�         If a group practice, all the doctors are on board to work with a coach.

�         They agree on and support the changes they want to see happen.

�         On a scale of 1 to 10 with 10 being high they rank at least an 8 or above on importance for changes to happen.

�         They are willing to hold themselves and the team accountable by following thru with the agreed upon consequences.

�         They believe this is about enhancing the entire team's performance including them.  They are open, enthusiastic and on board to grow and change as well.

Step One:

Establish a clear vision of what you or if a group practice, what the group wants to achieve. What does it look and feel like?  Define even the smallest of details.  What is your purpose?  Why is it important to for you to have it this way?  It is important to be clear and confident.  People will only follow someone who is confident and knows where they want to go and what they want to achieve.

Step Two: 

Get the right crew on your boat.  Do you currently have the right crew on your boat?  So many offices, so much drama, so much pain many times over just one person!  Together as a team establish a standard of attitude and behavior.  What does it look, sound and feel like?  How will you interact with each other and your patients?  What is appropriate and what is not. 

Step Three:

Lead by example.  It is one of the most important steps in sustaining change.  Everything really does come from the top down.  Set standards and don't allow double standards.  Live and maintain those standards.  If you want your team's focus to be what's in the best interests of the patients and the practice, yours must be as well.  Remember actions speak louder than words. 

Step Four:

Create a systematic approach to all tasks and responsibilities that you would like to grow and change.  Together as a team practice verbal skills, role playing and the entire walk through before implementing it with your patients.  Team meetings are an excellent way to introduce and implement new ideas, systems or protocols.  Introduce one idea at a time and go deep and resolve instead of a data dump of many unresolved ideas that have to be revisited.  Even if you accomplish only one item per monthly meeting you will have accomplished twelve new ideas, systems or protocols per year. 

Step Five:

Establish accountability and consequences. 

Accountability starts with everyone being equally accountable to the ideas, systems, protocols and standards that were set.  No double standards for anyone including the doctor or manager or you divide the team.  Develop a protocol of consequences for when there is a lack of accountability.    

The reality is that to change we must go through a transformation zone.  It's not easy being in transformation.  Thoughts, beliefs and habits are changing.  It can create a sense of groundlessness and uneasiness.  When we're in the transformation, our first impulse will be to revert to old habits because they feel comfortable.  Our goal is to hang in there until the change is complete.  Knowing that transformations are part of the change process can help us have the courage to overcome the discomfort and the uneasiness.

In the end, change requires letting go of what we've always known and done to allow in something new.