Solve Problems Without Doing All the Work

bottleneck fix this next fix this next for healthcare providers healthcare hierarchy of needs hhn order order level pass method problem-solving processes systemization systemized systems Jul 15, 2021
Solving problems is something every business owner has to do. How you solve those problems matters to your own wellbeing and mindset, but it also matters to those who work with you, your employees. Use a problem solving method that allows you to address the root of the problem without spending all your energy on controlling the symptoms.

|By Tara Vossenkemper, Ph.D.

“I’d hate to have to deal with everybody’s complaints.” 

This is a direct quote from one of my employees after overhearing another employee make a complaint and lodge a request about something they wanted to be different. 

There are two important things I want to note right off the cuff. First, I love my team. They work hard and exude our core values. They’re also human and fallible, and there’s healthy friction that ebbs and flows as a function of a strong team of people. Second, I hardcore value candor and feedback (and they’re part of our core values). I would much prefer folks speak up when they’re having an issue or issues rather than keep things to themselves. And when it’s followed up by a way to resolve the complaint? Even better. Not that their proposal is always possible or realistic, but I appreciate people proactively thinking of how to resolve their own problems.

Here’s the catch. When I was starting out as a group practice owner, I relished this. I wanted people to come forward with any issue they had because I wanted to be able to get feedback and adjust systems and processes. I also wanted to make sure they knew they could speak up and wouldn’t be admonished or punished or treated poorly. I wanted (and still want) a healthy flow of communication in all directions. Further still, input from folks who are in the weeds of doing the technical and operations side of things is invaluable. At that time, as both the owner and clinician, I knew my perspective was very unique to both running the practice and being a part of the direct services we provide, so while I trusted my own input, having it either corroborated or disagreed with was helpful, to say the least. 

Even as I shifted out of the technical role and more into the ownership and leadership role, I knew I wanted to be able to stay in touch with the clinician's perspectives. This means, well, candor and feedback. And so the pickle begins. 

Like they tend to do, my business kept growing, changing and evolving. All of which is a good problem to have. The growth, changes, and evolution also lent themselves to new problems. Specifically, feedback.

As much as I initially relished that feedback, I started to grow tired and resentful from hearing things. It began to feel less like helpful feedback about our systems and processes and more like petty frustrations. Worse than that, I became a bottleneck with feedback. I was the person that was stopping things from getting done or being changed.

See, in a lot of cases, it’s not that the feedback wasn’t valuable. It was really that the sheer amount of things required from me was higher and, frankly, I didn’t have the time or inclination to listen attentively and respond accordingly (read: bottleneck). When you’re hungry, it’s hard to think about two little shrimpies when you’ve got a five-pound bass to fry. I needed a whole damn fish. 

Now, I hear you on this and I’ve had the same thought. That’s not fair, Tara. You can’t relish something and then just turn the tables on folks. I know. And I agree. I was requesting candor and feedback and then getting frustrated by the sheer amount of candor and feedback I was getting. On top of that, I was slowing down any changes that actually did need to be made.

Here’s where I take a Jocko Willink approach (think Extreme Ownership). This setup, the one where I was feeling frustrated and resentful of the very people I love and adore because of their input? It was my fault. This was my doing. They hadn’t done much wrong except being forthcoming and invested, so the onus of this was on me. 

For as long as I can remember, I’ve questioned my role in situations. As in, what role did I play in creating this dynamic? And as a business owner and leader in my business, I can think of no other person who is better suited to embrace the extreme ownership mentality. In this situation, I was the person who wanted all the information, but couldn't filter/process/act quickly enough to keep up with it, just like the damn bottleneck of a funnel that’s overloaded. I couldn't get things pumped out quickly enough. 

Recognizing the problem is one thing, but the real question becomes, “how do I fix this?” That’s where the fun begins.

Now, I don’t know the research on this, but anecdotally, I know that lots of business owners operate from a reactionary standpoint. They see a problem and jump right on it so that the problem goes away immediately.

This isn’t helpful.

Short-term? Sure, it can be helpful. Long-term? Not helpful. Unless we use a method to isolate the actual problem and get rid of it for good.

There are two similar (yet distinct) approaches to problem-solving that are worth sharing. Kasey Compton uses something called the PASS Method. Gino Wickman uses something called IDS. They are similar in that they both focus on identifying the actual problem and then attempting to come up with a solution that gets rid of the problem for good. This means taking a “problem” you might be having and then questioning what the root cause or real problem is. 

