Is your medical practice ready for a "Starbucks" makeover?

Can't you just smell the coffee?

Or the fresh-baked cookies?

Imagine walking into your doctor's office and smelling the aroma of a fresh brew or hot-out-of-the-oven mini chocolate chip cookies. What would that suggest about the office?

Of course I am being a bit fanciful, but here is a fun and thought-provoking article from Medinnovationblog about shaping your patients' experiences when they walk into your practice.

Starbucks doesn't sell coffee - it sells community, a coffee-drinking experience and free coffee grounds for your roses!

Why not reconsider what it is you "sell" when patients come to see you?

Is it comfort (think cookie and coffee aromas, with plaid or chintz-covered furniture), "cutting edge knowledge" (plasma TV screen with educational videos), serenity (small water fountain and "spa music") or Platinum Club treatment (bronze sculpture with spot-lighting, and art on the exam room walls)?

This is a snippet from the article:

Why do some doctor practices attract and keep loyal patients? Why do Starbucks customers in New York City return for coffee an average of 18 times a year?

In Starbucks case, Howard Schultz, founder of Starbucks, it’s the total “experience.” Starbucks a neutral place – neither home nor work – where one can meet friends, listen to music, use your laptop, find a date, conduct business, snack, enjoy various coffee concoctions, and even pick up coffee grounds for free for you roses. Yes, Starbucks is offering coffee grounds for free to feed your roses at home, as part of its “green” image.”

In a 2006 book The Starbuck Experience: 5 Principles for Turning the Ordinary into the Extraordinary, Joseph A. Michelli, PhD , says all of these possibilities flow from 5 principles Schultz uses to inspire and motivate his employees to do their level best to please Starbucks customers and to keep them coming back.

These five principles are:

• Make it your own - experiment on your own in your own way to give your customers a unique experience.

• Everything matters - It’s not only the big things – the layout of your café – but the details that your customers observe and talk about and tell others.

• Surprise and delight - Free coffee grounds for roses or a specially made coffee drink for a special customer are examples.

• Embrace resistance - If a customer resists, overcome that resistance with special attention and warmth.

• Leave your mark - Do something that your customer or the community where you serve remembers.

I encourage you to read the entire article (click here to access it) as it goes on to give several good tips from Susan Keane Baker's book, Managing Patient Expectations: The Art of Finding and Keeping Loyal Patients - tips  for getting the "scoop" on what it's like to come to your office, and how you might use that information to truly shape a desirable patient experience and build fierce loyalty!

As the article author, Dr. Richard Reece, writes in conclusion:

Look at the total experience of your practice through your patients’ eyes. See through their lenses how your practice fits into the human condition and into the community as the place to go. This new perspective may pay dividends. It’s the total “experience,” and every detail that goes into that experience, that counts. (emphasis mine)

How do you want your patients to experience your practice?

Answer the "3M" questions before plunging into physician entrepreneurship

Jeff Cornwall , an academic professor of entrepreneurship and author of The Entrepreneurial Mind recently wrote an article for The Tennessean, in which he cautions aspiring entrepreneurs to consider the Three "M" questions before taking a leap of faith into a new business.

Since this topic is on my mind following the conclusion of our first fun and lively 4-week BizIdeas^TM Teleseminar, I thought I'd summarize the article for you as it is so relevant to the process of deciding what business to start. Thanks to Jeff for the inspiration!

He begins (and I completely agree!):

"A key skill that successful entrepreneurs learn is to assess possible opportunities more efficiently and quickly before they make an extensive commitment of time and money to launch the business or even to develop a full business plan.

This process allows entrepreneurs to weed out ideas that are doomed to fail before they even begin. There are three basic questions used to assess opportunities, which I call the '3 M's'."

And his questions are:

1. Is there a MARKET?
   Are there people or businesses that will pay for your services or products? Is there either a strong need or a powerful want? Is the market big enough? Can you reach your market collectively in "gathering places" or will you have to try and reach them one by one (expensive to do!)? Is the market growing?
   
   
2. Is there a MARGIN?
   Once you have run the numbers for your business model (projected revenues, fixed and variable ongoing costs, start-up costs etc.), is there a high enough profit margin to not only allow you to sustain the business and yourself, but potentially reinvest to allow the business to grow, if that is part of the plan?
   
   
3. Is this for ME?
   This is where Passion rears its princely head, alongside its twin sister Persistence. It is your emotional investment and tenacity that will help you navigate the waters when they get rough or uncertain. Do you care enough about your idea, and what it stands for (a better world, a better community, a better outcome for someone, a better education for your kids - whatever it truly means to you) to commit the precious resources of your time, your energy and your money to succeeding?

