One of the most common frustrations I hear from surgeons is this: “We have so many great ideas, but nothing ever seems to get finished.”
The assumption is usually that the team is resistant to change. In my experience, that’s rarely the problem. More often, they’re overwhelmed by competing priorities.
Every practice has limited operational capacity: the time, attention, and energy your team has to implement change while still taking excellent care of patients. Every new initiative uses some of that capacity. When leaders ask their team to improve ten things at once, even good ideas can stall.
I worked with one practice where this had become a constant source of frustration. The surgeon had plenty of ideas: improve the consultation process, refresh patient education, implement new software, update compensation, redesign forms, and launch a new marketing initiative. The list kept growing. Very little reached the finish line.
So, we did something surprisingly simple. We put up a large board in the office and divided it into three columns: To Do. Doing. Done.
At first, nearly every idea lived in the To Do column. A handful had been started and sat in Doing, but Done was almost empty. That visual made the problem obvious. The practice didn’t have an idea problem. It had a prioritization problem.
Together, we agreed that only a small number of projects could be in Doing at one time. Those were the practice’s priorities until they were fully implemented. As one project moved to Done, another could move to Doing.
Within six months, the board looked completely different. The Done column had grown substantially. More importantly, the practice wasn’t just talking about change anymore, it was experiencing it.
The board didn’t create accountability. It created focus.
The takeaway is not to stop improving. It is to narrow the work in progress so the most important improvements have enough attention to get done.
Good ideas are rarely the limiting factor. Most practices already know what they should improve. The limiting factor is operational capacity.
Every initiative competes for your team’s attention alongside patient care, phone calls, surgeries, follow-up, and the countless responsibilities required to keep a practice running. When everything becomes a priority, nothing truly is.
Shift from asking, “What else should we improve?” to asking, “Which three or four improvements will have the greatest impact over the next 90 days?” Then commit to seeing them through before adding anything new.
For each priority, make sure you can answer five questions:
That last question is the one most often skipped, and it matters most. Accountability is not assigning a project. It is creating a rhythm of follow-up. Without regular check-ins, even important initiatives lose momentum as urgent daily tasks take over. Before long, they are replaced by the next exciting idea, and the cycle begins again.
Make a list of every operational improvement currently underway in your practice.
Then ask:
If the list feels overwhelming, don’t ask what else you should add. Ask what you’re willing to pause.
Protect your team’s operational capacity. Progress isn’t measured by how many projects you start. It’s measured by how many meaningful improvements you finish.
In Your Corner,
Amy
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We’ll learn about your practice, your goals, and your challenges.
Then, we’ll design a proposal tailored to you.
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