Achieving Medical Practice Goals for 2015

December is a time when many of us begin to evaluate the past year. It is often a frustrating exercise because we are dissatisfied with the year's results. Rather than looking back, use December to set yourself up to accomplish meaningful goals in 2015.

The nine step process is the same for both personal and professional arenas, as well as for individuals and groups. Let's take a medical practice as an example.

1. Evaluate the status quo.

What do you want to maintain and what must change? Be specific. Free-floating anxiety and general discontent do not provide actionable information. What threats are immediate or looming? What are the potential opportunities that could be exploited?

2. What are your long-term goals?

Review your mission, vision, and values; whether personal or professional. They can change in response to circumstances. What is your ideal situation or outcome? Your ideal may be temporarily or permanently out of reach. That's OK. The point is to make conscious decisions over time that move you as close to your goals as possible.

3. What must be accomplished in 2015?

The initial list is likely to be long. Shorten it by being brutal in distinguishing between what is absolutely required, what the conventional wisdom says is required, but is not, and what you would really like to have happen. For instance, unless there is yet another postponement, ICD-10 is a must; an EHR is still optional; and a shorter workweek with the same or more income would be really good.

There is a psychic benefit to making sure that only the truly required goals survive on the "must do" list. It makes it clear that you are not entirely at the mercy of external forces; you have more autonomy than may be generally apparent. The practical benefit is that the must-do items are clearly articulated and will not get lost in the shuffle.

4. What would be nice to accomplish in 2015?

Do not try to keep this list short. Give yourself permission to dream. Not everything on this list will actually be pursued in 2015. You may be surprised, however, at how many of these items can be addressed as ancillary benefits of other projects.

5. Rank the objectives according to priority.

Everything on the must-do list has a priority of "1" and is non-negotiable. Everything on the "nice to accomplish" list has a priority of "2" or lower.

6. Allocate resources and build timelines.

Beginning with the highest-priority objective, allocate resources and build timelines.  Resource allocation has two aspects: what and when. Without seeing the flow of projects throughout the year, it is typical to feel overwhelmed and respond as if everything has to be tackled simultaneously.

A good schedule can also demonstrate that the plans for the year are too aggressive. In that situation, the plans need to be scaled back or current resources must be augmented. When a project or activity is scheduled for August you can, for the most part, ignore it earlier in the year.

7. Include goals and completion dates in the timelines.

Some project managers like to track percent completion.  I think it is a terrible idea, because percent completion is subjective. It is much more effective to have a specific goal tied to a specific date. The objective is met on time or it is not.

For example, rather than saying, "70 percent of paper patient files will be scanned and indexed before the fourth quarter," say, "All paper patient files for patients whose last names begin with A through S will be scanned and indexed by Sept. 30."

8. Monitor progress and make adjustments.

There is nothing magic about timelines and checkpoints. They are simply tools that make it clear when a project may be in trouble. They also make available options for adjustments more obvious when the timelines for multiple projects are combined.

If you get to Sept. 1 and have only scanned and indexed the paper patient files for patients whose last names begin with A through F, you may have a problem. Once it becomes clear that you won't make the Sept. 30 deadline, it's time to allocate more resources or adjust the time line.

9. In December 2015, enjoy the solid record of what you will have accomplished; congratulate yourself; and repeat the process for 2016.

Following the described process ensures that your end-of-year review of 2015 will be satisfying. The documentation will assure you that the most important issues were successfully addressed. It will remind you of all sorts of good things that were accomplished. If you did it right, you will also understand that there was a conscious decision or immutable constraint that kept other projects from being addressed and accomplished.

The point of the exercise is to look forward and ensure both an optimal allocation of resources and meaningful progress. The extra energy and satisfaction that come from being successful and in control are bonuses.