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The Most Expensive Meeting in Healthcare Is Probably Useless · The Operator | Healthcare Business

0:01
All right, this one feels personal.
0:03
Most healthcare organizations have an all
0:06
hands meeting.
0:07
I've been to one, you've been to one.
0:09
The CEO comes on, smiling,
0:11
gives an update.
0:12
The CFO comes in, spreadsheets and graphs,
0:15
gives numbers.
0:17
And then a few carefully selected
0:18
questions get answered.
0:20
Hopefully.
0:21
Then everybody logs off and claps.
0:23
The leadership calls it communication
0:25
because you say it's done.
0:27
But on the operator,
0:28
the latest article makes a pretty
0:29
uncomfortable argument.
0:31
The all hands has the largest audience in
0:35
the company,
0:36
but maybe often produces the least
0:38
learning.
0:39
Because when leadership spends an hour
0:41
talking and five minutes listening,
0:44
the platform, everybody else,
0:46
learns almost nothing about itself.
0:48
So...
0:49
Larry, let's start there.
0:51
How'd the all hands become a broadcast
0:55
instead of a conversation?
0:56
More one way and less two way.
1:01
Over time.
1:02
It didn't happen in one bad decision.
1:05
And that's the thing people probably get
1:07
wrong.
1:07
I mean,
1:07
nobody ever stands up in a meeting and
1:09
says, you know,
1:10
let's make this quarters all hands safer
1:13
and more boring, right?
1:14
What they say is let's make it more
1:16
focused, more polished, more on message,
1:18
more on point.
1:20
And every one of those words is the
1:21
same word, just wearing a different suit,
1:24
right?
1:25
So it happens sort of one safe decision
1:28
at a time.
1:28
The gravitational pull is toward a real
1:31
curated, professionalized version,
1:34
when that's exactly what you don't want on
1:36
these kind of meetings,
1:37
pre-screened questions,
1:40
slightly less likely to surface the real
1:43
hard questions if they're pre-screened.
1:45
I mean, people are scared of them, right?
1:48
And none of those feels like sort of
1:49
corruption in the moment.
1:52
Each one is responsible again over time.
1:55
But within about, I don't know,
1:56
a couple of years, a few quarters,
1:58
the meeting that's supposed to be the
1:59
platform's most open conversation has
2:03
become quarterly press conference.
2:04
And the best analogy is like during COVID,
2:08
Many companies went to daily, weekly,
2:10
multiple times a week,
2:12
all hands on deck type meetings.
2:14
And they were very transparent and
2:17
vulnerable.
2:18
And then when we sort of went back
2:21
to doing them quarterly, it changed.
2:25
And that's not just a health care problem.
2:26
It's a gravity problem.
2:28
I mean, look at Google.
2:29
They invented the meeting, TGIF.
2:31
Fifty percent of it was live Q&A.
2:34
you know you could ask anything and google
2:36
couldn't keep it alive and if they
2:38
couldn't who could right so the company
2:41
you know they built the model and yet
2:43
they had the gravitational pull and so the
2:45
average multi-site you know healthcare or
2:48
dental platform is not going to resist it
2:51
you know just by accident
2:53
But the exact moment it tips is
2:55
identifiable.
2:56
It's the prep meeting where somebody says,
2:58
why don't we just collect the questions
3:00
ahead of time so we can be ready?
3:03
This happened in our Q&A meeting the other
3:05
day.
3:06
We didn't allocate enough time.
3:08
and by the time we got to q
3:10
a we had gone through the powerpoint deck
3:13
and it was very very frustrating for me
3:15
and i'm like you know okay so i
3:17
put the meeting through my you know ai
3:19
generator to tell me what went wrong in
3:20
all hands and you know here i am
3:22
trying to preach it but it's so easy
3:24
to default into an incorrect way of doing
3:27
the meeting and and that's what i'm that's
3:29
why i'm writing about these
3:31
Will you start this article off on your
3:34
Substack, the operator,
3:35
from the other side of the spectrum,
3:37
from the other side of the camera,
3:38
from the viewing angle,
3:40
in the perspective of a dental hygienist,
3:42
sitting through one of these meetings,
3:45
hearing the numbers, all the updates,
3:47
all the growth,
3:48
while she's or he doing something,
3:51
doing the actual work or charting or doing
3:52
some other things,
3:54
but they're hearing none of the answers
3:57
she actually cares about.
