Planting in the Dark

Planting in the Dark

I went back and forth with myself, contemplating whether to share this post; because weakness, doubt, and vulnerability are seldom championed. But, in my binge of business podcasts, startup stories, and entrepreneurial fairytales I felt it important to share when things are low and you wonder when favor will shine again.

“Let’s not get tired of doing what is good. At just the right time we will reap a harvest of blessing if we don’t give up” (Galatians 6:9 NLT).

It’s been a challenging year. It began with one of our biggest contracts being taken away from us.There’s really no appropriate way to verbalize it, but just that. Without cause or reason. About 70% plus of our business came from that one contract, and we were mailed an amendment essentially dissolving it. I cried that day. I felt the air escaping me faster than I could catch it. Trying to remain stoic, I reviewed the document with my father. He remained calm. I insisted we get lawyers, that we defend ourselves. He agreed, ready to fight. But before we bolstered ourselves for that new challenge, I dissolved. I was angry and hurt. We worked so hard, harder than our competitors, proving we were equal if not better and here we were with the rug pulled from under us. I cried, because it was an affirmation that life is unfair. That you can toil, and sometimes no matter how intentional you are, sometimes you lose.

My father scolded me, “No.” As if my tears were propelled by a push of a gas pedal, like if I eased up they would end. “No.” Like, my tears were an affront and not from a space of endless overtime, weekends, and nights; an army of me’s from my past standing at a collective front questioning if all that time would end in defeat.

“I can’t be quiet! I am angry and bitter. I have to speak” (Job 7:11 GNT)

This was the beginning of my descent into regret and resentment. I spent much of this year feeling like maybe I should never have began to help my father. A dutiful daughter is not allowed to say that, but I will. I spent many moments wondering if maybe I should not have offered myself. The endless hours, low pay, and tedious tasks that could have gone into my own pursuits. Further and further I felt I was moving away from my own dreams. I began this endeavor so hopeful, content, and aligned with purpose. In the very least, I felt assured that no matter what, I was honoring my father. But now this honor feels like sludge. An exalting crown, now a heavy weight on my head and I’m not sure I want it anymore.

Can any one of you by worrying add a single hour to your life?” (Matthew 6:27 NIV)

Between new insurance guidelines and regulatory restrictions, I’m tired. In an industry where everyone is being bought out or shutting down; I’m tired. Every time we meet a new obstacle I want to say, “But we are small!”, “But we are family-owned and operated”, “But we are black!”, “But we are immigrants!” And the reality is that in business, when the status quo benefits people who do not look like you, inclusion is not a discussion you can bring to a table you aren’t invited to in the first place.

“What strength do I have, that I should still hope? What prospects, that I should be patient? (Job 6:11)

There is no one black at our table. No one immigrant. No one woman. And here we are up against behemoths; multi-state, national corporate accounts. There are some smaller competitors, but they’ve got the game down. One of our competitors is doctor-run, so they get to self-referral (Stark law doesn’t apply to private payers). Then there are those who have been in the industry for decades (all white and with connections and existing capital). Some of our competitors have been in the industry so long, my father worked for them. So here we are, providing service unparalleled and getting by the fucking skin on our teeth.  

“This is what the kingdom of God is like. A man scatters seed on the ground. Night and day, whether he sleeps or gets up, the seed sprouts and grows, though he does not know how. All by itself the soil produces grain — first the stalk, then the head, then the full kernel in the head” (Mark 4:26-28 NIV).

Our contract was eventually reinstated, but it’s again hanging in the balance. We aren’t sure what will happen but are diligent and not wavering in our quality of service. Our biggest mistake was being so reliant on one source of capital. Even without, we were still doing well but I used the time to hunt for more contracts; and fortunately was able to get a new one. I know there is worth in what we do. Patients rave of my father, of his care and love. Patients call asking for specific staff, who they have grown to trust. There is heart here. There is intention of public good. I wish quality of care was enough, but it isn’t. Not in this country. Not in healthcare.

I’ve thought a lot about the almost four years I’ve put in and wondered what of my own ambition? Lord, I am to honor my father and mother but how much more before I break? Rather than wallow, I decided to put intention behind growth. Implementing ways to streamline day-to-day operations. New software, management systems, hires, services. In my most discouraging year I’ve spent more time diversifying and facilitating growth and change remembering that in the very least if I’m not motivated by my earthly father, then maybe my heavenly one can push me.

“If God cares so wonderfully for flowers that are here today and gone tomorrow, won’t he more surely care for you, O men of little faith?” (Matthew 6:30 TLB).

 

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Feeling Lost When You’re the Driver

Feeling Lost When You’re the Driver

When I first started working with my father, I really had no intention of spending more than a year helping him. If someone told me that I’d have spent four, I would have been concerned. I had no vision when initially starting other than helping him get the business afloat, helping streamline and organize the existing structure, and then eventually passing the baton on to someone more qualified and experienced. I think because I did not have a vision, I lost sight.

My employees will ask me for direction or support and there are often times I really am throwing an answer out there. An educated one, but, still a damn guess. And really, there are staff with more experience than me in the business so I want to tell them, “You tell ME!”. There really are times I say this, in a more diplomatic way (obviously); telling them I believe in their decision making and that the worst decisions are sometimes just ones that have never been attempted. So sure, let’s try your idea, and worst case scenario we have to scrap maybe a few hundred dollars but best case scenario we may have found a methodology which could make or save us thousands. This isn’t a zero sum game. All “losses” are gains in knowledge. Fortunately, we found this to be a good approach internally: to encourage dialogue for staff to suggest new methods and/or implementations that would either simplify tasks or make them more cost effective.

