Welcome to the Evolution of Medicine podcast! On this episode, guest host Kristen Brokaw sits down with Ari Meisel, founder of Less Doing. Ari discusses how doctors can utilize automated systems and organize processes into their practice. If you are someone who needs help with implementing better systems in place for not only your practice, but your day to day life, then listen to Ari talk about what made him realize these processes made for a better business mindset!

Highlights include:

  • Walking through the six levels of delegation
  • How automated services like voicemails and shared emails can help make your practice more organized
  • How to structure a new process by recording the steps and how the process flows, so it will be in place in case there is a new member to your practice, or someone is out sick.
  • Better ways to help practitioners think about what changes they can implement into their practice, so they don’t feel burnt out
  • And so much more!

Resources mentioned in this episode:

James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs in health technology, as well as practical tools to help you transform your practice and the health of your community. This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective, functional, and integrative medicine. To find out more and to get started, go to goevomed.com/lmrc. That’s goevomed.com/lmrc.

Kristen Brokaw: Let’s face it, decision fatigue and overwhelm are rampant in functional medicine doctors’ clinics. This podcast, I was able to interview Ari Meisel. He is a self-proclaimed Overwhelm-ologist expert. He helps entrepreneurs attack things like overwhelm, and really shifting their mindset around, how are you effectively communicating with your team? How are you delegating? Are you perfecting your processes? Do you have actually a strategic mindset to outsourcing, or automating things that currently you’re probably manually doing, day in and day out.

There are so many things that you possibly could be eliminating and you are going to want to listen to this entire podcast because Ari works specifically with a lot of functional medicine doctors and clinicians of all types, and he helps them set up the systems and processes, to eliminate this overwhelm. And so, that they can do more of what they love and less of what they don’t. Hi Ari, thank you for joining me today on the Evolution of Medicine podcast.

Ari Meisel: Hi, Kristen. Thank you for having me, it’s always a pleasure to talk to you.

Kristen Brokaw: Absolutely. Well, Ari, you have lessdoing.com, right? And so, I want to hear about your story. Just tell the listeners about your story, about why you even invented this kind of mindset and methodology.

Ari Meisel: Sure. So, the condensed version I guess, is that after I got out of college, I started working in real estate development and got very involved in a major construction project in upstate New York. And after working on that project for about three years, I was actively working in construction, so I was doing 18 hour days pretty much, I was not taking particularly good care of my body. I was under an enormous amount of stress and when I was 23, I was diagnosed with Crohn’s disease. And I feel like this is the first podcast I’ve ever been on, where I probably don’t have to explain what that is.

Kristen Brokaw: Right.

Ari Meisel: So, I got really sick, very quickly after the diagnosis and I was put on a lot of meds. And after a couple of really heartbreaking, I guess that’s the best way to describe it, bouts in the hospital, I turned things around and I went on this really intense journey of self-tracking and self-experimentation. And was able to get off my meds after about five months, from when I decided to do that, and ended up going on to compete in my first triathlon a few months after that, which was a big deal because I was so low in energy. I set my sights on Ironman France after that, which was about a year and a half later, and sort of a confluence of events while I was doing that and training a lot, and also still having to run a business and also still recovering.

The sort of package on everything is that I went from working 18 hour days, to struggling to get an hour of work done on a given day. And that extreme restriction on my time, is what has formed the genesis for everything that’s come since then because I had to figure out a new way to optimize and automate and outsource everything that was happening in my life and my business, in order to be more effective because I just didn’t have the time. And so, Less Doing was born out of that and that since has grown into books and speaking and coaching and formed into a business methodology, which I call the Replaceable Founder. So, what I do now, is I help entrepreneurs who have opportunity that exceeds their infrastructure, to create systems and processes that ultimately make them as replaceable as possible.

Kristen Brokaw: Absolutely and that’s exactly what drew me to you, was I had all these things I had to do, not enough time to get it all done and I heard you bringing up things that really, this mindset shift that I had to adopt. Bringing up things like, “How’s your communication with your team?” Or, “If you’re handling emails like this, you’re doing it wrong,” or, “Do you have your processes written down?” And it was just all these things time and time again, or, “Are things slipping through the cracks? Do you have a project management tool that you’re using?” And I just listened to you for a few years before I engaged with you and you’re hitting the nail on the head here with doctors.

