The simplest fact is practice harmony is required for human resources to be satisfied. Each of the foundation elements of the practice values and operations are like footings on a building. If one starts to deteriorate, the building becomes unstable. If the ownership has already conveyed the message by example, in the four basic areas, and the elements are dependable in all the areas, then the team exercise to develop the foundation elements are unneeded. Look at these elements and assess if your practice has solid and dependable footings:

 Vision: How are we planning to differentiate ourselves and our practice in this community? Does it make the staff proud to be part of it? Where will this vision take our practice during the next five to ten years?

 Core Values: What are the inviolate core values of the practice, such as expectations, behavior, performance, etc., on which staff members can use to make unilateral decisions for the good of clients, patients, staff, and practice welfare, and not ever catch the wrath of the owner? If there is an exception, it is not a core value.

 Standards of Care: What wellness and protocol items are consistent between all providers, so staff can be veterinary extenders and clients are not confused with variances in "hospital protocols" between providers? Continuity of care is not only possible in this environment, it is a natural outcome!

 Mission Focus: How do we apply our philosophy of practice and mission statement to each program and activity we attempt or maintain? And if someone violates any one of these four basic factors, is our mission focus such that anyone can call for an immediate evening meeting to ensure it does not continue?

As any team member can see, as well as ownership and any "prima donna" doctors, there is an immediate consequence for anyone who varies from these four footings of vision, inviolate core values, consistent standards of care, and mission focus. Unstable practices do not survive, and the work place is never harmonious. In practices, harmony must be a term of employment, and fracturing that behavior expectation is terms for immediate discharge for cause.

Cowboy says: When he calls your bluff, it's time to look at your hole card again.
Consultant says: When you say you are the best, look at what you are measuring.

When we assess these key "footings" of vision, inviolate core values, consistent standards of care, and mission focus, which keep the practice stable and running smoother than most, there are major indicators for the leadership to address, including, but not limited to:

 Doctor-centered healthcare delivery must shift to client-centered service.

 The phrases "recommend", "should", and "options include" in veterinary healthcare delivery nomenclature must be replaced by "deserve" and "need" terminology.

 Patient advocacy, and sharing "needs" must replace wallet medicine. To consider anything less than quality performance in veterinary healthcare delivery seems unthinkable. Core values in veterinary healthcare delivery must become inviolate.

 The future of a veterinary practice manager is directly related to the hospital director's desire to let go of the control.

 Computer phobia will not be allowed in the new millennium, and e-business will be required by 2015.

 In the next twenty-five years, there will be three stages in the adoption of computer-based e-health technologies and applications:

 Early: Static presentation of information, with direct automation of existing processes.

 Mid-Stage: Delivery process changes combined with more advanced technological support.

 Advanced: Integration of veterinary healthcare delivery processes and technologies.

 Distance learning must become an expectation in every practice setting, regardless of facility size or staffing levels.

 There are three key elements for any person working in the veterinary practice of the future:

 Team fit or harmony.

 Competency.

 Productivity.

 There are three key elements for any leader who works in a healthcare delivery or other team-based environment:

 Respect.

 Responsibility.

 Recognition.

 The traditional habit of all staff doing all things inside a single practice setting must give way to veterinary practices that develop minimum levels of training for each staff group or each zone, as described in later chapters. This will ensure meaningful career progression.

Cowboy says: Anyone kin look tall when surrounded by shorties.
Consultant says: Quality is relative only to the next comparison.

Innovation is the Rule in Meaningful Recognition

It is not that a leader does not have great ideas, but a great leader lets the team enhance those ideas until they become theirs. The leader of tomorrow creates the environment that nurtures change. The vision and values brought to bear by the veterinary leaders of tomorrow will be centered on client needs and rapid response to those needs (SCR*). The great leaders cause conversation and feedback in this new open environment. They use all the brains available to resolve a problem (PCA*). Change becomes the expectation (JDI*). Creative chaos is the standard used to measure innovation and creativity (OI*). Together they become continuous quality improvement (CQI*). Create chaos and you can control it. Allow someone else to create it and you can only react to it. The choice is yours!

Use the following acronyms for new perspectives:
Client Focus: Service-Client-Response (SCR)
Systems Controlled, Outcome Vision, Job Redesign: Operational Innovation (OI)
Bias for Action at Staff Level: Just do it! (JDI)
Uncommonly Led: Problem-Change-Activities (PCA)

Final Thoughts
Successful Strategic Assessment Is Essential for Leadership
Rapid Strategic Response is Essential for Practice Growth
A Vision Without a Roadmap Is Just a Dream.
What Gets Rewarded Gets Done!
If it is to be, it is up to me!
JUST DO IT!