The “Aha” Moment: Grasping the Rest of the Five Focusing Steps
The 30-minute break failed to quell Brian’s anger. As they regrouped for the second part of the webcast, he was already seated, reclined slightly in the swivel chair, staring angrily at the ceiling. Joe took one look at his friend with his tightly crossed arms and made a decision. He called Rich and reported his observations. When Rich called the group back, he addressed Brian first. “Brian,” he began, “What’s up? Something’s really bothering you. Want to share?”
The room grew quiet as everyone waited to hear what Brian had to say. They didn’t have to wait long. Brian exploded, “This makes no sense to me whatsoever, Rich. Come on! If I had a $14,000 opportunity to do implants, either my assistant would work the overtime to get it done or we would delay some other, less important work. There’s no way we’d just say, ‘Sorry, we don’t have time to do this.’”
“You’re right, you are absolutely right,” Rich answered, surprising everyone. “What you are describing is that you would make a compromise to try to achieve at least some of your goal.”
“What do you mean by a compromise?” Barb demanded.
Brian added, “Yeah, a little bit of overtime to bring in $14,000 doesn’t sound like a compromise to me!”
“First, remember that it’s not $14,000 that is left in your bank account after paying suppliers. It’s $6,000. Still, that’s a lot of money. What I mean by compromise is that to try to achieve at least part of your goal, you take a win-lose course of action. If you delay something else that was already scheduled, you have a high risk of upsetting another patient. If you demand that your assistant work overtime and your assistant already told you she was at her max, you risk upsetting your assistant. When you win by adding the additional throughput to your practice, someone else loses. Hey, if this happens rarely, who cares? Or you might think, ‘Big deal.’ But if this happens regularly, it can be a big deal. You might lose patients who get tired of being low priority, or you might lose an assistant who gets tired of forfeiting her personal life to your demands. There is a much better way. I didn’t get to three quarters of a million net income by compromising. Will you agree to work through the principles before deciding for yourselves?”
Everyone agreed, listening with interest, and Brian’s face began to relax.
Rich asked, “Brian, in the example we just went through, of course someone could work an extra hour one night. But eventually, don’t you hit a limit?”
Brian agreed and smiled. Rich continued, “Leveraging your business means constantly looking for a win-win solution. There’s nothing wrong with occasionally compromising. But win-win means that everyone is much better off than he or she was before. It means that there is a much better, easier answer and much higher potential in the end. So let’s pick up where we left off and learn the rest of the Five Focusing Steps. Then you’re going to make some decisions about your practice.
“In the exercise we just did, let’s assume the dentist has no choice. His assistant has told him that if he ever asks her to work overtime again, she will quit on the spot. He doesn’t want that to happen because she’s the best assistant he’s ever had. Also, assume that the last time he tried to shuffle a patient’s appointment, the patient got very upset and canceled permanently. The Five Focusing Steps give us a formal way to improve our system.” Rich put a slide up on the screen that listed the Five Focusing Steps.
The Five Focusing Steps
- Identify the system’s constraint (ie, your biggest leverage point).
- Decide how to squeeze the most out of your system’s constraint.
- Make sure everyone, including yourself, follows the above decisions.
- Get more of your system’s constraint.
- If your constraint is overcome in any of the previous steps, go back to step 1.
WARNING: Do not allow inertia to cause a constraint.
“We did step 1, establishing that the system’s constraint is the assistant. Step 2 tells us to decide how to squeeze the most out of the system’s constraint.”
Barb piped up, “Rich, I don’t know where you got this terminology from, but ‘squeezing the most out of someone’ sounds pretty nasty in my counseling profession.”
Rich laughed. “I agree that it sounds like we’re taking advantage of someone in a very negative way, like billing a patient for the full amount and sending the insurance company a claim for the procedure. However, it’s not like that at all. These Five Focusing Steps are done in collaboration, not with high pressure or nasty tactics. When you know you have a resource that is the biggest factor in achieving more of your goal, for heaven’s sake, don’t waste it! Squeeze everything you can out of that resource without hurting it. So knowing that the assistant is the constraint, without having her work overtime, how could we squeeze more out of her in a way that she is not stressed and the whole system benefits?”
Everyone in the room began answering at once. Jen began with, “Get a faster computer.” Joe shouted, “Let the office staff do some of her work.” Barb yelled, “Help her figure out how to set up faster.” Brian laughed, “Order in her lunch every day.”
Rich concurred, “Yes, there is never a shortage of ideas on how to improve. In our example, let’s look at two different suggestions. One idea is to get specialized software that facilitates the implant procedures. This software will cost us $3,000. Almost immediately, we’ll be able to take one step in the impla/>