Selling to a consolidator does not necessarily mean bailing out immediately and having nothing to do with the practice. As the consolidation market is developing and more clinics are changing hands, corporate buyers are becoming more flexible with their buyout options.
Some new owners may desire to retain some of the existing employees and clinic culture, which could still leave you in the driver’s seat, even if you are wary of being in charge of all the management duties and related challenges. After all, you have been nurturing the practice and building its culture for such a long time. For a situation like this, you have several options to negotiate with the corporate buyer while finalizing the deal.
Whichever option you go with, you should realize that the clinic’s ownership change is inevitable and will directly impact your staff. When practice owners decide to sell their clinic, most do not put much thought into what will happen with the team. The relationship between staff that existed before the acquisition may change.
You and your team may need to go through and overcome what is known as the five “dysfunctions.” We want to look at the ownership change process through the lens of the book Five Dysfunctions of the Team, written by Patrick Lencioni, and prepare you for what you may face during and right after the acquisition from the team perspective. Any team needs to overcome these dysfunctions while establishing internal relationships.
These dysfunctions are associated with the absence of trust, fear of conflict, lack of commitment, avoidance of accountability, and inattention to detail.
Dysfunction #1. Absence of trust
Teamwork is something that you cannot buy, and that is primarily the reason why it is so challenging to achieve.
Collaboration requires emotional energy, level of discipline, courage, and persistence. It takes time and effort to create a sense of connection and belonging. When ownership changes, the first link in the chain of dysfunctions that you may face is the absence of trust.
Members of great teams trust one another, and they are comfortable to be vulnerable about their weaknesses, mistakes, fears, and behaviors. This state of self-awareness means that they can be completely open and communicate without filters. If you have the trust established in your team, be ready for everything to change the moment you announce that you are selling the clinic. The team was used to the fact that they could come to you if they were facing any issue regarding procedures, schedules, or even personal matters. The tactic of keeping the clinic “the kind of place it’s always been” and selling only a minority stake may not work. You should realize that consolidators will still be responsible for management duties, which will influence and alter the clinic’s usual workflow.
What can you do when there is a chance of losing trust with your team? Try to have an honest conversation with them and be transparent. Vulnerable-based trust is what you are trying to reach. During the staff meeting, take a moment to discuss and prepare your team for the transition, unless you are temporarily unable to discuss it due to confidentiality matters surrounding the sale. When you have a chance, discuss the following points with your staff:
- What organization are you selling to? Your team is scared. The last thing you want to do is to keep them in the dark. Sharing details about the new organization may shine some light on what is waiting for every employee after the transaction and calm them down. You can discuss the benefits that a new owner possesses. For example, many practices sell to big corporations with exciting career opportunities, compared to the narrow career path that a single organization could provide.
- Why did you make this choice? I bet you had other reasons for selling the practice aside from the financial considerations. This may be the right time to expose your vulnerability and establish trust. Being burned out or needing to relinquish the business side of it, are fair enough reasons. Admitting that may also help other employees reveal their struggles and feelings and share them with the team, which will create a sense of belonging.
- What is our mission? Will our core values change? If you want the clinic culture to survive, discussing core values is crucial. Explain how the clinic’s mission and vision may be altered and what changes it can bring.
Dysfunction #2. Fear of conflict
If trust is established, team members are not afraid to get into spirited dialogue around issues and decisions that are key to practice success. They can disagree with, challenge, and question one another to find the best answers and make the best care decisions. In the situation where ownership is about to change, you may face resistance from your team, who will not be ready to share their concerns anymore. As they will start reporting to a different manager after the sale and will be in an unfamiliar environment, they may feel that their job security is threatened. Some staff may be wanting to jump ship right away.
According to Patrick Lencioni’s book, people are driven by the competition and desire to be right in a conflict without trust. This means they are not listening to the opponent and focusing on how to “win the fight” and get what they want. During a crisis, such as change in practice ownership, the risk of staff members being afraid of conflict, and looking out for their self-preservation is greater. There is a line between destructive and constructive confrontation, and the way for you to eliminate disputes at the workplace is to create an appropriate environment. In this environment, employees should feel supported by the leader and by other team members. Then, they will express their feelings, concerns, and conflicts, which will only help you to reach an effective solution.
Dysfunction #3. Lack of commitment
A team engaged in unfiltered conflict can achieve genuine buy-in around important decisions, even when various team members disagree. That’s because they are sure that all of the opinions are considered.
Teams that commit to decisions and standards do so because they know how to embrace two separate but related concepts:
- Buy-in. It implies acceptance of the situation and emotional support
- This concept implies the removal of assumptions and ambiguity from the situation
Lack of commitment comes from the unanswered question — “Why?”.
Many practice owners build their clinic from scratch and weather through numerous challenges over the first years. You spend long hours establishing processes — both clinical and business — working side-by-side with your staff and dealing with all the problems. Before the sale, employees were committed to specific core values and the mission you established. Once you sell the practice, those values may not be as clear or can change. Your staff may be lost and do not have an answer to the “why.” Why should I care? Why should I commit and follow the existing procedures your practice was valued so much for in the first place?
Buy-in and clarity can help you deal with any lack of commitment after the sale. Transparency and continuous support can help to overcome any lack of commitment that you may face.
Dysfunction #4. Lack of accountability
Accountability is the willingness of team members to remind one another when they are not living up to the group’s performance standards. The key to this accountability is that it shouldn’t always require the intervention of the team leader. It is direct, peer-to-peer accountability.
When the team loses an understanding of “why,” group performance standards may suffer. You, as a leader, should prepare your staff for the transition. If you build trust and maintain clarity and transparency throughout the entire process of the practice sale, you should not have an issue with accountability.
Dysfunction #5. Inattention to results
Without metrics, a team cannot measure the effectiveness of the job.
A scoreboard is a simple tool that will ensure that team members do not lose sight of the results. It can be a dashboard or just a list of metrics. In any case, every team member should have a visual, easy-to-read tool for assessing their success at any given moment in time. Daily and weekly meetings can help you and your team to understand in which direction you are going. It is also an excellent opportunity to go over core values, mission, and vision. So what should you measure?
- Number of Patients. You can calculate how many patients came to the clinic per day or per doctor.
- Customer satisfaction. You can use the Net Promoter Score (NPS) which is a management tool that serves as an alternative to traditional customer satisfaction research. Remember that appointment time and quality should be balanced to measure clients’ satisfaction.
- Employee card satisfaction. Measuring staff satisfaction is crucial to overcoming all the listed dysfunctions. Being aware of the challenges that hold your team back from delivering efficient results can be a game-changer.
After all, human capital is your most valuable asset. If you think about preparing your team for the sale process, you can expect favorable results, just like you do with the legal and financial aspects of a transaction. Provide your team with needed support, and they will stay loyal even during challenging times.
The transitioning period is the most turbulent time, requiring the most attention from the leadership to the staff, clear communications, and alignment. Using the “The Five Dysfunctions of a Team” concept you, as a leader, can overcome the team shortcomings and prepare them for any turmoil, be it a global pandemic or a local acquisition or management change.
Finally, you don’t get to the be Amazon’s #1 business bestseller on just a whim, right?