3:59
Why is that the right place to start?
4:04
yeah so um the entire failure you know
4:09
the open you know the all hands-on is
4:13
really invisible to the ceo um or this
4:17
you know executive team but it's
4:19
completely obvious for those that are in
4:21
operatory four if you're a dental
4:23
hygienist for example or in the clinic if
4:26
you're a technician or a physical
4:27
therapist
4:28
You know, from the stage, the CEO,
4:31
we think it's a triumph,
4:32
but that eight hundred people attended at
4:35
the meeting ended at a time that the
4:37
slides look professional.
4:39
Every dashboard says it worked.
4:40
But from the operatory,
4:42
from the PT clinic,
4:44
they see a meeting that answered exactly
4:47
one or, you know,
4:49
they answered none of the questions that
4:50
they really walked into the room with.
4:52
And oftentimes what you find is the people
4:53
that attend these meetings are your folks
4:55
in your back office,
4:56
not the people who you really want to
4:58
hear,
4:58
which those are your frontline clinicians.
5:02
And so they just stopped attending because
5:03
they feel it's a waste of time.
5:06
And when we take attendance,
5:07
we look at numbers,
5:08
but not the people on the front lines.
5:11
So every instinctively,
5:12
every operator reads the company from the
5:14
top down,
5:15
but the whole argument of this series,
5:17
the entire basis is the truth lives on
5:20
the floor.
5:21
If you can't feel the meeting from the
5:23
operatory, from the clinic,
5:25
from the back room of seeing a patient,
5:28
you can't fix it in the boardroom.
5:31
And you'll keep optimizing the things that
5:33
most people have tuned out on.
5:37
And notice that the two questions that the
5:41
hygienist, for example, wants to know,
5:43
her pay and a person she cares about,
5:46
such as her coworker or best friend,
5:49
the people that people actually talk about
5:51
at work, compensation and colleagues,
5:53
right?
5:53
That's what people talk about at work.
5:55
Never,
5:56
ever do any of them make it to
5:58
one of the slides in your deck,
5:59
and they should.
6:00
And so you have to be intentional about,
6:03
you know,
6:03
I want to start out this meeting by
6:04
talking about this clinician and that
6:06
clinician.
6:07
That's what you should be talking about,
6:08
not your volumes and not your EBITDA,
6:11
right?
6:12
So we build, you know,
6:13
an hour or half hour long meeting about
6:15
the company and systematically leave out
6:17
the only two subjects that everybody who's
6:19
on the front floor wants to talk about,
6:21
their compensation, their benefits,
6:23
and their coworkers.
6:24
I've been at large enough organizations.
6:25
Someone asks that question.
6:27
They quietly get shushed out of the room.
7:09
I've been at organizations that you're
7:11
describing where if someone from the
7:13
audience,
7:13
if the hygienist or the physical therapist
7:16
were to ask questions about colleagues or
7:17
compensation,
7:20
I've seen this happen.
7:21
You get a polite answer, non-answer.
7:23
Then that question is moved on.
7:25
We move quickly on.
7:26
And then in the background,
7:27
there's find out who that was,
7:29
who their manager is.
7:30
We got to have a talk with them.
7:31
So the people in the audience understand
7:34
after very, very quickly, like you said,
7:36
faster than the leadership team,
7:38
what this is and what this isn't.
7:41
So you wrote that at all hands is
7:43
actually supposed to be the moment when
7:45
the platform talks to itself and
7:48
So what's the all hands goal?
7:50
How do you know if you've succeeded?
7:51
Because eight to eight hundred people,
7:53
you know,
7:54
attending is not it should not be the
7:55
goal.
7:56
Cannot be the goal.
7:57
Correct.
7:58
It is the one venue in the entire
8:00
operating meeting stack,
8:02
as I've been calling it,
8:03
where the floor meets the leadership at
8:05
scale, at volume,
8:07
at ubiquity with everybody participating.
8:10
Think about how information normally moves
8:13
in a hierarchy or a platform.
8:15
It's filtered, right?
8:16
It goes up through the site leads,
8:18
through the regionals,
8:19
through kind of whatever clinical
8:21
hierarchy you have, the clinic director,
8:23
team manager, etc.