So, functional medicine doctors, nine times out of ten, are entrepreneurs, so they’re having to manage everything. And a lot of times, they’re their office manager, they’re also sometimes answering the phone. So, there’s a lot that can be done and a lot that can improve with these types of practitioners. So, let’s start from the beginning. Well, actually, where do you think it all starts for a doctor in this situation?

Ari Meisel: Yeah. So, there’s so many different angles that I can, I’ll hit them all if I can, but there’s just so many different ways to approach this and I’ve worked with so many doctors at this point, both functional medicine doctors, as well as MDs and veterinarians and dentists, you name it. There’s some really common things that I find come up for all of those different groups. So, in terms of one of the [inaudible 00:06:47] the essentials necessarily because we’ll do overwhelm aspect and just managing all different pieces, which we can definitely address. But, one of the ones that just keeps popping up for me, is the customer journey, best way of putting it, and how you provide patient care outside of the actual treatment, so beyond the bedside manner, the whole experience of dealing with your practice.

First of all, it’s an area where smaller groups, or sole practitioners, really have a hard time keeping up with that and the larger ones, oddly enough, they still have the actual practitioner doing a lot of it themselves. So, I’ll give you a very specific example, I don’t know why but I see this more commonly with dentists that we worked with but it’s something that affects all doctors. It’s very typical at least for dentists, you’ll see nowadays, a dentist will often call every appointment that they had that day, just to check up on them. Just to see how they’re doing and maybe that’s six, maybe that’s eight, maybe it’s 10 patients but we’re seeing that more and more often. And it’s the first thing that goes when they’re busy, or they don’t get to do it.

So, I was speaking at the dental event several months ago, actually this is over a year ago now, and this one dentist was like, “Yeah, but it’s really important, I think my patients really care about that and it really has a human touch to it.” And I was like, “Great, so how many do calls do you make on an average night?” And I think he said eight. And I said, “How many of those typically go to voicemail?” And he said, “Eight.” And I said, “How many of those patients actually call back?” He said, “None.” And I said, “Great, okay but I’m not trying to discount it, it all has an effect, they get the message. It’s nice that they hear your voice and I think that’s important but that is something that we can actually automate and even outsource.” And there’s a tool that I’m sure you’ve heard me talk about called Slybroadcast, that allows you to send what’s called a Ringless Voicemail.

Now, I want to buffer this by saying that, automation for me is about enhancing the human connection, not replacing it by any means. So, we have to remember that. Slybroadcast allows you to prerecord voicemails, or messages of any kind and then you can send them at a scheduled time, or anybody can send them. It still has pretty much the same effect because it is your voice, you do care but this just systematizes it and makes sure that things don’t fall through the cracks. So, that’s a very, very small, simple example but there are ton of things like that, in terms of the customer journey and ways that you can provide that human touch, that follow-up, making your patients feel like you’re going the extra mile for them, without A, it having to take a lot of your time at a really inconvenient time. And B, not happening when you get busy. That’s one that I would call more the icing, so let’s talk about something that’s a little bit more, people being under water.

So, communication, project management and process, are the three main areas that I focus on in the program that we operate. And if you’re a sole practitioner, communication and processes become a little bit less important necessarily because the communication, we’re often talking about how you communicate with your team, or maybe even vendors. But again, as a sole practitioner, that might not be the biggest issue. Project management, in the middle, I find is one of the really big ones because a lot of doctors will sign up for some sort of EMR system because somebody else told them about. And then it’s clunky and they don’t really necessarily know how to use it properly and it doesn’t really serve the purpose of helping you manage your patients. And the number of different tools out there, especially as a sole practitioner because HIPA becomes less of an issue at that point, where you can track what’s happening with different patients at different points.

And while that might sound really basic, I think from the conversations that I have very often with doctors, a lot of the patient information just sort of blends together and it’s hard to keep track of what’s going on with any individual one. And ultimately provide an extra level of service, or drum up more business for yourself by reaching out to people at the right time, to deal with the right issues. So, I don’t want to not give you a chance to jump in here but I can keep going.

Kristen Brokaw: Keep going, absolutely. From what I see with providers, you’re right, communication, they have the team typically right there and it’s not as much of a problem but the projects of making sure that patients are getting rescheduled. Did they actually get the proper lab drawn? What were the results? Did we get back to them with the results? There’s so many different things, so I like what you’re saying. Continue.

