Collaborative co-diagnosis
Collaborative co-diagnosis
by Deb Castillo
The new person experience is a collaborative process. Deb Castillo wrote this article about her business of consulting. Think about the co-diagnosis process as consulting with a patient about their dental health. Bob Barkley and Carl Rogers are probably chuckling with pleasure about how their work is being applied.
Consulting as a collaborative process
I have grown to see successful consulting as a collaborative process. At the start of my consulting career I saw my self as a change agent. One who would and could “unfreeze” non-working systems or behaviors of a practice and then teach and defreeze” new more effective behaviors to create a steady productive environment. The skills necessary for me to be effective were:
- Proper diagnosis
- Training
- Implementation
- Feedback
The flaw in seeing consulting in this light is that I, as the Super Consultant, really did not have control! There are no levers I can push, no switches I can throw …to shift and change behaviors in a lasting manner. The longer I continued to hold onto this belief – the more I would set my client, the practice and myself up for failure. I had to find another way -another conclusion. I have come to believe that success does not always beget success – often failure is the greater stimuli for success.
What I seemed to find as I worked with my practices is that the key to my success as a consultant was dependent on paying attention to what “enlivens” the people involved!What excites and engages those that are in the practice so that they make the commitment to change? So what skills are necessary here? What did I have to learn so that my clients would make me look good?
- Learn to perturb and disturb the status quo—make those involved uncomfortable with their current reality.
- Learn to be enough like those with whom I am working with to be accepted by the group and, therefore, credible.
- Learn to be enough unlike those with whom I am working with to bring a different perspective and different opinion: a different point of view.
If my goal is to unleash the full potential of those with whom I am working, then I must master the four D’s:
- Develop the relationship
- Discover the assumptions
- Design the structure
- Deploy the follow up
Develop the relationship
This involves building trust and understanding with the client(s) (define this as the one who pays the bill) and also with all the individuals in the group who will be responsible for the success of the practice.
Discover the assumptions
Discovery is both the discovery that leads me to certain first assumptions (probably the only thing that I do that requires expertise in my field) and the creation of a discovery process that allows everyone involved to see what, up until now, has been invisible: the barriers to success but more important the talent and potential of the people involved.
My job is to discover the objectives to be achieved, the strengths that we have available to accomplish these goals, the opportunities we can take advantage of and the current barriers and the problems or challenges we need to overcome in order to change the current reality. My role is primarily to get the staff engaged – it is not so much to determine what the problems are because usually the doctor and staff know what the problems are.
In fact, I enter the practice with the assumption that those who are intimately involved in the practice know more about this particular practice than I do. I usually am correct. What I am asked to do is create a climate where we can create a desire to work interdependently in the pursuit of a common cause.
Design the structure
It is my belief that structure supports behavior and behavior determines results. That said, I bring my expertise to the situation to design a system that supports collaborative effort so that the players in the system not only accept the problems but also will accept the responsibility for the outcomes.
I know if the solution is perceived as my idea alone, then no one has a vested interest in seeing it succeed but me! Because this doesn’t work automatically, it is essential that ways are found to gain the participation of the whole group such as:
- Creating effective morning huddles
- Having meaningful staff meetings
- Collaborating in the designing and implementation and evaluation of the effectiveness of systems in the practice
- Sharing key numbers, not just those that measure the performance of the practice but also the cost of doing business. What good is knowing the production per patient if I can’t compare it to the cost per patient? I can’t possibly know if what I am achieving is going toward or away from profitability unless I can compare the two.
- When training is necessary, know who is the most appropriate trainer: is it me, is it the doctor, is it the supply rep, or is it the team member who will be most effected by the successful training of another on the team?
Deploy the follow up
I have found that all of the “4 D’s” are critical but one of the most often overlooked is a prescribed method of follow-up. It is far too optimistic to assume that a well- designed change effort will consistently happen without implementing a follow-up. This follow-up must be part of the system or procedure that will need to happen to see the goals and objectives take place.
Sometimes the follow up is watching the resulting outcomes and if they are not as expected, evaluating the implementation of the newly designed systems. More effective is incorporating in the new procedure or system a feedback measure that insures implementation and can reveal the lack of commitment to follow through.
Did you see the movie “A Beautiful Mind?” Do you remember the theory that Russell Crow’s character John Nash disproved that got him the Nobel Prize? Adam Smith said that individual competition promotes the highest achievement. John Nash discovered that if everyone is working only for their individual goals, they tend to cancel out the abilities of others. It was his discovery that the way to maximum achievement is to develop a strategy that works to meet the needs of the individual and that serves the needs of the group.
My discovery has been that my success is totally dependent on finding a way to energize and encourage a learning culture within the dental practice and a culture in which the individuals involved accept responsibility for outcomes. It is the challenge of a lifetime that requires a commitment from me for continual learning if I am to achieve my goal: to celebrate with our clients as they reach and exceed their goals for professional and personal success.
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
