Tom's Story

 “Hi Jane. I’m Kate. I’m looking forward to working together, but right now I’m here to meet with Tom. Is he available?” I had arrived at Bob’s bustling practice five minutes early.

“Yes, he’s waiting.” Did I see an eye-roll? “Let me show you...” A fellow in a grey suit appeared from the back – the only suit in sight.

“No problem, Jane. I’m here,” he said, and ushered me to his small office. We squeezed in, Tom behind his desk, and I took an uncomfortable chair facing him. His desk was pristine; computer turned off, pens lined up with precision on a fresh pad of paper, not a photo or personal trinket in sight.

“So, Bob says I need coaching,” Tom began. Ah, I thought.

“Bob wants to offer everyone coaching, but I understand it’s voluntary. He wants this to be the best workplace possible. You’re an important part of that, Tom.” Tom nodded, slowly. I had circulated information about coaching, and the goals of this project. It was time to let Tom lead.

“What do you think would improve things, Tom?” I listened intently.

“Well, I’m not sure people here understand that this is a business, and needs to be run like one. There are bills to be paid, insurance reimbursement s need to be collected, and accounts receivable followed up on. Some people spend way more time chatting than doing what’s important. And I get receipts for expenses without any information. I can’t make hide nor hair of them, but the staff expect me to keep it going, financially, and get the cheques out on time.”

“So, your work is fundamental to keeping the financial management of the practice current and liquid,” I clarified. Tom nodded, straightening his tie.

“And, you are concerned that staff don’t understand how important financial health is to the business. Am I right?” He nodded again.

“Exactly. That’s why Bob hired me – to make sure the accounting is up-to-date. All the resources, really. Sometimes staff just order stuff without asking if we can cover it. They presume they can restock at any time, or order new equipment. Sometimes it gets really close to the edge, frankly.”

Photo by Michael Jastremski

“You carry a great deal of responsibility, and I hear some stress,” I acknowledged.

“I do. The staff don’t understand.” Tom sat back, looking a little deflated.

“Is that the most important issue to address today?” I asked. Tom paused, then chuckled.

“No. I don’t think so.” Tom was looking at his blotter, so I gave him time. He looked up.

“I’d like to change the way we do patient intake, so the important pieces around payment are dealt with up-front, and they’re done right the first time,” he said. “I spend hours sorting through patient records to extract information for third-party benefit providers. It takes way too much of my time.” Tom looked down at his blotter again, and I gave him a few more moments.

“If we took care of collecting for our services on time, all the rest of it would be easier,” he said, looking up. I smiled.

“So help me understand,” I said. “Concerns around cash flow are pressing, and the most effective way to reduce the pressure is to get payment for services in a timely way,” I summarised.  Tom nodded and I continued. “What piece of this do you want to talk about today?” I asked. Tom looked up, his eyes brightening.

“I think the biggest headaches for me, and for the office, begin when a new patient comes in,” he said. “Jane is really friendly, and everything, but she is a complete ditz when it comes to getting accounting information. She just chats about anything, recipes, people’s pets, but doesn’t do intakes well.” I could hear Tom’s frustration.

“Why do you think that is?” I asked.

“Maybe she doesn’t realise how important it is. Or she just doesn’t follow through, even after I tell her what’s important. She sometimes inputs data incorrectly.” I nodded.

“I want to make sure I understand your frustrations. There is a system for intake of new patients, and it isn’t working well. You aren’t getting the information you need to bill quickly and successfully. Is that right?” Tom nodded again, his eyes narrowing just a bit.

“And at the end of our session, what do you want to have in place?” I asked. Tom’s eyes got bigger as he kept thinking. A couple of moments later, he spoke.

“A plan. We have forms and stuff to gather information, but they don’t seem to be working, and I don’t know why.” He said. He reached for his pad of paper. “I need to make a list of the information that’s most important. What I can’t do without,” he said, starting his list. I let him work on it for a minute, and then refocused on today’s goals.

“So, some changes in how the information is received,” I said.

“Yes,” Tom answered, continuing to re-draft the form.

“Okay, so that’s one part of an action plan you can follow through on. What else?” Tom looked up, blinked, and put his form aside.

“Hmmm. I need to understand what Jane is doing, and how I can help her do the financial bit better,” he suggested. “Do you think that’s a good idea?” he asked.

“I think it’s worth putting on the list, along with some other ideas, and then when you’ve got them all down, you can assess which actions are most likely to bring you the results you want,” I suggested. Tom tore off a new sheet of paper, and quickly jotted down about 6 ideas. I could sense his frustration lifting as a plan developed. A few minutes later, he looked up at me, his pad of paper filled with columns, ideas, and even some scribbled out bits and arrows indicating amendments.

“Here it is,” he said. “I’m going to start off by talking to the staff involved, and finding out what parts of the money bits are hard for them. Then I’m going to suggest some changes to the system we use to the collect information I need. I’m going to pass it by Bob, and then hopefully take it to the staff.” He looked satisfied.

“Great!” I added. “That seems like a plan you have energy for. What three things are you going to do today to get it off to a great start?” Tom didn’t stop at three.

“Book a meeting with Jane. Maybe I’ll suggest we go out for coffee, because I can’t get her to focus here. There’s always something going on at the front desk,” he said. “I’m going to make a flowchart of the plan, and take it to Bob. And start redesigning the forms,” he finished.

“How will you know if the forms are better than the current ones?”

“Hmm. Maybe I’ll set some parameters that have to be improved, and ask for Jane’s help. Even Bob’s.” He thought about it a few more minutes. “And I’ll create a time-line for the plan. I’ll put together some questions, and ask everyone for input at the next staff meeting.” He sat back for a minute.

“I think I need to make my interactions with staff more productive, less tense,” he said. I let that rest for a minute.

“And why is it important to you to improve your relationship with staff?” My voice was quiet, curious. Tom took the time he needed.

“I don’t like being the hard-ass all the time,” he said, and his voice cracked. He reached up and loosened his tie, just a bit. “Everyone else seems to get along here. Be respected. I guess I wonder what it would be like to be on the inside of that,” he said. I smiled at him, and nodded.

“That’s huge, Tom. And it sounds like it’s important to you.” Tom nodded slowly, shuffling his papers. “How will you remember that?” He smiled again.

“I guess my usual strategies – post-it notes, lists, reminders in my calendar.” We chuckled together.

“Well, those strategies work for your other important reminders, so…” I shrugged. “I’ll check in and see if it works in this case the next time we’re together. I know you’ll focus on what’s important.”

 “You’ve given me lots to think about. And a plan I can work on,” he said, touching his notepad. I was aware our time was almost up.

“Great!” I assured him. “I’m glad this was useful. You’ve come up with concrete ways the accounting challenges can be shifted,” I said, making sure he knew he’d done the heavy lifting. “And you’ve got some pieces to work on for personal growth. Do you want to send me some notes with time frames so I understand your plan?” I asked.

“Good idea, I’ll do that by Friday” he committed, jotting it down. He stood up, shaking my hand.

“One last thing. Did you want to book another appointment for a few weeks down the road?” I asked, and we did.

Meredith Egan is a certified executive coach with Wild Goat Executive Coaching. She is committed to high professional standards and a strong code of ethics. As such, confidentiality is foundational to her client work. This serial blog is a work of fiction, through and through.

All characters appearing in this work are fictitious.

Any resemblance to real persons, living or dead, is purely coincidental.