Ari Meisel: So, I could name tools and things but the tool is not as important in this situation, it’s more about just having the right setup to do this. So, in terms of project management, there is a tool that I really love, which is called Trello and people can check that out. We have tons of resources on that but the thing that makes Trello really great, is what’s known as a Kanban method. So, it’s basically lists that represent phases and you can do this on a whiteboard, you don’t actually have to have technology for doing it but it’s a really great way to manage your patient flow. Everything from perspective patients, if you’re actually doing a sales outreach, through to actually treating them and then even to getting referrals. That whole customer life cycle. You really ultimately need to think about patients as customers, or clients at some level, if you’re going to be operating a business.

If you were just going to be treating people and not having to deal with any of the business stuff, then that would be a different story but most people that’s not the case. You’re both running the business and treating the patients. So, you really do have to have that layer, where you see them as clients, right? And doing the things that go along with that, like we talked about before, the customer journey and the tracking and for lack of a better word, almost like a CRM in some cases, customer relationship management.

So, in terms of communication, you want to be communicating with those clients and those patients obviously and coming up with a sort of, communication cadence, a rhythm of when you communicate with those patients and by what method and so much of that can be automated. We’re talking about, like I mentioned, the voicemails, text messages, postcards, hand written letters, emails, video messages, all of those things and that might sound like I just gave you a list of 15 things that you have to do but we can automate almost all of it. And again, this does not take away from the human element, it absolutely enhances it because the right intention is there and from the user perspective, they’re getting a more personalized experience than they might have gotten otherwise. People have to get out of the mindset that if they’re a small sole practitioner, they’re making a ton of money yet, you can do all of these things very cheaply and very easily.

Kristen Brokaw: And freely actually. We use Trello on my team and I don’t pay a dime for it.

Ari Meisel: Right, neither do I. I was part of Trello’s biggest users at one point and I’ve never paid for Trello. So, in terms of communication outwardly, something to think about right from the get-go, is shared inboxes. They’re probably a new concept for a lot of people listening to this. So, obviously you might have your email as like, bob@bobshealthcare.com, great. It’s a very simple thing to set up help, or concierge@bobshealthcare.com, right? And then, even if you are a solo practitioner, this is still a good idea because it almost immediately changes the expectations to some extent. If somebody’s emailing a role basically, instead of a name, it just sets a different expectation, even though you might still be the person answering it. So then, you would take that generic email and you would use a tool like Intercom, or Front, or Drift. There’s tons of apps out there to do this.

And again, it’s an effectively shared inbox with the ultimate goal of allowing you to bring in other people, whether it’s other practitioners, admins, or even virtual assistants, to help you manage that communication flow and it becomes a team sport. But, it sets a very different precedent and in all honesty, I think it makes you more established if you do that. So, rather than having a business card, or even when you meet somebody and you tell them, “Email this email,” it has a very different connotation I think than giving your, quote/unquote, “personal email.” And then it allows you to scale that communication a lot more effectively. So, that’s another big one.

Kristen Brokaw: Yes, and I personally use Front with my team and it’s changed our life. It was the very first thing you did for me and it changed my life because I’m staring at a windshield all day long, I’m driving around, going from office to office but I’m not just staring at my email while I can have my virtual assistant then looking at this shared inbox. And is so responsive, right? I would say that, providers, nine times out of 10 because they don’t live and die by their email, like the rest of the world does. Stuff is falling through the cracks and it would be great if someone could help them with that, so you’re spot on.

Ari Meisel: Yeah, that’s something that I honestly think that you want to try to, offload is not quite the right word, but you really want to try to systematize that communication as quickly as possible. And if you’re answering your own emails through your personal email, or not even personal but your individual email, to your clients and patients, that’s not going to work. You’re going to seem small time, even when you’re not, at that point. Honestly. And furthermore, you’re not going to be able to answer emails all day, every day, that’s just not a realistic thing. And then people are going to be disappointed and I’m telling you, as simple as it sounds, having that general inbox it just changes the expectation.