8:24
and every layer sands the edges off.
8:26
By the time it reaches the top,
8:28
it's a summary of a summary of a
8:30
summary.
8:31
The all hands is the one moment
8:33
that filtering is supposed to be removed.
8:37
Eight hundred people get an honest look at
8:39
the people running the company and those
8:41
people get an honest look back.
8:42
So counterintuitively,
8:44
the more professional that you look,
8:46
unless you act that way,
8:48
twenty four seven,
8:48
I don't know anybody that does,
8:50
the more disingenuous you're going to come
8:53
off.
8:53
And when it works,
8:55
when you show vulnerability,
8:57
when you answer questions honestly and
9:00
admit you don't know things,
9:02
it's the single highest leverage hour that
9:04
you've spent on your operating calendar.
9:06
I'm speaking from a CEO or an operator
9:08
perspective.
9:09
There's no other moment where the entire
9:11
nervous system over the organization is
9:14
assembled at one place and at one time.
9:17
When it doesn't work,
9:19
It's the most expensive meeting you can
9:22
ever imagine.
9:24
Because you're spending an hour,
9:26
the whole platform's attention,
9:28
which is the scarcest resource that you
9:31
own.
9:31
It's the only thing you produce is a,
9:34
if the only thing you produce is a
9:35
CEO or CFO update,
9:37
everyone could read that in an email in
9:40
about four minutes.
9:41
Or the way I like to communicate those
9:43
things is by Loom or video.
9:45
So they don't have to read anything.
9:47
If they could have listened to a
9:49
two-minute video of me,
9:52
that should not be what I have in
9:54
the all-hands meeting, right?
9:56
And I tell operators,
9:58
this is the one-hour quarter you can feel
9:59
the whole body at once.
10:02
Most of them used to take the body's
10:04
temperature with a slide deck and never
10:07
actually touch anything.
10:08
the patient.
10:09
Yeah.
10:10
And so you have to think of it.
10:12
These are clinicians working on patients.
10:14
You have to be management working with
10:17
your clinicians and you have to think more
10:20
in a clinical realm than in a
10:22
professionalized business sense.
10:26
Yep.
10:26
You brought in cost as well.
10:28
I was I was taught early, you know,
10:30
I needed permission at one of my jobs
10:32
to spend more than a thousand dollars,
10:34
but I didn't need any permission to waste
10:36
twenty five people's time.
10:37
for an hour.
10:38
When you start looking platform wide,
10:40
eight hundred people's time for one hour,
10:42
everything stops.
10:43
Nothing's being produced.
10:44
It's an opportunity for waste or success
10:47
or connection.
10:48
So that was one of the strongest lines
10:49
I thought in the article.
10:51
The platform learned nothing about itself.
10:53
So how can eight hundred employees attend
10:57
a meeting and the organization just
10:58
doesn't learn anything?
11:02
Yeah, I mean, you know, there's math here,
11:04
right?
11:04
Eight hundred people times an hour of
11:06
salary equals one big expense.
11:09
Yeah.
11:09
And in some ways it's actually worse than
11:12
that framing.
11:13
It's not just an hour of salary.
11:14
It's an hour of the entire platform's
11:16
attention and attention and trust.
11:19
And it's more expensive than payroll
11:21
because you can't get it back and you
11:23
can't stockpile it.
11:25
Here's how you produce nothing with it.
11:27
You design the meeting to flow in one
11:28
direction.
11:29
Slides go out, nothing comes back.
11:31
And an organization only learns something
11:33
when information travels up.
11:35
When a question gets asked that leadership
11:36
didn't already know the answer to.
11:38
That's the entire mechanism.
11:40
That's the learning.
11:42
And now look at what pre-screened Q&A
11:44
does.
11:45
The question about compensation gets,
11:47
well,
11:47
we annually do a compensation survey and
11:50
we look at the market and everything is
11:53
vetted to be comfortably answered,
11:56
which means it was vetted to contain
11:58
nothing leadership didn't already know.
12:00
So by design,
12:02
nothing crosses from the floor to the top.
12:04
You've engineered their learning out of
12:06
the meeting.
12:07
and you've kept the attendance.
12:08
Eight hundred people showed up.
12:10
Participation could have even been a
12:12
hundred percent.
