Creating Policies and Procedures in your Counseling Practice without “Going Corporate”

As Thriveworks practices have grown–now to about 70 locations–we’ve had to overhaul the way we do some things. For example, ten years ago if a counselor wanted to talk with me he/she could holler my name from their office, and I’d pop my head in. Today, they’d need to send me an email, or schedule a call (and I might then refer them to their direct supervisor). When a practice grows, even at a minor scale, say from 1 to 4 team members, new processes are often needed to make sure that clients receive consistent quality care. Here are some examples:

• After an insurance audit, you learn that a payer wants you to document something differently.
• An internal HIPAA review reveals a few additional best practices to implement.
• You switch from paper notes to electronic health records.
• You find you need to update the way you fulfill record requests or respond to subpoenas.
• You might need to develop a policy around dress code, or team member conduct on social media.

Every one of these changes directly effects counselors working in a practice. So, if you’re a manager introducing new procedures like these, it’s a delicate endeavor to be sure. If you don’t handle it well, get ready for some pushback. A criticism I’ve received once or twice (at least) over the years is: “This feels really corporate! I chose to work here because it seemed not corporate.”

This is important feedback. So, how should you respond? You could explain that your practice is and has always been registered as an S Corporation, or that technically, you’re not a corporation at all but a Limited Liability Company (LLC). But, with either response, I think we’d be missing the point (not to mention, it might come across as a bit snarky). Actually, what the counselor is saying is, “I don’t like this change. I didn’t have a say in making it. It doesn’t feel good.”

Nobody Likes to be told what to do.
Nobody likes to feel powerless about changes that affect them.
Nobody wants their situation to get worse.

So, how do you create necessary processes updates without being accused of “going corporate,” of losing that crucial human touch. Here are four ideas.

1) Involve team members in the change process
Many of us want to feel like we’re part of something bigger than ourselves. However, if we don’t have a vote or say on how that something changes or evolves, we stop feeling like we’re truly involved. The “something bigger” begins to feel uncomfortable, imposing, and foreign (and corporate?).

Counselors care deeply about clients and are motivated to optimize care. Hence, when presented with the operational challenges you see as a manager (e.g., there’s a HIPAA best practice not being followed), they’re likely to come to the same, or better, solutions as to how processes can to be updated to protect quality. As a manager, you might find that it takes a bit longer to involve others in the improvement process, but the final outcomes are almost always better.

2) Communicate why a change is good for clients
Focus on the why. Explain how a new process will better serve the practice’s mission of helping its clients. If your team sees that the change is a good one for clients, they will be quick to rally behind it.

3) Communicate why a change is good for counselors
As a manager, most of the changes you implement should benefit the counselors (e.g., “Good news! Now when you get a records request, you no longer need to handle it. Just forward the request to the admin desk.”). Your team members have a choice about where and how to build their careers, and it’s your job to make sure that working at your practice, together as a team, is the best choice for them. Continually striving to make your practice a better place to work is the best way I know to make that happen.

4) Try to simplify
A practice without processes is chaos, but a practice with too many processes is crushing. As you implement new (necessary) procedures for your practice, try to find places you can simplify. The Canadian government has a policy like this: for every new federal regulation that’s approved, two must be cut.* This discipline has helped to slowly peel away the mounds of red tape that seem to inevitably junk up governments and businesses alike.

What’s Better than Going Corporate?

If someone says you’re “going corporate,” it’s not a compliment, it’s a warning that you’re headed in a direction that’s lost touch with what matters (and that doesn’t care about the people your policies effect). So, what’s the antithesis of going corporate? What shall we call it? Let me know your ideas @thriveworks or @anthonycentore.

*Planet Money Episode #870: Trump vs. Red Tape.