Kristen Brokaw: Right, because it’s not sustainable that they’re going to be able to manage that email. A lot of those questions that they’re getting, you can also have help, one of your supportive people that can probably get good, at answering a lot of those things over time. And then you can even set up some templates, “Okay, when they ask about this, this is the protocol.” So, let’s talk about the sixth levels of delegation. This was something that really helped me and I know that providers just being entrepreneurs and oftentimes, solopreneurs, that they think they have to do everything. And if they get some help, and a lot of them have staff, but this really clears things up. So, why don’t you tell us a little bit about that.

Ari Meisel: So, outsourcing, delegation, first of all I use fairly interchangeably, so whichever one I use, it applies regardless whether, or not you’re using a virtual assistant somewhere across the world, or a billing specialist that’s sitting at the front desk. It doesn’t really matter, a lot of this comes down to communication and being able to effectively communicate what needs to get done in a way that, really empowers the person that you are delegating to but more importantly, avoids confusion. So, I developed a methodology called, The Six Levels of Delegation and a lot of the hang-up that people experience, or have experienced with outsourcing, is that they often see it as a very binary activity. And what I mean by that is that, internally, or subconsciously, we tend to think that, it’s all, or nothing. Either I have to do everything myself, or I have to give everything up to somebody else and neither of those is really a comfortable situation.

So, I actually teach that there are six levels of delegation that you should be utilizing and they go from, just do what I say, which is level one. Meaning, don’t think about it, I don’t want your opinion, you just have to do exactly what I’m telling you to do, which is very freeing in some ways. It’s not empowering at all but it is very freeing because there’s nothing to question at that point. And then we go all the way down to level six, which is, just get it done. And just get it done meaning, I don’t care how you do it, or who you have to talk to, or how much it costs, or how much time it takes, just get it done. Which is the ultimate level of empowerment and connotes a certain level of trust but more importantly, recognizes that your involvement at that point, would probably hinder the process. That’s really key with level six.

I’ll give a basic example, a graphic designer, I have an idea of what things should look like and what I like but I don’t know anything about fonts and the difference between 17 different red colors and stuff and so, for me to weigh in at that point, just screws up the person who really does know what they’re doing. And that’s an ego thing for some people but recognizing you sometimes have to really just get out of the way in that situation, is really crucial. Now, there’s a whole sort of spectrum of different levels within that but when we teach people how to delegate properly, you tell people what level it is and it allows you to actually more quickly, hand off things because you know what the limitations are and so do they. It sounds simple but it makes a huge difference, especially when it comes to overworked doctors, who are in a rush, seeing lots of patients and also, very, very educated. It’s hard sometimes to quickly and effectively, connote what you need to get done.

Kristen Brokaw: Let’s talk about those six levels. The first one is, just do as I say and then, take us down all the way to level six.

Ari Meisel: Sure. So, level two is, look into this basically, look into this and get back to me, do some research. In some ways, level two is kind of like a punt. It’s buying yourself a little bit of time, while not wasting anybody’s time. It’s like, “Look into this, get back to me with what you found and I’ll take it from there.” Level three is, advise me. So, “You look into this and you tell me what you think we should do,” and that could be choosing a piece of software, it could be what color to paint the office, whatever it is. But, “You look into this, you come back to me with your opinion on what you think we should do and then I’ll make the decision though.” Level four, is where we sort of flip the script a little bit and it becomes a lot more empowering, where we’re saying, “Decide.” So, “You look into this, you decide but let me know, keep me informed of the decision that you have made and move forward.”

Level five, which is where I operate most of the time I would say. Actually that’s not true, I’m pretty much a level six as much as possible but level five is great and it’s one that I think a lot of people don’t consider. So, level five is, you decide within limits. So, the limits could be money, time, space, kind of anything. And where this came up for me was, this was years ago, but I was away for a long weekend I think with my family and I came back to find that there was a delay in something with the team because they didn’t want to make a $225 decision in my absence. So, that was not okay but they also hadn’t had the parameters previous to that, so it wasn’t their fault. Going forward, you can set those limits saying, “Look, if it’s a $500 decision, or less, I don’t need to know about it and I don’t want to know about it, anybody can make that decision.”