12:13
Learning was zero.
12:15
And the CEO measures the thing by
12:17
attendance and runtime.
12:18
The two numbers that have absolutely
12:20
nothing to do with whether anybody
12:22
actually learned anything.
12:24
It's a green dashboard,
12:25
but a dead meeting.
12:26
Now, what some organizations do,
12:28
it's very difficult for a multi-site
12:30
provider because you can do it at lunch,
12:31
but people have clinic during lunch.
12:33
You can do it early.
12:33
It's going to eliminate some.
12:35
You can do it after hours.
12:36
Some people want to be paid for it.
12:38
If you're going to invest that much money,
12:40
you want participation,
12:41
but you want active participation,
12:43
not eyeballs.
12:44
You're not streaming video.
12:46
You're streaming across exchanged in a
12:51
conversation.
12:52
And that's what the all-hands meeting
12:53
should be called.
12:54
It should be an all-hands conversation.
12:57
You identify three potential failures.
13:01
This is what people like.
13:02
This felt a little like, you know,
13:04
pick your poison.
13:05
EBITDA theater, the pre-screened Q&A,
13:08
which you've mentioned a couple times,
13:10
and then audience mismatch,
13:12
either clinical operations and mashing the
13:13
two.
13:14
Which one's doing the most damage in
13:17
healthcare today,
13:18
or is it sort of just a little
13:19
bit of all three?
13:21
Yeah.
13:22
So the way I think about it,
13:23
EBITDA theater is the most common and
13:24
that's ridiculous because your folks don't
13:26
even know what EBITDA means.
13:28
And most of the people on executive teams
13:29
don't really know what EBITDA means.
13:31
The audience mismatch is probably sort of
13:34
the most structural,
13:34
but the one that's the most damage in
13:36
my opinion is the pre-screen Q&A.
13:39
It does the most damage.
13:41
And let me be sort of precise,
13:43
which is sort of the whole point of
13:44
the article.
13:45
I rank these by what they cost you.
13:47
EBITDA theater costs you attention.
13:49
You bore them.
13:50
You bore them with same-store comp.
13:53
You bore them with phrases that have never
13:56
been spoken between clinicians in the
13:58
history of the company, right?
14:00
The audience mismatch causes you
14:02
relevance.
14:03
You try to serve operators and clinicians
14:06
together in one shapeless agenda,
14:09
and they end up serving sort of neither.
14:10
But the pre-screening costs you belief,
14:14
right?
14:15
Okay, audience is damaging,
14:19
the mismatch costs you attention,
14:22
the pre-screen costs you belief and trust,
14:25
because when you stage a question,
14:27
you answer that,
14:28
it's effectively a press conference.
14:31
The floor is not full,
14:32
they know exactly what they just watched,
14:34
and it teaches them that something is
14:36
permanent,
14:37
that this venue has been engineered
14:39
to prevent a real exchanges.
14:41
It also does a damage from what I've
14:43
talked about before,
14:44
which is psychological safety.
14:46
Is this a place where I am safe
14:48
bringing things up?
14:50
And when you get pre-screened answers,
14:53
the feedback you get is no,
14:55
I'm asking a question,
14:56
I'm at a press conference,
14:57
I'm not seeing vulnerability,
14:59
I'm not seeing trust,
15:00
all I'm seeing is pre-screening.
15:03
And it's boring and you don't recover from
15:06
that.
15:08
Irrelevance,
15:09
you can fix over time in a segmentation.
15:12
Cynicism, you do not get back.
15:14
Lack of trust, you do not get back.
15:15
Psychological safety is too hard to build.
15:18
And once the floor decides that the
15:19
meeting isn't real, it's inauthentic,
15:21
they stop bringing you anything.
15:23
It's not an all-hands meeting anymore.
15:27
It just isn't.
15:28
And so you've trained the whole
15:29
organization to really stop talking to
15:31
you.
15:32
That's the most expensive outcome on the
15:34
list.
15:35
Yeah.
15:35
Well, you stuck on that for a while,
15:36
that pre-screened Q&A section.
15:40
You basically argued like you just did
15:42
there.
15:42
Many organizations have created that
15:43
appearance of openness while carefully
15:46
preventing anything uncomfortable
15:48
happening.
15:48
And it has that negative effect.