What are YOUR answers?

The time is right for physician entrepreneurs....and the news is good!

OPEN from American Express ® recently released the results of the "Small Business Monitor" , a semi-annual survey of small business owners.

Here are the highlights taken directly from the article, to stimulate you into action, if you're contemplating an entrepreneurial move. Things are looking pretty good for small business owners.....which of course makes me happy!

Small business optimism is growing.

Business owners are optimistic and clearly see the glass as "half-full". According to the survey, 87% of business owners identify with this positive outlook. This optimism is reflected through their view on the economy and how it relates to their business.

The percentage of small business owners planning to make capital investments over the next six months remains on par with last spring (60% vs. 64%). Business owners will likely invest most heavily in the area of technology (45%). More are planning to make their next purchase in mid-priced equipment such as desktops, laptops, printers than a year ago (57% vs. 47%). One-in-five (20%) plan on making more substantial investments in major technology infrastructure such as software, servers or telephone systems. In addition to technology, other investment areas include office equipment (22%), office furnishings (15%), manufacturing/production equipment (14%) and real estate (13%).

Hiring Plans Remain Stable

Over the next six months, one out of three (36%) businesses report plans to hire full and/or part-time staff, on par with 39% reported last spring. Among those, seven out of ten say they need to hire to handle their growing business or to help increase business volume (both 72%).

Male or Female, Entrepreneurs Manage to Make Personal Time for Themselves

Business owners recognize the importance of "down-time" in their lives and most are satisfied with the amount of leisure time they have (81%). However, carving out this time does not come without stress. Two-thirds of business owners (64%) find it stressful balancing their personal life and their business. Women business owners are more stressed by work/life balance than their male counterparts (71% vs. 62%).

Two-thirds of business owners (67%) report they find themselves making sacrifices in order to be an entrepreneur. Among those who feel they are making sacrifices, family (52%) and friends (42%) are areas where they make the most sacrifices, followed by personal finances (36%) and health (35%).

As business owners find themselves trying to achieve balance, they identify flexibility as the most essential entrepreneurial attribute. One-third of business owners (34%) identify flexibility as the most essential aspect of being an entrepreneur. Following at a distance is working well under pressure (24%) and knowing the market (18%).

Taking their own advice on the importance of flexibility, two-thirds of business owners (64%) report making personal time for themselves during the business day. Men are slightly more likely than women to make personal time for themselves (66% vs. 60%). Although entrepreneurs realize the importance of taking time for themselves during the business day, nearly half (45%) consider taking time off from work to pursue a leisure activity a ‘guilty pleasure'. Female business owners are more than four times more likely than their male counterparts (18% vs. 4%) to consider ignoring an email as a ‘guilty pleasure.'

Exercise and Business Acumen Linked; Genders Differ on Idea Generation

There may indeed be a connection between exercise and business success. Fifty-nine percent of small business owners report exercising several times a week with nearly one-quarter (24%) exercising every day. 

Female business owners are five times more likely than males to come up with their best ideas while exercising (10% vs. 2%), an indication of the gender differences in creativity and brain-storming.

Both sexes are using their personal time, when they are not thinking about business, to let creative juices flow. More than one-third of entrepreneurs (35%) report coming up with their best ideas during "down-time". Male business owners are more than twice as likely as female business owners to come up with their best ideas on the way to work (18% vs. 7%). Women are also more likely than men to wake up in the middle of the night with ideas for their business (70% vs. 56%).

Familial Support is Universal

Whether male or female, the vast majority of entrepreneurs have the support of their significant other. Most entrepreneurs (89%) report a happy marriage or relationship with their spouse or significant other. Of those who report having a happy marriage, a similar number (81%) believe being an entrepreneur contributes to their happy marriage/relationship. Again, this percentage shifts among the sexes, women are more likely than men to report that this is true (85% vs. 77%).

Passion is Nothing New to Entrepreneurs

Four-in-ten (38%) respondents said the biggest influence in becoming an entrepreneur is passion. As an influence, passion is followed distantly by natural entrepreneurial inclination (20%) and being "born into it" (18%). Business owners are most passionate about building their customer base (34%). Turning a profit (27%) and closing the deal (15%) were of less importance.