So, the difference between level four and level five, four being decide, five being decide with limits, at level five they can sort of operate on their own and as long as they’re within those limits, they don’t even have to tell me, or anybody. So, they can just keep moving. A lot of this is really about removing the bottle necks and removing the slow downs, and letting people do what they need to do and getting out of the way. So, level five is huge for me. And then level six is, as I said, just get it done. “I ultimately trust you to do it, I don’t have a good amount of input to give you, quite the opposite. As long as it’s done, I don’t really care.”

Kristen Brokaw: I think that is going to help so many people because the doctors are dealing with decision fatigue on the regular, with just the patients, much less their staff. And if they were able to just go in and say, “Okay, this is within these parameters, or just get it done, I don’t want to be…” And they understand that they are actually bottlenecking. That was the big aha for me, is I realized I’m actually bottlenecking progress by having to see everything. So, thank you, that’s huge.

Ari Meisel: Sorry, I want to pick up on that for a second because that’s one of the most common issues that we see come up, which is the leader, or the founder, or whatever it is, or the boss, just feels like they need to be on top of everything. And there’s several things to unpack there. The first one, it’s a total ego thing because assuming that you are the best at this thing, in and of itself is a problem because probably not, none of us are, it’s a false baseline to start from. Just because I’m looking at it, doesn’t mean it’s going to be done right. The second part of that is, that you are actively robbing the people that work with you of the opportunity to grow. Furthermore, it sets a precedent and a culture, that mistakes are not okay.

Now, obviously in patient care, we don’t want to have mistakes happen, although they do and we have to learn from them, but that’s not what we’re talking about here, we’re talking about the business operations. And I think that line gets blurred often for doctors, where it’s like, “Well, I can’t make a mistake in patient care, so mistakes can’t be made in the business.” And that’s just not realistic.

Kristen Brokaw: Right. Since we’re honing in on communication, this ties into the three decisions, the three D’s. So, let’s talk about that because again, we’re talking about this decision fatigue. So, what made you come up with this and tell them a little bit about it.

Ari Meisel: It’s actually the very first module that we teach in The Replaceable Founder, which is the three D’s, the three decisions. And we use it as a way of teaching inbox 0 but it really is a decision-making matrix in general. And so, the idea, and you mentioned decision fatigue and absolutely doctors have that probably worse than many. The average person is good for maybe a couple dozen decisions any given day and most of us are making hundreds, if not thousands. So, we need a way of making more effective decisions and my way of attacking that, is to limit the decisions that we can make.

The three D’s are, deal with it now, which could include delegating it. Say no, so that leads to delete because again, we use this for email but say no, or decline it. And the third one, is to defer it to a time that you can more effectively deal with and really take ownership over it. The idea is for us to be able to take any decision that might come our way and this is the initial way of handling it and sort of triaging it, if you will for lack of a better word. Obviously if we’re talking about which heart valve do we replace, that’s a very different decision. This is the initial interaction with any decision you have, you should be able to sort things in such a manner. So, either we’re going to deal with it right now, which again, could include delegating it. We’re going to say no, which most of us have to better at doing anyway, or we’re going to defer.

Deferring is really interesting to me because there are better times and places where any of us does different things better, or worse and starting to learn that about ourselves, is really important and most of us don’t know that. For example, I’ve been an EMT for almost a decade now, a volunteer EMT and when we see a patient, we have to fill out a PCR, which is a Patient Care Report. I pretty much can only do those at 10:00, or 11:00 at night. It doesn’t require a ton of brain power, you’re just kind of painting the picture of what happened in that call, but it’s just something about the way my mind works in timing. So, if I try to do that in the afternoon, or if we have a call in the morning, or something, I try to do it in the morning, it’s just not going to happen. So, whether I see one person, or three people in a day, I’m doing all my PCRs at 10:00, or 11:00 at night, after the kids have gone to sleep.

It’s really freeing because I’m not going to try to slug through it during the day and not do a good job and be frustrated. I recognize that there’s a better time and place for me to do that. There’s a better time and place for you to learn, for you to deal with email and admin stuff and to have team meetings. All of these things have their own time and place and we have to be able to discover those, through various different methods but ultimately, that third D, that defer decision, allows you to take back control and say, “No, this is not procrastinating. I can do this better at 8:00 tomorrow morning, or 8:00 on Friday morning than I can right now.”