For example, not having new inquiries for a week is a problem. But what’s the actual problem? Is it technical? A glitch on your contact form, perhaps? Is it marketing-related? Have you decreased your marketing suddenly and are seeing the fallout? Have you hired a new marketing person? Is it a holiday? Is it a norm with your practice that this week is notoriously slow? 

See what I mean? Not having inquiries is a problem, but doesn’t actually tell us what the real problem is. With both the PASS Method and with IDS, we spend time drilling into the actual problem and then coming up with solutions to that. It’s the only way of getting rid of the problem for good. 

Here’s why this matters. I needed to use a framework for figuring out what the problem was when it came to my feeling resentful and frustrated about the what-felt-like incessant feedback. 

If you (or I or anybody else) looked at that at face value, we might immediately say, “they need to stop coming to you.” And yes, maybe that’s accurate, but is the problem that they’re coming to me, or is the problem something else? 

So when I’m drilling down into the problem, my face value problem is that people keep coming to me with feedback, but what about the actual problem? Here are some possibilities: 

  • employees are using me to vent
  • employees don’t feel empowered to solve their own issues (when appropriate)
  • employees don’t know the person to go to with concerns or complaints
  • I haven’t made clear the changes in structure related to feedback
  • I haven’t been clear with my current expectations
  • I haven’t enforced a feedback-goes-here policy
  • I haven’t clearly communicated the feedback process
  • I don’t have a sustainable feedback process
  • I require all people to come through me instead of going elsewhere

From there, I need to identify the most probable root cause and then adjust accordingly. 

And in this specific situation? I didn’t have a sustainable feedback process. 

It was clearly communicated to my employees that they could come to me and I would fix the issues. That worked well when I had time, but not as we kept getting busier and busier. No time, no energy, and no space for additional things to fix. 

I had an Order problem.

This is where we reference the Healthcare Hierarchy of Needs (HHN). Level one, Sales, is all about creating a foundation. Think of it as generating revenue such that your business can actually exist. Level two, Profit, is all about stability. This is where we ensure that we’ll weather a variety of storms. Level three? Well, that’s the Order level. And this is all about creating efficient systems so that your practice can run smoothly and streamlined. 

When I look back at that time (which was pre-HHN), it’s painfully obvious that I had an Order problem. Beyond that, I had a Systemized problem. 

Systemized: Do you have an ongoing and working model to reduce bottlenecks, congestion points, and inefficiencies?

I absolutely did not. I was the damn bottleneck!

As a reminder, we’re always going after our “vital need” with the HHN framework, which is the lowest unmet need within the assessment. This will fall on any of the aforementioned levels, Sales, Profit, or Order. Beyond that, any other unmet need is a “core need.” Both are important, but the “vital need” always takes the cake for focus. We must spend our time there first.

Systemized was my vital need and this meant I needed to create an ongoing and working model to reduce bottlenecks (i.e., me), congestion points, and inefficiencies. I needed to create a new feedback system to remove myself from the fray, and to make sure that feedback went to the most appropriate person.

Here’s my short version to the end of this story: I called a meeting with my most obstinate employee (me) and sat down to flesh out a new system for feedback. The values I knew I wanted to maintain were candor and feedback, so I created something to ensure there was still ample and appropriate opportunities for feedback, including embedding discussions into meetings, funneling certain requests/complaints to the Office Manager, funneling other issues to the Clinical Director, and removing myself from things almost entirely. My ultimate goal is to actually remove myself entirely from being the first filter for employee needs, while also staying engaged with the practice and the people. Although this time, with much less frustration and no building resentment.

Order level, for the win.


Tara Vossenkemper, PhD, is the founder and owner of The Counseling Hub, an accidental group counseling practice in Columbia, Mo. Tara has since stepped into consulting in a more serious capacity, setting out to ensure that practice owners know both what they need to do and how to do it. Tara's favorite consulting-related topics center around tracking, culture, structure, and diagnosing core issues. 

Tara is known for her colorful language (#PuttingItNicely), love of The Office (#USVersion), neuroticism around dashboards (#FormulasAreLife), and hashtags (#AllDay). When she's not in the office, Tara can be found hanging out with her husband and two young sons, probably drinking a glass of red and wishing it was quiet enough to read.

Check out Tara’s professional bio and her practice, The Counseling Hub

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