Jorge Garcia-Zuazaga, MD, and his staff at Apex Dermatology in northeast Ohio.
Running a successful dermatology practice in the current health care climate is challenging, to say the least. But by all accounts, Jorge Garcia-Zuazaga, MD, was excelling at it in 2013. His practice, Apex Dermatology, had three locations in northeast Ohio, and all were thriving. But growth brought its own challenges, and Dr Garcia-Zuazaga, a former Navy flight surgeon with an MBA from Case Western University, felt there was only one way to overcome those challenges: He had to think like a CEO.
“In the midst of complete and total industry disruption, holding on to the status quo is rarely effective,” said Rick Simmons, co-founder and CEO of the telos institute, a global organizational consulting firm based in Cleveland, OH. “Jorge saw that happening, and he didn’t sit on his hands, he got ready for it. He has a bent toward continuous improvement, and he was really devoted to providing opportunities for other members of his team to grow as well.”
Jorge Garcia-Zuazaga, MD, founder, Apex Dermatology in northeastern Ohio.
Dr Garcia-Zuazaga reached out to the telos institute to implement leadership programming in all his practices. In the nearly 8 years since, Apex has experienced tremendous growth, with more than 100 employees and 15 providers in seven locations. Retention rates are high, burnout is low, and patients are happy. He credits all this success to cultivating great leadership skills—both in himself, and in others.
The Leadership Deficit
The days when doctors could hang their shingle and practice quietly until retirement are long gone. “Dermatology is very fragmented, and health care is constantly changing. To be successful in medicine nowadays, you need to be part of a solid group with solid leadership,” said Dr Garcia-Zuazaga. Medical school, he pointed out, does not always prepare doctors for those aspects of the job. “By the time you get to be a dermatologist, you’re a pretty smart person. But you might not necessarily know how to lead people. Many doctors have never led a group, never had to hire or fire anyone, never had to coach anyone for improvement.”
Dr Garcia-Zuazaga developed many of those skills during his military training. “As a naval officer, you get put in situations where you have to make decisions that affect a lot of people,” he said. “You learn how to motivate people, and how to set high standards for yourself and your group.”
He sees his role as a doctor and physician owner in a similar light. “When you’re a physician, your name is on the door, but you are also part of a team. A very important part, but still part of a team.” Embracing that attitude, he said, makes for a high-performing practice, where everyone remains motivated, happy, and actively involved. “That is what drives the patient experience, which in the end is what makes you successful,” Dr Garcia-Zuazaga said. “That’s the secret sauce.”
Rick Simmons, co-founder and CEO of the telos institute, a global organizational consulting firm based in Cleveland, OH.
People call the telos institute when they are at what Mr Simmons calls “a key point of inflection.” Dr Garcia-Zuazaga was at such a point. When a mutual friend introduced them, the doctor proposed leadership training for his staff. His thinking was, “Motivate your team, and they will help you achieve your goals.”
First on the agenda was crafting a mission statement that clearly spelled out the core values of the group. The doctor was adamant that all his team members be involved in the creation of this foundational document. “If you feel like you are part of something bigger, it is always more meaningful to come to work,” he said. “We’re not just doing dermatology, we’re really transforming people’s lives. When you walk out our door, and you are skin cancer– or acne-free, that’s very powerful.”
A mission statement will also help inform a practice’s culture, or the way people in the organization are expected to behave. “If you have the right culture, patients will get the best care,” said Dr Garcia-Zuazaga. A big part of Apex’s culture is teamwork and transparency. For annual performance reviews, the group took a cue from major corporations and uses a 360-degree evaluation model where employees are rated based on feedback, not only from their direct managers, but from subordinates and peers as well. Doing so, Dr Garcia-Zuazaga said, allows him to better identify how the team works together, and individual strengths and weaknesses.
“In a lot of big groups, there’s no ownership,” he said. “You would be surprised how many doctors don’t share something as simple as how many patients they want to see in a day with their team. When you are transparent with expectations and share them with your team, they will try to meet them.”
Building on Success
From there, Dr Garcia-Zuazaga worked with the telos institute to create professional development programming for physicians and key people in upper management—“Anyone who has potential for leadership,” he said. “Every 3 or 4 months we would meet and tackle issues that would help make the practice better,” he said. Topics ranged from budgeting to conflict management. “Not everybody is a natural leader, but what we did made people more comfortable opening up that way and interacting in the group.”
Dr Garcia-Zuazaga during his days as a Navy flight surgeon.
Programming focused on what Mr Simmons calls “hard skills” and “soft skills.” “Just because you went to med school doesn’t mean you have a full understanding of the ramifications of running a practice,” he said. “Lead physicians are quasi business owners. You have to be able to analyze and have a working understanding of the metrics that drive a business.” Those skills are what he characterized as “hard skills”; “soft skills” involve how to communicate effectively, build a team, and make effective decisions.