You work hard day in and day out. You put in the time and the effort needed to build a successful practice. You set goals for yourself and your team. You consistently miss those goals. Why?

First, you’ve got to set yourself up for success from the beginning, using the SMARTER goal-setting process. 

But it can’t stop there.

If you genuinely want to achieve your goals, set milestones and surpass them, you need to have the mindset to do so. To achieve your goals, you must embrace above the line thinking and accountability.

The Danger of Excuses

The Merriam-Webster Dictionary defines an excuse as “an explanation that frees one from fault or blame.” When it comes to achieving goals, nothing could be more dangerous. 

Excuses hold us back and keep us from admitting truths to ourselves and our team members. When a doctor fails to hold team members accountable, and likewise when the doctor does not have someone in their life and their practice that keeps them accountable, we see a culture overflowing with excuses, constantly underperforming, and missing their goals.

In your practice, it might look and sound something like this:

Dr: “I noticed that collections were well below our goal this week. Do you have any idea why?”

Team Member: “It was just really busy; I didn’t have time to collect for all of the appointments. And with the snow, there were a lot of reschedules, and I just couldn’t get it done.”

Dr: “OK, well, let’s do better next week.”

Both parties have failed here. There is no accountability; there is no plan of action the improve; there are simply excuses, and likely, this behavior will continue. 

The above example is exhibiting what is known as below the line behavior. When we dwell in below the line behavior, we do not take accountability for our actions. There is always some external force, some reason, some excuse for why we did not get something done, that we did not hit our milestone. This type of behavior is devastating to progress.

Staying Above The Line

If you want to change this behavior, you must change this mindset; you must stay “above the line.” In contrast to below the line behavior filled with blame and excuses, above the line behavior involves taking ownership, accountability, and responsibility for one’s actions.

When a doctor and his team members stay above the line, hold each other accountable, and the doctor has a mentor or coach to help keep them accountable, progress happens, goals are hit!

The below the line conversation noted above looks quite different from this perspective:

Dr: “I noticed that collections were well below our goal this week. Do you have any idea why?”

Team Member: “I know, it was busy this week, and I realized that I missed collecting for all of the appointments. We also had a lot of reschedules this week with the snowstorm.”

Dr: “So, what is the plan to make that up and get those patients back in.”

Team Member: “I have one hour set aside tomorrow to call all of the patients that I missed collecting from. I already reached out to the patients that canceled and set a reminder for another follow up in one week if I do not hear back from them.”

This is a big difference that will have a big impact.

When we set goals, we have to be willing to hold each other and ourselves accountable for the actions required to meet those goals. When tasks are assigned to team members, leaders need to understand the need to step up and speak up when the team member does not follow through.

Author Craig Groeschel summed this up beautifully when stating, “You can make excuses, or you can make progress, but you cannot make both.”

If you want to hit your goals and achieve progress, everyone in the practice MUST exhibit above the line behavior and embrace accountability. As a leader, if you see team members offering excuses, blame, and denial, ask them, “Now, what would an above-the-line response be here?” 

Get comfortable with this question, and then get ready for progress.