talk About. That’s more than a great hit by blues musician Bonnie Raitt, it’s a good philosophy to follow in your practice. Talk with your practice team. Gather their input. Keep them in the loop about what’s happening. You may not always have the answers, and there are always going to be people who are not happy with certain approaches, but one thing you know for sure, change causes stress. You can help alleviate some of that stress by keeping the lines of communication open.
  • Triangulation. The AAFP’s National Demonstration Project found that a shared leadership model is one that works best when it comes to practice transformation. Leadership requires accountability and the shared leadership model has that built right in.
  • A little KISS. You know the adage, Keep It Simple, Stupid. That works well when it comes to change initiatives as well. Don’t take on too much at the same time. Doing that can have you doomed to fail. Create small, strategic approaches to change. Measure results. Share the results with your team and talk about ways to refine your work as you move forward.

With the KISS principle in mind, I’ll sign off this article. If you have any of your own tips for change, we’d love to hear about them!



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