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3 mistakes that cause medical practice change initiatives to fail

By Nick Hernandez  bio

Good is rarely good enough, and opportunities for improvement are never lacking. Unfortunately, the success rate of major change initiatives in medical practices is often low due to poor management of the change.

Physician leaders and practice managers should expect and accept disruption and resistance to change, and never lose sight of the fact that costs are high when change efforts go wrong.

The consequences of poorly executed change are not only financial costs, but also lost opportunity, wasted resources, confusion, and diminished morale.

Your change management efforts stand a greater chance of success if you avoid these three common mistakes.

Mistake #1: Failing to clarify and communicate direction

As the saying goes, “culture is everything.”  To effectively manage change, you must consider your practice culture, and thus clarify how the change relates to your practice culture, vision, and goals.

Communication is paramount when trying to raise the level of understanding of why the change is taking place. Employees should be told why the change is taking place, what the change will mean for them, when the change will be happening, how the change will be carried out, what support will be available to help them adjust to the change, and what will be expected of employees as a result of the change.

Over-communicate your goals, direction, and expectations. It’s not enough to send out an email addressing those points. Communication should be regular and should continue over an extended period of time.

Mistake #2: Dismissing staff’s concerns and not encouraging their input

Make change a part of your business and an expectation among staff and providers. Many members of your practice are innovative and eager to contribute their insights and suggestions for improvement. Treat them as a natural part of the process and address resistance by asking for input.

Work with all staff to measure “real” vs. “perceived” disruption. The path of rolling out change is immeasurably smoother if these people are tapped early for input on issues that will affect their jobs.

The goal is to quickly get employees through the denial and resistance stages and on to the commitment phase where you get the buy-in from staff.

Mistake #3: Demanding staff’s compliance instead of requesting commitment

Work on developing commitment from the staff and avoid demanding compliance. People respond to calls to action that engage their hearts as well as their minds, making them feel as if they’re part of something consequential, so make the rational and emotional case for change together.

Your staff’s full-hearted engagement can smooth the way for complex change initiatives, whereas their resistance will make implementation an ongoing challenge. Address any reservations and give some consideration to possibly rewarding initiative. You must either build commitment or prepare for the consequences.


Medical practices must constantly change in order to survive in today’s competitive healthcare arena. Practices should never settle for something that is considered completed; all things can improve with change.

Managing change in an already busy practice environment, however, can be challenging and you may want to consider bringing someone in to help structure the rollout of a project and guide you through key change initiative milestones. When employees who have endured real upheaval and put in significant extra hours for an initiative that was announced with great fanfare see it simply fizzle out, cynicism sets in.

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