Kristen Brokaw: This I think, is another huge one for providers because as I’m in an office, I’ll see the doctor come out and it’s like a hurt cat kind of, come at them, right? Because then the staff has to get the six question, [crosstalk] everybody. The doctor is just thinking, “I’m still processing what I just did and what I need to focus on with this patient and now I have to deal with all these little things,” potentially. And so, I think for providers, that would be so huge, if there was… I heard Dr. Shilpa Saxena talk about clinical case conference. She’s a functional medicine provider and she said she’ll say to the staff, “You know what, that should go to case conference.” And once a week, maybe a question about a patient, it’ll go into case conference. So, very similarly to what you’re saying, they designated a time when X can be done better. And you’re right about delete. We all could stand to say, “No,” a lot more often but if they also had the six levels of delegation kind of understood and utilized amongst the staff, I bet those questions would diminish.

I want to finish here with processes. I have been working with you for a while and following you for years, I have created processes in how we do things. Even processes for just myself but processes so that I’m able to hand this off to someone else. Well, first of all, a lot of people don’t have their processes documented, let’s just face it, right? I realized I didn’t have my processes documented, so that’s first and foremost. Then when you think how many providers have had that one person, who knows how to do the one thing, go on maternity leave, leave, get sick and then they’re up a creek. And then none of the user IDs and pass codes are remembered, it’s one of those kinds of things, but having a process that can actually be refined and done better, is excellent.

But, when you gave me the tip of, “Kristen, you do not have to do these processes, you don’t have to even create the checklist, or the outline. You video yourself doing XYZ, something on the computer,” how you enter a new patient into the EMR, “and if you take a video of that, then that way…” Actually, I won’t steal your thunder, why don’t you just tell us about the best way to document processes.

Ari Meisel: I was enjoying that. A lot of people do it backwards, that’s really the short version of it. They’ll show somebody how to do something and then they say, “Okay, now go do it.” And that doesn’t usually work very well and it sort of enhances this vicious circle, that we don’t trust people to be delegated to. When you do that, you’re showing them the shortcuts that you have picked up and figured out and learned over months, or years of doing that process, without actually identifying the shortcuts for them. So, then they get into and it’s, okay, this isn’t working and they don’t know why. We need to flip that around and what you do instead, is you show somebody how to do something, whether that’s in person, or with a video, or with a screen cast, depending on what the task is and then ask them not to do the task but to document the process that they saw. So, they’re going to write a checklist down, maybe it’s five steps, maybe it’s 20, doesn’t’ matter. And then, we want them to take that ideally and give that to a third person, who has never seen it before.

And honestly, that third person could be your mother-in-law, if you want, they should not be somebody who has any skills necessarily related to the task because if you document a process in this way, what you’ll eventually find, is that you can take very complex process and break it down in a way that anybody should be able to do it. And I really do mean any process. We’ve done this with very extensive, not medical procedures, but medical office procedures. And a 182 step, multi-conditional, mortgage loan origination processes for really large mortgage banks, so this works, I promise you.

What happens is, that third person goes through it and they’re going to find all the inconsistencies because what happens then, is they get to step three and step three says, “Open the patient record for, this patient today.” And that third person is going to say, “Well, how do I access that record? Where is it? Where do I log in? What password do I need?” And you’re like, “Okay, right. So, we have to identify that in the process, that you have to go to this link and your password is in your password manager,” whatever it might be. It’s not enough to just refer to an asset relatively, we got to be absolute about it. It’s not, “The document,” it’s like, “This exact specific document.” Then they’re going to get down to step 15 and it says, “All right, when you’re done with this part of the record, click the big red button.” And that third person is like, “Well, I don’t see a big red button.” And you say, “Right, because I was logged in as the admin, you’re not. I have to make that adjustment, maybe create guest privilege,” or whatever it might be.

And then at the very, very end, it’s like, “Okay, when you’re done with this whole thing, send a copy of this record to Jerry in medical billing.” And the third person says, “Who’s Jerry? How do I… What do you mean?” And that has to be switched, so that the people are not referred to in an absolute sense, they’re referred to a relative sense. So, it would be, “The medical bill are responsible for this account, which can be found here,” or something like that. And that sounds like a very trivial subtle shift but let me tell you, if you want to make somebody irreplaceable, name them in a process. So, you do that and you iterate in that way and it sounds tedious but first of all, you get really good at it really quickly. Second of all, some processes are six steps and there’s not much more to them but learning to do it this way, you end up with a process that is so bulletproof, that you’ve now shown that it works. Not only the tertiary level, which effectively means you could grab somebody off the street and have them run through that process.