15:52
That feels like it's even worse than
15:54
having no Q&A at all.
15:55
We can get to that mathematical formula,
15:57
which you actually say there is at least
15:59
a guideline of.
16:00
So why is this fake one, fake Q,
16:03
pre-screened Q&A worse than having nothing
16:06
at all?
16:07
Yeah, and Jimmy,
16:08
you've been on the comp side,
16:09
so you already know where the room gets
16:11
built and where it's framed.
16:13
It's just deceiving, right?
16:17
And you're trying to protect the principal
16:19
here.
16:20
You're trying to protect the CEO and the
16:21
executive team.
16:23
And you want to make sure that everybody's
16:24
not blindsided.
16:26
Everyone in the room thinks they're doing
16:27
their job, and they are.
16:29
But here's why it's worse than nothing.
16:31
No Q&A...
16:33
is just an omission.
16:35
There's no Q&A.
16:36
Everybody knows there's no Q&A.
16:38
Nobody's pretending otherwise.
16:39
It's honest by just being present.
16:42
The pre-screened Q&A manufactured
16:46
appearance of openness,
16:48
specifically engineered to prevent the
16:50
openness that it's advertising.
16:52
Okay,
16:52
so one thing is not having any Q&A.
16:53
That's just an omission.
16:54
Pre-screened is actual damage.
16:56
It's the absence of something.
16:58
It's counterfeit.
17:00
The tell is in one sentence.
17:02
The CEO never says, he never says,
17:04
I don't know.
17:04
He never says that's a fair criticism.
17:06
He said, I hadn't thought about that way.
17:08
He's never shown any sense of
17:10
vulnerability.
17:11
That's not a conversation.
17:15
It's man reading.
17:17
a room and responding to a curated input
17:20
stream.
17:20
And the part that's unfair to the comms
17:23
team, to folks like you,
17:24
is that nobody in that prep room is
17:26
assigned to represent the floor,
17:28
to represent the commission.
17:29
Everybody's representing the CEO.
17:32
They're kowtowing to the CEO.
17:33
So, of course,
17:35
the meeting comes out optimized for one
17:37
person in a building of about eight
17:39
hundred.
17:41
Yep.
17:42
One thing I kept thinking when I was
17:44
reading this,
17:44
I jotted this down was
17:47
What do leaders actually want?
17:49
If everyone's just there to support the
17:51
CEO from the production side,
17:54
what do leaders actually want?
17:56
What are they looking for?
17:57
Do they want feedback or do they want
18:00
confirmation?
18:01
Because your article suggests those two
18:03
things are very different things.
18:08
No, it's great.
18:09
I think what they really want, Jimmy,
18:11
is honesty.
18:13
They want, most want really, you know,
18:16
confirmation.
18:17
A few want, you know,
18:18
a few people just want airtime, right?
18:20
And generally, you know,
18:22
there's those that want feedback.
18:24
And the beautiful thing is that you can
18:25
tell which one you're dealing with inside.
18:28
You know,
18:29
I would say within about the first ninety
18:30
seconds of a real Q&A, you know,
18:33
but watch what happens when a hard
18:35
question lands.
18:36
And I've been in this seat before.
18:38
The leader who wants feedback leans in.
18:41
They get visibly curious or interested,
18:44
you know,
18:44
because a real question is the most useful
18:47
thing that can that's happened all hour.
18:49
So it's exciting.
18:50
And the leader who wants confirmation gets
18:52
defensive.
18:53
Or worse, they demur.
18:55
Or my favorite is they say, well,
18:57
I'll flip that over to HR.
18:58
I'll flip that over to our general legal
19:00
leader.
19:01
Or one of the lines that you like,
19:02
but we'll talk about it offline.
19:04
Yeah, we'll talk about it offline.
19:06
I mean,
19:06
the question I put to operators is simple,
19:08
and it also makes them squirm.
19:11
When's the last time somebody changed your
19:14
mind in a meeting?
19:16
It's a mentoring question I ask.
19:18
When did you admit that the data that
19:21
you were feeling or seeing, inculcating,
19:26
conflicted with what people were telling
19:29
you and you literally changed your mind?
19:32
If you can't relate to a specific
19:34
instance,
19:35
you haven't run into the very
19:37
conversations as a leader that you should
19:39
be having with your folks.