After things began to pick up, and my responsibilities grew, I really found myself faced with a moral conundrum. How can I build direction for a place, where I was not entirely sure where I fit? I began focusing on small goals that were attainable that could bring me closer to a larger goal. The logo needed to change: that I could work on. Our documents needed updating: easy. We had no web presence: done. We had only one insurance contract: I began contacting insurers to contract with. We needed to hire more people to handle the volume increase: challenging, but done. These small elements became a means to begin understanding, structurally, what to look for in larger goals.

I began to ask my father questions like: what were the intentions at the outset? What was the driving force behind the company? And, what are you looking to do different from other players in the market? I wanted to use the answers to frame how we could use these as our values and the driving force behind our growth. His interest was in steady growth while maintaining quality of care, a fair and ethical approach for patient treatment, and reliability for both patients and physicians. For me, this translated to patient care with a familial approach. It made sense that we market ourselves as a family business, where we treat our patients, “as our own”. That is to say, provide attention to care that is genuine.

With a sort of ethos built, I felt more confident in what the company stood for. But, strategically, where were we going? The quality of service is good, but so what?  What is the end game? Unfortunately, there is no play book in small business. There’s no one size fits all approach. But, there is a sort of road map I’ve come up with that has been helpful with steering us in the right direction. I’ll be sharing a sort of outline of this in a part two of this post.

The Three R’s to Goal Setting in a Small Business

The Three R’s to Goal Setting in a Small Business

Starting in 2017, I decided New Year’s was not only a great tradition to set for the company to celebrate the holiday season but a way to reflect on met goals and setting new ones as a team.  By looking at the year before as a collective, everyone’s contributions as a team are recognized; furthering a sentiment of cohesion and teamwork. Having our holiday party thereafter became a great way to bond and renew hope for New Year goals.

We continued this tradition in 2018 and it proved to be incredibly effective with major goals. I think a few different elements play into why this works. The first being accountability. I don’t know how many macro level goals I’ve set for the company but because they remained in my head, they never came to fruition. It is very easy to get side tracked with day-to-day operational tasks that you can lose sight of the bigger picture. Because of this, you are not spending any time on strategy and implementation. For an example, are you looking to expand services? What services are you looking to add? How are you going to add it? What is the cost benefit and how much more resources will it take to implement it?  A company should not only just function, but flourish.

Secondly, by sharing company goals with employees, you are essentially proclaiming your growth. In doing this by faith, and in works, not only do you build trust between staff and management but you’re also demonstrating the importance of follow through. Ideally, your staff should reflect your work ethic. By sharing larger goals, your team is affirmed in the necessity of drive and accountability. Essentially if you assign a project to an employee, you are expecting them to take the helm and not only orchestrate but also produce quality work in a timely fashion. But, can you do this? Leading by example is far easier than by commands.

Lastly, having a deadline matters. Even if you spend the second half of the year scurrying to meet your goals, this is better than having put in no effort come the following year. Small steps are still movement! There’s a personal goal I’ve had for this business for almost four years and it wasn’t until last year that I even started to set it in motion. Now that I have the tools, I feel more motivated to complete the goal.

To make our goal setting meetings thorough, I use the three “R’s”.  We reflect on the previous year’s goals and accomplishments (“In Review”), the New Year goals (“Resolutions”) , and then concluding with any exciting benchmarks that reflect on significant growth and/or sentimental value (In “Retrospect”).  Here is how I formatted the three R’s with some examples of bullet points:

In Review:  2017’s Resolutions

  1. Double our numbers from last year. (Did a recap of how we met this.)
  2. Gain 2+ new insurance contracts. (Cited two new contracts we gained.)
  3. Find a new, prime location for our office. (Reflected on our move and how grateful we were to find the right location.)

2018 Resolutions:

  1. Double our referrals from 2017.
  2. Gain 2+ new insurance contracts (Listed a few insurers we will tackle).
  3. Strengthen our commitment to clinical and therapeutic results. (Cited how we will do this.)

In Retrospect:

In 2017 PRHSInc experienced the incredible benchmark of hiring two new full-time employees and finally being able to add the owner to our payroll. At the core we want to maintain an ethos of quality over quantity. We are a family and do not want to lose the cohesion and heart that we’ve put into the foundation of this business. Remember that you are a member and your presence matters. We are looking forward to 2018 and going into it with much hope and faith.

After our meeting we went out for dinner and drinks. The New Year represents reinvigorated hope and purpose. To share this with those you spend such a significant part of your days with reinforces perspective. Scripture tells us “Let’s not get tired of doing what is good. At just the right time we will reap a harvest of blessing if we don’t give up” (Galatians 6:9-11). When you set goals by faith and action, even if you are not religious, what you are doing is habituating trial and error. When a goal that you made does not turn out, despite persistence, it is easier to regroup and try again when it has been quantified. If you have a destination to go to by a certain time, and there’s a road closure, do you go back home or do you use your GPS to find another route? You may be late but you will still arrive at your destination!

Here’s to hitting the road running in 2018 and being able to see how far you’ve gotten by 2019. Happy New Year!