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Changing a Team Resisting Change

Stith Keiser, BA, Blue Heron Consulting, Rochester, New York

September 2018

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You are ready with ideas for improving the practice’s financial health, culture, and service offerings, but the team is cautious. After a few steps in the right direction, team members seem more interested in just getting through the day rather than working toward change. Change for the sake of change may be pointless, but when a practice needs to change (eg, one plagued by a low profit margin1), failure to do so impacts the ability to practice excellent medicine, hire and retain superstar team members, and reinvest in equipment and facilities. Ultimately, an owner’s prospects of retiring with financial security can also be affected.



Look in the mirror. Many practices fail to change because the leaders “talk the talk” but do not “walk the walk.” For example:

  • The team avoids ordering excessive inventory that will just sit on the shelf costing money. During an unusually busy week, the practice runs out of 1 of 3 parasiticides and the veterinarian blames the inventory manager.
  • After deciding that thorough, quality medicine must be a team effort, the veterinarians ask the veterinary nurses, after they step out of the room, to point out anything they missed telling the client (eg, a conversation about nutrition, a missed charge for a diagnostic procedure). The veterinary nurse does as instructed and the veterinarian immediately becomes defensive.
  • The lesson? Change starts with leaders.

Determine each team member’s Why2 (ie, why the practice exists, what each team member considers important). Leveraging a team to drive change is easier when the team helps determine the practice’s vision, the reason for change, and what that change should look like. College football coach Nick Saban credits much of the football powerhouse he has built to the time and energy he expends understanding what motivates and drives each player.3 Your enthusiasm for change becomes the team’s enthusiasm for change by formulating a common Why after learning what drives each team member. 


Consider the 4 Ws before embarking on the road to change.

  • Does this change align with the practice’s Why?
  • What needs to be done to achieve this goal?
  • Who is the project “champion” responsible for completing, or overseeing the project’s completion?
  • When is the champion expected to update progress and when should the project be completed?

After understanding the team members’ why and putting the right team member in the right seat, regularly discuss (ie, at team, department, or project meetings) any hurdles and celebrate successes.


The practice sees sustainable, positive change. Change, when forced, only remains as long as the change is enforced. Change, when owned by the team and guided by a plan, is sustained through pride in ownership.

Like the complicated cases in your practice, some challenges may need a different approach or original solutions. For more ideas and direction, consider looking for an individual consultant or someone with a specific area of expertise at


For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

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