19:40
What you're running is broadcast.
19:42
You're running spin.
19:44
And you've been making mistaking the
19:46
silence in the room for agreement and
19:48
consensus when it's actually people who've
19:51
just checked out.
19:52
They've just stopped trying.
19:55
Yep.
19:57
Yeah.
19:58
You proposed a pretty radical idea for
20:01
healthcare companies anyway.
20:03
Take live questions.
20:06
Don't screen them.
20:07
Let the audience sort of upvote them and
20:10
answer them in real time.
20:11
What the floor is actually thinking about.
20:14
Why are so leadership teams in twenty
20:17
twenty six so uncomfortable with that?
20:19
And then what is that discomfort?
20:21
Actually, that feels like a data point.
20:23
What does that tell us?
20:25
Yeah, it's interesting.
20:26
I've been at real meetings where they do
20:28
that.
20:28
They have all these questions and they
20:30
vote on the questions through all these
20:31
various tools that you've seen that all of
20:33
the meeting software have.
20:37
but the discomfort's the single most
20:39
honest point in the entire exercise.
20:44
I want to say that even harder that
20:46
in the article,
20:46
if your leadership team is uncomfortable
20:48
taking live on screen question,
20:50
that discomfort is information.
20:53
And here's the part that people miss.
20:55
The audience also gets uncomfortable too.
20:58
You're not the only one with something at
20:59
stake in there.
21:00
You've been in meetings where somebody
21:01
asks a question, you're just, you know,
21:04
You're getting all uncomfortable in your
21:06
own seat too.
21:08
And the leadership is uncomfortable
21:10
because live questions remove the one
21:12
thing that the entire meeting was
21:14
organized to protect,
21:16
controlling the narrative,
21:18
controlling the spin.
21:19
You cannot pre-write the answer to a
21:21
question that you haven't seen.
21:23
And for a leader who's used to a
21:25
scripted room,
21:26
that loss of control feels like free fall.
21:29
When that loss of control,
21:31
you have to normalize.
21:32
And normalizing discomfort is a saying
21:34
that I love.
21:36
to say in our company.
21:37
But to turn around and win the discomfort,
21:41
it should feel useful because fear has a
21:44
shape.
21:44
And there are three or four specific
21:47
questions, by the way,
21:47
that you're hoping nobody stands up and
21:50
asks.
21:51
And here's the move I give every operator.
21:54
It's the most important thing in this
21:55
entire episode, Jimmy.
21:56
The next time your comms team wants you
21:58
to prescreen, let them.
22:01
but make them tell you which specific
22:03
questions they're screening out.
22:05
Don't argue with them.
22:06
Just write the list down.
22:08
That list is your real agenda.
22:11
Those are the conversations your platform
22:13
really needs to have and has been
22:15
avoiding.
22:16
The discomfort was never reason to skip
22:18
the live Q&A.
22:19
It's the map to really the meetings that
22:22
you should be trying to run all along.
22:24
Yeah.
22:24
Yeah.
22:24
Show me what you're scared of.
22:25
Show me what you're avoiding.
22:26
And I'll tell you what we should lead
22:28
with right out of the gate.
22:30
And that should be the intro.
22:32
Here are the things we are going to
22:33
talk about.
22:33
And if the audience doesn't lean in,
22:35
you got the wrong group of people or
22:36
you're avoiding the real problem.
22:40
You end the article on your Substack with
22:42
a line that I loved.
22:43
Ending sixty one seconds early was never
22:47
the achievement.
22:47
Eight hundred people out of eight hundred
22:49
and sixteen attended is not a goal.
22:52
It was the sound of a room with
22:53
nothing left to say to each other.
22:56
So if a CEO or a director or
22:59
someone who's on the.
23:00
camera side looking into the camera for
23:02
meetings like this right now and listening
23:04
wanted to met what wanted one measure to
23:07
determine whether they're all hands is
23:08
working or not what's a you know for
23:11
their language what's a KPI I think it's
23:15
what I would call the Q&A ratio one
23:17
number
23:18
And you can calculate it very easily.
23:20
Take your last all four hands meetings,
23:23
add up the minutes leadership spent
23:25
talking,
23:25
then add up the minutes of the real
23:27
live Q&A.
