Lean Practice Management for Physicians

In karate, the colors of the belts are significant:

"The belt colors in karate hold a significant value for the practitioners and for the general public as well. When a person is wearing the karate belt of any color, people perceive that the belt wearer has taken up the specific philosophy and significant function of martial arts, and strives to undertake the challenges of acquiring expertise," says blogger Phillip Goodman. "Even though the person is wearing a white belt, it does not signify his inexperience in the field, but it represents the initiation of his personal drive to acquir[e] that expertise."

There are strong similarities between the karate belt philosophy and other lean management programs that use lean manufacturing principles. Lean strategies started in manufacturing and a number of people claim that the healthcare industry is a different animal. They say manufacturing principles will not work in that environment. I won't dispute that opinion, although I don't agree with it. I believe it’s important to look at the areas of similarities between the two systems.

In lean management programs, there are levels of belts based upon the colors found in karate: white, yellow, green, black, and levels of black. Each "belt" represents a level of training and commitment to the lean philosophy. The people "wearing" the belts have made strides in achieving the goals of lean management.

They've done this by making a commitment to improve patient care in their organization and by recognizing that there is inherent waste in any system. Further, they recognize that the patient comes first - committing to provide a high-value experience to each patient, whether the encounter is in the medical office or other health facility. This commitment to quality will lead to a change in patient care towards an approach focused on improvement, effective communication, and positive outcomes.

A white belt is at the basic level and represents an individual's commitment to begin learning the principles of lean management. The yellow and green belts drill down into more specifics. Those who participate in training at these levels will participate in case studies and have to do a basic project. A black belt represents a person highly skilled in lean philosophy as well as in project management, and who is capable of leading team members of all levels to achieve the practice's goals.

You might ask yourself, "Will I, as the leader of a small medical practice, need to achieve the level of a black belt in lean management?" Probably not. But does the practice need the skills of someone who understands and buys into lean philosophy? Absolutely. Lean principles can be applied to the revenue cycle, management of daily patient flow, facilitating the treatment plan designated by the provider, and everything in between.

I encourage my readers to review literature on lean management, look into training programs to receive certificates of achievement, and more importantly, adopt the lean philosophy. Those who receive belt certification can look upon their accomplishments with pride, knowing they put in the effort to gain personal knowledge and help lead their practice in the direction of improvement. For many, this can lead to the ultimate goal of improving patient experiences and outcomes.