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Lean Management for Physicians: See the Bigger Picture


How seeing everything from a 50,000-foot view could satisfy your patients and your medical practice peers.

This week in my Lean Management class, we discussed a tool called SIPOC. I’ll spare you what the letters stand for, but the basic idea is to look at a process from a 50,000-foot view - not getting caught in the weeds, but seeing the most important components.

The first step is to identify who the process is for. Whoever the “customer” is drives the rest of the process. This challenges me to carefully consider who most benefits or is the biggest focus of my own personal and professional choices. I often cite a patient or family need to help support a decision I really wanted to make anyway. However, if my “customer” is the focus, then I need to consider what he or she wants, not what I want from them.

The second step is to identify what you are producing with this process. Is it what your “customer” wants? Over the years, I have entertained many theories about what would most benefit my stay-at-home husband.  Many of these products were what I wanted to do anyway, so I attempted to fit them into some semblance of what he was asking for. This is akin to buying a gift that you want someone to have (or share) rather than something they would actually enjoy.

Next comes the high-level view of the process broken into four to eight steps. It doesn’t have to be perfect, just a rough approximation of what actually happens. This helps identify if your process is designed to give your “customer” the “product” she actually wants.

So, enough with business speak. How does this apply to real life? I have a couple of examples. 

First, I’ll start with my clinic schedule. I have a lot of people to satisfy with this process of how I schedule and take care of my patient needs. I need to not only satisfy my patients by being available often enough and at the right times to meet their schedules, I also need to be aware of my medical assistant’s desire to not be stuck late at clinic every night because I add on patient after patient to the end of my schedule. I also need to satisfy my employers because they’re not going to be too keen on covering my overhead if I decide to spend a leisurely hour with each patient during an eight-hour workday. Starting with the customer and product in mind, I can look at my process from a very high-level view to see if I’m set up to produce what is wanted from me.  In this case, my customers are patients, staff, and my employer.  Fortunately, they all want the same thing - an efficient clinic schedule and physician. 

Second, I'll apply these ideas to my family. I don’t think of my family as “customers” although I have many processes designed to produce something they value. Much like my husband knows how to plan, prepare, cook, and serve a meal to please his “customers,” I need to determine how to use my time at home, particularly as it pertains to balancing the fun (watching a movie with the kids or playing legos) with the necessary (washing the clothes or making sure the kids have clean towels in the bathroom). 

I think the whole idea behind SIPOC is to begin with the end in mind - what is it you’re trying to do and for whom?


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