Kristen Brokaw: Yes and this totally works everyone, I am living proof. At first I was like, “Oh, this isn’t that big of a deal and does this really…?” No, we are documenting everything and here’s the secret folks, when you keep going through it each time that process needs to be addressed, you’re iterating, you’re always changing and tweaking. It doesn’t mean it’s static just because it’s done once, right? You taught me that, that like, “Yeah, you’re always kind of tweaking and changing and actually making better.” And then we house those in a system called Process Street but we also even house smaller ones in our Trello cards and that seems to work for some of the smaller ones. I’m just throwing that out there, you could even just use an Excel document, or a Word document.

But, back to the video, like I said, we use Loom, L-O-O-M, L like lion and Loom allows you, and it’s free, to just record on your screen of you doing something and then someone can go and watch that and create the process watching you do it. And then that way, you’re not the one doctor who is, on your weekend, trying to create checklists when, let’s face it, you’re never going to do it because you’d rather stick a hot poker in your eye. Am I right Ari?

Ari Meisel: Oh yes, you are absolutely right. [crosstalk 00:39:43] And the thing is too that, especially when it comes to this industry, there’s a lot of processes that are the same. How we enter patients into records and how we do billing and insurance, you’re really not reinventing the wheel with this stuff at all, so why act like you are? Why should that be an opaque process that exists in your head, or the head of somebody else? We can easily document these things. And by the way, once we document them properly, and by properly I mean the way that I just told you to do it, it becomes so much easier and more obvious, to automate and outsource those things because it just does, it’s sort of like the nature of the beast.

Kristen Brokaw: All of this is, so that you give someone more freedom, to do just what they were put on this earth to do. And that’s what every functional medicine doctor wants to be able to do, is more of what they love and less of what they don’t. They have a lot of decision fatigue and I think processes and time management and all this, doesn’t sound exciting but once I dove into working with you and your team, it’s been a game changer for just my mindset and my free time really.

Ari Meisel: And that’s the key word. Sorry, not to interrupt you but the mindset is really what this is about because I mentioned actually several technology tools but none of those matter, if you don’t have the right mindset for this. I could tell you the greatest automations and the greatest tools but if you think that using them is going to somehow dehumanize the process, then you’re never going to do it. So, this really does come down to a mindset about empowering people, about offloading things, about getting out of the way of good business operations.

Kristen Brokaw: Ari, you work with doctors and clinicians of all sorts but you do a lot of it one-on-one, so tell them how they can find you and work with you if they would like.

Ari Meisel: One of the things that we really need to touch on, in terms of communication, is asynchronous communication, which to me, is the greatest possible productivity weapon I have. Which is the opposite of what we’re doing right now but this is the kind of setting where you would have synchronous conversation. Obviously patient care also, although there [are] exceptions to that too, where you’re going to be hands on, that’s going to be synchronous too. But, a lot of the other stuff like, the office stuff, the admin, the team stuff, a lot of that can and should be done asynchronously. So, that’s how I operate, that’s how I do my coaching. I use a tool called Voxer, which is a voice communication app. And I actually do have a doctor that I’m working with right now because I’m doing a one-on-one coaching, and it’s asynchronous. They can send me a message three, four times a day if they want, for a minute and we can go back and forth, or something. And then they can send me a much longer message when they have the time.

I get so much more rich information this way and it’s honestly the most effective coaching I’ve ever done. Currently I’m working one-on-one with 12 really high-level individual entrepreneurs and I don’t have a single call scheduled on my calendar, so that’s how I operate. And to find out more about that, the best thing to do is just go to voxwithari.com and if it sounds interesting, then you can reach out to me on Voxer and it’s going to be me. Not an assistant, not a salesperson that’ll respond and I’ll be able to tell you in about two and half minutes, or so, if I’m a good fit for you, or not.

Kristen Brokaw: Awesome. Thank you so much Ari, for joining us and I sure hope you guys got tons of tips out of today. Thank you.

James Maskell: Thanks for listening to the evolution of medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools like the group visit toolkit. That’s goevomed.com/lmrc. Thanks so much for listening and we’ll see you next time.

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