Growth Does Not Necessarily Mean More Personal Sacrifices

Growth is a priority for a large majority of business owners. Over the next six months, seven in ten (71%) small business owners report planning to grow their businesses in a variety of ways. While most in this group (50%) plan to grow by selling more of the same product or service, one in five (22%) will introduce new products or services, and 14% will branch out into new markets or increase investments in their business (11%).

In the area of work/life balance, those driven by growth are only somewhat more likely to find balancing work and life stressful (66%) compared to small business owners overall (64%). Growth-focused small business owners are also only somewhat more likely to find themselves making sacrifices in their personal life in order to be an entrepreneur (70%) when compared to businesses overall (67%).

Parents Want Kids to Join in the Business

For many, business is a family affair, and six in ten entrepreneurs (61%) who are parents would like their children to join their business. Nearly one-in-five business owners (18%) are where they are today because they themselves took over a family business.

As entrepreneurs aim to alleviate stress and maintain balance in their lives they look for ways to spend more time with family and friends. The majority of entrepreneurs (63%) believe it is true that, ‘working with friends or their spouse/significant other benefits or would benefit their life'. Six in ten (61%) also believe working with friends or their spouse/significant other benefits or would benefit their business. Nearly all (90%) report their spouse or significant other as supportive of their decision to become an entrepreneur and more than half (57%) of business owners discuss business with their spouse/significant other on a daily basis.

Business owners believe the most important commitment they make to their family is getting involved around the house, including chores, homework and grocery shopping (32%). Male business owners are more likely to believe this to be true (37% men vs. 27% women). The most important commitment women business owners make to their family is always taking their calls when they are at work (32% women vs. 23% men).

More than Half of Entrepreneurs are on Track for Retirement

In terms of life upon retirement, nearly four-in-ten entrepreneurs (39%) believe social security will fund less than 25% of their retirement. More than half of entrepreneurs (58%) believe private investment accounts are a good way to save social security. More business owners are concerned about their ability to save for retirement this spring than last year (66% vs. 62% in 2006). More than half (57%) of business owners report they are on track to save the funds they need for retirement.

For one-in-five entrepreneurs (20%) the top frustration encountered when running their business is not having enough time. Managing employees is a source of frustration for 16% of business owners. Slightly fewer business owners are frustrated by the difficulty in finding more money needed to grow their businesses or in developing all of the necessary managerial skills for running their business (both 15%).

As business owners look for ways to maximize their productivity, many rely on the Internet for assistance. Eighty-eight percent of entrepreneurs use the Internet for business activities. These activities include making travel plans (60%), purchasing goods from wholesalers (60%), and conducting market or industry research (48%). One in five male-owned businesses (19%) has established an online presence to sell products or services online compared to 16% of businesses overall and 10% of female-owned businesses. One-in-ten business owners (12%) do not use the Internet for any type of business activity.

Additional survey results are available by contacting OPEN from American Express.

Survey Methodology

The OPEN from American Express Small Business Monitor, released each spring and fall, is based on a nationally representative sample of 626 small business owners/managers of companies with fewer than 100 employees. The survey was conducted via telephone by International Communications Research from March 26-April 12, 2007. The poll has a margin of error of +3.9%.

Getting to "We Agree" - negotiating tips for the entrepreneurial physician

A coaching conversation with a physician client this week reminded me of a little book that has had a special place in my heart for many years - "Getting To Yes" by Roger Fisher and William Ury.

My client is in the midst of a business negotiation and, like many physicians (including myself), he has had no training in the artful give-and-take of dealmaking. The experience is discomforting, and I suspect that his unease stems from a conflict between his natural desire to "win well for himself" and an over-riding feeling of not wanting to be perceived as haggling. Isn't that the way we all feel when confronted with a situation we have to negotiate?

I pulled my yellowing and somewhat tatty copy of "Getting to Yes" from the bookshelf to remind myself of the invaluable principles, and decided to share them with you, in case you too need a refresher.

So how do you negotiate well?

To evaluate how well a negotiation has gone (from the book), you should judge it by three things:

1. Does it produce a wise agreement, if agreement is possible?
2. Is it efficient?
3. Does it improve (or at least not damage) the relationship between the parties?

And here is how a good negotiation is accomplished:

• Don't negotiate over positions. A position is a viewpoint that you hold, that is often quite extreme from the other person's position, and that you tend to hold onto stubbornly. Negotiation then becomes a series of small concessions inching you away from your original stance but nowhere close enough to agreement. Not very productive. The goal for most people who try to make deals this way is to WIN!
  