23:28
And the real is doing a lot of
23:30
work in that sense.
23:30
It means unscreened questions answered in
23:33
the moment with the CEO occasionally
23:35
saying, man, I don't know.
23:36
I haven't thought about that.
23:38
That's a fair criticism.
23:39
That's a perspective that I hadn't thought
23:41
of.
23:42
Then divide the second number by the
23:44
first.
23:45
Google, by the way,
23:46
their original target was fifty five.
23:47
Two to one, yeah.
23:49
Yeah, Slido,
23:50
which is another organization across
23:52
companies,
23:52
recommends at least twenty percent.
23:54
The health care platforms I watch run it
23:56
closer to five percent.
23:58
Under ten percent,
23:59
you're running a press conference and a
24:00
broadcast and you're controlling the story
24:02
and you've got spin control.
24:04
But just to be honest, you know,
24:05
if that's the case of what you're going
24:06
to do and you're going to do prescreen
24:08
questions, don't take any questions.
24:09
Just call it quarterly update.
24:11
Another one,
24:12
it's just not an all hands meeting.
24:14
If you're under five percent,
24:16
It's probably because your floor stopped
24:17
asking questions because, you know,
24:19
they've stopped expecting the same old
24:21
answers.
24:22
And on the line that you quoted,
24:23
ending sixty one seconds early was never
24:25
the achievement.
24:26
The executive mentions it with pride
24:28
because they think they finished early.
24:30
They think that signals discipline and
24:32
efficiency and respect for everyone's
24:34
time.
24:35
Oh, that line where they say,
24:38
we'll give you that sixty one seconds back
24:40
in your day.
24:41
Man, if anything needs to disappear,
24:43
it's that.
24:44
No, that's exactly right.
24:46
And here is the interesting thing is it
24:50
goes to the basics of efficiency versus
24:52
effectiveness.
24:54
With efficiency, be a systems thinker.
24:57
With effectiveness, be a people thinker.
25:00
In all hands is meant to be an
25:02
effectiveness meeting,
25:04
which means time should not be
25:06
constrained.
25:07
The best all hands meetings run eleven
25:11
minutes or so longer because the questions
25:13
wouldn't stop and the CEO refused to cut
25:16
them off and said, look,
25:17
I'll be here as long as there are
25:18
questions.
25:19
I can remember this during the COVID days,
25:21
man.
25:21
It just was
25:22
I remember getting over a hundred
25:24
questions during one of the COVID
25:25
meetings,
25:25
and they were tough and painful and
25:27
vulnerable.
25:28
And we made the decision way back then
25:31
that we weren't going to lay anybody off,
25:32
or if we were going to balance the
25:34
part-time with whatever dollars we were
25:37
going to get,
25:37
because at that time we weren't able to
25:39
take the dollars because we had some PE
25:42
investment.
25:44
And man, we didn't lose anything.
25:45
We didn't have shortages and those kind of
25:47
things.
25:48
We just kept everybody together.
25:49
And I think it was because in those
25:51
meetings,
25:51
we just tried to make everybody feel
25:52
secure.
25:53
And if we didn't know something,
25:54
we didn't know it.
25:55
Who knew what the heck the next stage
25:58
was in COVID after the first week,
25:59
after the second week?
26:01
And by the way,
26:01
nobody thought about bragging that I'm
26:03
giving time back to you, right?
26:05
Nobody cared that the meeting went long.
26:08
They were just too busy talking and
26:09
engaging with what you were saying.
26:12
You also had something,
26:13
I don't have the exact quote,
26:16
pay attention to your last four all hands
26:18
meetings,
26:18
the questions that were asked but not
26:20
answered.
26:21
If they keep showing up, that's a trend.
26:24
And if they're not, if the audience,
26:25
the floor is continually asking and you're
26:29
uncomfortable answering,
26:31
that's a good thing for now.
26:33
But once they stop asking,
26:34
that's the real loss.
26:36
No, that's right.
26:37
Avoidance is not a good strategy in
26:39
business.
26:41
You know, problems, as I like to say,
26:42
grow in weeds.
26:44
Your job as an operator is to get
26:46
as much water away so that the weeds
26:49
drown out.
