For Growth-minded, independent, specialist physician-owners.
Why Most Practice Goals Fail (and the One Shift that Changes Everything)
Faster, Simpler Goal Achievement Series, Part 1 of 4
GOAL ACHIEVEMENT
3 min read
Most medical practice owners don’t lack ambition. If anything, ambition is part of the problem.
It’s common to hear things like:
• “This year we want to grow revenue, fix staffing, improve marketing, and get our systems under control.”
• “Once we hire a few more people, everything will calm down and we can focus on growth.”
• “Honestly, everything needs attention right now.”
All of that feels true. And almost none of it produces real, lasting progress.
The Real Reason Goals Stall
Most independent practices operate without a true management infrastructure. That means your available capacity for change is limited.
Capacity isn’t just “time”. It includes:
• Owner focus and decision energy (decision fatigue by end of day is a large limiting factor)
• Staff capacity (each member's capacity to deliver the outcomes you want in the volume and quality needed)
• Cash flow availability and flexibility
• Tolerance for disruption (staff and owner)
When you try to push multiple major initiatives at once, you don’t speed things up. You starve them all into failure because each initiative competes for the same limited resources. Failure is inevitable on this basis alone.
You’ve seen it before. You come back from a conference energized with new ideas and pearls. Staff nod their heads, and wait. Sooner or later (usually sooner) your changes fall by the wayside, never to be seen again. Staff go back to the pre-pearl status quo.
It’s not your fault; nor is it the staff’s fault. This isn’t a motivation problem. It’s a capacity problem.
Because continuous, profitable growth is the lifeblood of any practice, it’s important to understand what actually stalls it.
A research study conducted on 500 U.S. companies found that 87 percent of prolonged financial declines were caused by factors within management’s control. I find similar factors in medical practice, even with the unenviable price-fixed constraint medicine has that commercial business doesn’t.
A staggering 70 percent of these management failures resulted from choices about strategy.
Let’s start with some basic definitions, so we’re on the same page going forward.
GOST
GOST stands for Goals, Objectives, Strategies, and Tactics. It is a strategic planning framework used to align an organization's activities with its goals.
Goals are outcomes, like “More Revenue”, or “More New Patients”. They are broad, reasonable to achieve within a time frame and with available resources. Goals are not actions, they are results.
Objectives, strategies, and tactics are types of “what” and “how” actions practices take to reach goals.
While goals outline the desired result, “objectives” are specific, measurable, achievable, relevant, and time-bound actions taken to achieve goals.
“Strategy” is the plan or approach taken to meet your objectives. It’s the “treatment plan” for your practice.
“Tactics” are very specific, single actions taken to carry out your strategy.
GOST provides a strategic road-map. Of course, making decisions about what your strategy should be in order to achieve your goal is another matter. When so many failures occur due to wrong strategy choices, it would be very helpful to have clarity, so your efforts give you the results you want.
Clarity starts with this:
The Counter-intuitive Fix: Only One Problem at a Time
High-performing practices don’t try to improve everything simultaneously. They sequence improvement in a very specific way.
They deliberately choose one primary objective and temporarily subordinate everything else to it. Not because other problems don’t matter. But because focus creates leverage.
I’m going to show you a highly leveraged, simple strategy to achieve goals that you can successfully implement even if you are uber-busy, whether or not you have “management” background or training, and even if staff haven’t been champions of changes you’ve wanted to make in the past.
Using this method you can compete with corporate, PE practices financially (even with the reimbursement advantages they have) and retain your independence.
The next post in this series (Post 2) gets you started – it walks you through what to do with the overall goal you pick, so it doesn’t just fail out of the gate.
Post 3 then identifies what really prevents your goal achievement - the diagnosis for your strategy.
Post 4 covers what you must do to make sure actions are executed – often the most difficult part of goal attainment, because the key to success is usually missing.
👉 Go to Post 2: Make sure your goal is aligned and realistic
👉 Got to Post 3: Identify the real problem stopping goal achievement