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Are You a Mouse or a Rat?

Steven H. Dayan, MD, FACS
Group of surgeons, with two shaking hands

Author’s note: Excerpts and material from this column are from the book Thrive: Pearls to Prosper in Any Economy by Steven H. Dayan, MD, FACS,and Tracy L. Drumm (College of Cosmetic Medicine Press, 2009).

Abstract: As a physician, you are the center of your practice. Your behavior and management style can either help or hurt the success of your practice in the long run. If you are a RAT, you may exhibit rigid, absent and tyrannical behaviors that eventually will run down a thriving career. If you are among the ranks of MICE and focus on messaging, information, customer service and efficiency, you most likely will be at the center of a practice that is continuously successful.

Mice always get the cheese; put them in a maze and they will find their way to the prize and won’t give up until they get there. On the other hand, rats get fat and lazy, stop along the way to eat whatever garbage there is, and contract and spread diseases. Following are formulas that relate these terms to ways a doctor can run a practice.

MICE—Messaging, Information, Customer service, Efficiency
RAT—Rigid, Absent, Tyrannical

The RATs

Let’s start with the RATs because it is important to first make sure that you are not a RAT. During the down economy, the RAT detriments are amplified. When the economy was good, and there was an abundance of cheese, it was easy to get fed; everyone did well. Now, times are different and you have to be leaner, faster and smarter. It’s like going from high school sports to the pros; it is a much faster game, and you need to react faster. The hits are harder, and they hurt more. You need to be more determined and more tolerant.

Unfortunately, being rigid, absent and tyrannical can be common among physicians.

Rigid. Rigid protocols are how doctors learn in medical school, and it makes most feel comfortable when trying to compartmentalize large volumes of information. But in real life, things are so different. There are no rigid protocols and although they may seem safer, the blinder effects inherent with rigidity will eventually steer you off the right path. Adapting to the times is important, and you must keep your finger on the pulse to know what is coming next. In the business world, there are thousands of examples of rigid leaders and businesses that at one time were incredibly cocky as they led the industry, and were soon passed by a less rigid, leaner competitor that recognized changing consumer desires. For example, IBM passed on the concept of home computers to Microsoft, and Toyota offered less-expensive gas-efficient vehicles, usurping the popularity of General Motors. Consider the protocols you learned in medical school, and how much they have changed since you began working in the field. The world of aesthetic medicine is changing, as well. If you are a one-trick pony and only do one thing, you’d better be great at it. If you aren’t, and the market decides to go in a different direction, you will lose your prospective patient population. Additionally, you will work a lot harder to find and reach a contracting group still interested in the old-fashioned way.

Absent. An absentee leader is the first step toward bankruptcy. If you are not attentive, others will run your practice based on their visions and most likely without your best interest at heart. Additionally, tomorrow’s disasters start with mild symptoms that are often overlooked by an inattentive leader. Before a dam breaks causing massive flooding, there are always leaks. Similarly, the patient on the cardiac floor with progressive shortness of breath and high-volume intravenous fluids who is heading toward pulmonary edema could have been saved from an ICU admission by tending to her earlier and with more focus. Your practice is the same. Others won’t recognize the signs that you will. If there is an issue, get ahead and jump on it. Absentee leaders don’t see the warning signs until it’s too late, and then they are quick to blame others.

Tyrannical. Tyrannical leaders are destined to eventually fail. Although in the short term an aggressive, hard-punching leader can muscle the business through and motivate the troops, in the long term, it gets tiring and ineffective. Professional diplomacy pays off with your staff, colleagues and competitors. The key to being a team leader is to be a member of the team. Keep your ego out of it, and look at situations from your team member’s points of view. This is a hard thing to do, but it is the foundation of a successful business or practice. What is your employee thinking and why? If you understand your employees’ points of view, you will likely figure out a solution to their ineffectiveness. Scolding, avoidance or continuous punitive action won’t work in the long run. An employee has to feel some sort of investment in your practice or business or else they won’t produce.


Let’s start with the “M” for messaging. Messaging begins with an honest assessment of who you are. You must define who you are, and what you want your practice to be.

As a physician, whether planned or not, you are the brand. Your dress, speech and actions are components of your brand. People encounter hundreds, if not thousands, of brands every day. Sports teams, holidays, even people are examples of brands that shape behaviors, attitudes and purchasing decisions. A brand is a way for patients or consumers to define you.

It is a collection of perceptions or natural associations. For real-world application, think of your favorite sports team. What images pop into your head? You probably think of the team colors, the mascot and maybe some of your favorite players. Perhaps you are flooded with distinct memories of the unique ballpark aroma of beer, peanuts and popcorn mixed together. These thoughts and images are all part of the baseball brand.

People can represent a brand, as well. Consider Oprah, Michael Jordan, Dolly Parton, Harry Carey, John F. Kennedy, Madonna and Al Capone. Each of these people are branded by attributes, actions, attitudes or an era, and each creates different associations. Everything from boldblack-rimmed glasses to a cone-shaped bra all become the costumes that help define who these people are, and what their brand represents.

So how does all of this branding relate to you after 20-plus years of schooling? Stop and think about the last patient you saw. What or who were you to that patient; how did that patient view you; and most importantly, how will that patient remember you? As a physician, you have to ensure that the brand you are creating matches the image you intend to project. This image will affect how—or if—potential patients choose, remember and recommend you.

Who are you? Start by defining who you are and be honest: Are you modern and sleek, or traditional and conservative? Are you loud, spirited and outgoing, or quiet, laid back and introverted? Do you specialize in a particular treatment or technique, or do you have a unique trait that defines you. Do you enjoy interaction and spending extra time with patients, or is your true passion to research groundbreaking treatments. A false representation of who you are is a poor way to start a relationship. Be true to who you are, and your brand will feel natural to everyone you encounter.

What sets you apart? While reflecting on how you want to be perceived as a physician, also consider what makes you different from your contemporaries. Do you offer a specific treatment or utilize a proprietary technique? Does your practice offer late night or weekend appointments? Do you have a partnership with a day care center or cater to mothers with small children? Are you bilingual? Once you figure out what makes you different, build it into your brand, and use it to distinguish yourself from others in your field.

What are your practice goals? Next, determine what your goals are for your practice. Do you aspire to reach a certain ethnic or niche group? Do you want to have a large-volume clinic where you can provide low-cost treatments, or do you want to be recognized as a high-end luxury practice catering to a luxury crowd? Once you determine how you want your practice to be viewed by others, it will be easier to create a brand that meets these goals.

Create a mission statement. Part of developing a brand is to first create a mission statement. This may sound cliché and sophomoric, but it really is helpful. After creating and announcing a mission statement, it will become much easier to manage your staff. It also can help you understand who you are and what you want to achieve. The mission statement should be clear, concise and simple, and stated in real words that everybody can understand. Remember that staff members will use it as their guiding foundation. Once you decide what it will be, then all of your materials must reflect your brand. Yes, your brand can change, but not too often.

Next issue’s column will cover the “I” of the MICE formula—information—and how to get your message to the consumer in an inexpensive, effective and efficient manner.



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