26:50
And that should be intuitive in those that
26:52
are in health care,
26:53
because do we ever say to a patient
26:56
who comes in complaining about their
26:58
problem, do we ever say to them,
26:59
don't ever bring me a problem unless you
27:01
can bring me a solution?
27:04
We are paid to help with solutions by
27:07
having conversations that are meaningful
27:09
and that create psychological safety.
27:11
And the more you can be proactive about
27:15
addressing uncomfortable conversations,
27:17
the better as an organization you are and
27:20
the more you'll grow and the more you'll
27:22
trust you'll have.
27:23
And the conversion for that will be KPIs
27:25
like retention.
27:26
Yeah.
27:27
You want to give a forward tease?
27:29
This was the end of the meetings series,
27:31
right?
27:32
What's on the chopping block next or
27:34
what's been bothering you?
27:35
We have one more.
27:37
We have the audit.
27:39
So the sixth article will be on how
27:41
to audit the meeting stack with checklists
27:45
and other things.
27:46
And so it's just kind of a summary
27:47
article, if you will.
27:48
But I'll tell you what's been on my
27:50
mind, Jimmy,
27:50
and that's those companies that recruit by
27:52
saying they have mentoring programs.
27:54
Ah, yes.
27:55
So we're going to talk about mentoring and
27:58
retention and turnover.
28:00
And it's interesting what the data and the
28:02
research say about all of this.
28:05
And I think, again,
28:06
it's this whole idea we use words to
28:08
recruit mentoring.
28:10
Then they get on and ninety to one
28:12
hundred and twenty days later, you know,
28:14
where's this so-called mentoring that I
28:16
had?
28:17
And so that's been on my mind a
28:18
bit lately as well.
28:20
buyer beware,
28:21
the words that we use to get someone
28:23
to show up,
28:24
but where's that thing when we want them
28:26
to stick around?
28:27
I'm going to give you one more,
28:29
by the way, Jim.
28:30
The other thing that's been on my mind
28:31
is
28:33
What we have seen in the economy the
28:34
last several weeks is there has been in
28:37
health care a slowdown in new patients.
28:39
And, you know,
28:42
I'm not saying this in a specific sense,
28:44
but in a universal sense,
28:46
less new patients are accessing dental and
28:48
health care services and physical therapy
28:50
services.
28:51
Part of that is copay.
28:52
Part of it is probably the economy, right?
28:53
When you're paying more money for
28:56
gasoline, you have other kind of things.
28:58
And so then everybody looks at their
28:59
marketing department,
29:00
says they're not doing their job.
29:02
And so, yeah.
29:03
I've got a whole series I'm looking at
29:05
on how marketing is your company's
29:07
responsibility or is it the clinician's
29:09
responsibility?
29:10
yes there's an element of both but the
29:12
real healthcare practitioners the real
29:15
dental professionals assume the
29:17
responsibility of building their practice
29:19
their practice and they assume it by
29:22
referrals that reveal not by gimmicks and
29:27
lead generation and purchasing and more
29:29
google ads but by conversations and care
29:33
and consistency
29:36
you know, clinical excellence,
29:38
customer service,
29:39
care and compassion excellence.
29:41
Those will reveal referrals that you don't
29:44
even ever have to ask for.
29:46
right well subscribe to the uh the sub
29:48
stack the operator for how much larry how
29:50
much does it cost to subscribe to the
29:51
sub stack zero it's free uh this month
29:55
uh fifty percent off of that as well
29:57
if you subscribe yes uh most leaders think
30:00
you're a friend if you're a perfect a
30:02
lot of a lot think the uh the
30:04
all hands exists to communicate
30:06
information larry would argue it exists to
30:08
gather information just as much as it does
30:11
to communicate it
30:12
Because when leadership spends an hour
30:14
talking and five minutes listening,
30:16
as grandma said,
30:17
you got two ears and one mouth.
30:19
Use them proportionately.
30:21
The platform learns almost nothing about
30:23
itself unless you listen.
30:25
Your grandmother is a smart lady, Jimmy.
30:27
Yeah, she's quick.
30:28
If today's conversation made you rethink
30:31
how your organization is communicating and
30:33
made you a little uncomfortable...
30:34
Good.
30:35
That's sort of the point.
30:36
Subscribe to that operator on Substack.
30:38
Until next time, keep operating.
30:40
Larry, thanks for the time.
30:42
Thank you.