  
• Don't give in to the compulsion to be nice. As contradictory as this may seem, being nice, and engaging in "soft bargaining", do not produce good deals. Instead, the deals tend to be what Ury and Fisher describe as "sloppy", and this bargaining style may place you at risk when the other person plays hardball.
  
  
• Separate the people from the problem. It pays to remember that the person on the other side of the table is a feeling, emoting human being, who is prone to human reactions, as are you. The relationship of mutual trust and respect is at stake, and this is especially important if you anticipate an ongoing affiliation.
  
  To separate the people from the problem requires that you be committed to accurate perceptions, putting yourself in the other person's shoes, recognizing the role your own fears and emotions are playing in your own judgments, and owning your own problems. Be explicit about your feelings and acknowledge those of the other person. Say things like "This is how I am feeling, and I am wondering how it is for you?". Communicate by listening actively and reflecting back on what you are hearing.
  
  
• Focus on interests, not positions. It is your interests - your concerns, hopes and desires - that really define the problem under negotiation. A quote from the book: "Your position is something you have decided upon. You interests are what caused you to so decide."
  
  Find the shared and compatible interests as well as the conflicting ones behind the opposed positions. Do you both want stability? Do you both value independence? Or is it customer results you both care about?
  
  Ask "why?" to understand the other person's interest - "why does this matter to you?". And realize that each side probably has more than one interest at heart.
  
  
• Be hard on the problem and soft on the people. When you are both pushing hard for your own interests, you may stimulate each other's creativity to generate mutually advantageous solutions. Work to find the place where you are in fact aligned with the other person, both attacking the problem at hand. This is hard, but not impossible to do!
  
  
• Invent options for mutual gain. Great brainstorming requires that you: come up with options without judging their merits, broaden the number of options on the table instead of narrowing them down to the single choice right away, and strive for mutual benefit.
  
  
• Insist on using objective criteria, not whose will is greater! Use commonly accepted standards (market value, precedent, "comparables", tradition, reciprocity etc.) as independent measures, or fair procedures  ("one cuts, the other chooses"). Use reason, and be open to reason. A great example is a negotiation over money. You want to pay the lowest price, the other person wants to get the biggest sum of money - opposing interests. What if you were both to reframe the issue to become a shared goal: "How do we determine a fair price?" "How did you arrive at your figure? Here's how I arrived at mine".
  
  
• Be prepared to opt for your BATNA. The reason to negotiate is to produce a result that is better than if you had not negotiated - correct? Your BATNA is your "Best Alternative to a Negotiated Agreement". This is the other option that you would take if this negotiation isn't going in the direction that is good for you. What result could you obtain elsewhere, or by taking a different course, that is better than a bad compromise in this negotiation?
  
  It is valuable to know your BATNA in advance of the negotiation. This will help you explore other more creative solutions with the person opposite you. Instead of ruling out any solution that doesn't meet your bottom line, you can compare the proposal to your BATNA to see which one is best for you.
  
  To develop your BATNAs, come up with a list of actions you could take if you don't reach agreement, pick your best ideas and convert them into practical options, and finally select the one that seems best. This is your BATNA - and the clearer your BATNA, the greater your ability to improve the terms of the negotiation. Judge all other offers against it. 
  
  Know that the other person also has BATNAs available to him or her - try to imagine or even discover what theirs are.

As Rudyard Kipling put it: "If you don't get what you want, it's a sign either that you did not seriously want it, or that you tried to bargain over the price".

If this is sounding a bit mysterious, I encourage you to read the book - it's short, concise and a classic, and you will quickly become a powerful negotiator, as I think my client is discovering!

Want to stand out in Pharma? Here's how from a physician expert.

Physicians often ask how they can make a career move into the pharmaceutical industry.

Well, it appears there is a thoughtful answer supplied by an insider!

Barbara Linney of The American College of Physician Executives graciously shared an ACPE-sponsored web-based conference in which Dr. Ross Tonkens offers his wisdom and expertise about becoming a "pharma physician". Dr. Tonkens is the Global Scientific Head, Cardiovascular Therapeutics, Quintiles, Inc.

Dr Tonkens' insights include what traits and skills are needed to succeed in pharma, ways in which you can bring extra revenue into your practice by participating in clinical trials (and how to go about doing that), and some of the job challenges and rewards to expect from the job.

This presentation is a nifty "webcast" with an audio track that is accompanied by a slide show. It is just over an hour long - so if you are interested in the pharmaceutical industry, find an hour, kick back in front of your computer and enjoy it!