Someone is Blocking Your Success
Someone is blocking your success. Who is it?
BLOCKERS, Episode 6.
Someone is blocking your success.
You already know who. You’ve known for a while.
And you haven’t said their name out loud to the person who could do something about it — which, in most cases, is you.
I know this because of the requests I get to change our software in an attempt to fix a people problem.
Let me explain. Every few weeks, a provider asks me for a feature that goes something like this:
Can you make it so they can’t change that?
Or: is there a way to lock that down so only I can edit it? Or: could you add an approval step before it goes out?
Every one of those is a reasonable feature request. Some of them we’ve built. But after ten years of hearing them, I’ve learned to ask a second question before I write anything down.
Who is “they”?
And about half the time, there’s a pause. And then a name.
It’s not a permissions problem. It’s a person. Someone on staff is doing something that shouldn’t be happening, and rather than say that out loud, the practice owner is asking me to build a wall around them.
I understand it completely. The software is easier. The software doesn’t get upset, doesn’t quit, doesn’t make Thursday awkward. You can solve a person with a settings change and never have to say the sentence.
It just doesn’t work.
Five issues in, let’s say the obvious thing
Everything I’ve written in this series so far has put the blocker inside you.
You were focused on the wrong thing. You didn’t know what to do first. You spent twenty hours avoiding a five-minute problem. You said too much in your patient meeting instead of offloading that education to a delightful system.
All true. All fixable by you, alone, this week.
But some of you read the other articles and thought: John, that isn’t my problem. My problem has a name and it comes to work every day.
You’re right. And I skipped it, because it’s the hardest one to write about.
So let’s do it.
The tell
A person-blocker has a specific signature, and once you know it you’ll spot it in about four seconds.
It’s the problem you describe without naming anyone.
Listen to yourself talk about it. We’ve had some challenges with consistency at the front desk. There’s been some friction on the scheduling side. Communication hasn’t been where it needs to be.
Passive voice. No subject. Nobody did anything — things simply happen, mysteriously, in your practice.
You don’t talk about any other problem this way. You don’t say “there have been some challenges with the printer.” You say the printer is broken and you call someone.
When the grammar goes vague, there’s a person in the sentence you’re refusing to put there.
Why it lasts three years
Here’s the part that makes this different from every other blocker I’ve written about.
The others are invisible. You can genuinely not see that you’re avoiding something, and the whole job of this newsletter is to make it visible.
This one you can see perfectly. You’ve seen it for a long time. It wakes you up sometimes.
You’re not confused. You’re dreading.
And dread has a longer half-life than confusion, because confusion gets resolved by information and dread doesn’t get resolved by anything except the thing you’re dreading.
So it sits. And here’s what it costs while it sits:
It’s not just that person’s work. Everyone else in the building knows. They’ve adjusted around it. They’re doing pieces of that person’s job quietly, they’ve stopped raising it because nothing happened the last two times, and some of them have privately concluded that you either don’t notice or won’t act.
Both of those conclusions cost you more than the original problem.
Your good people are the ones who leave. They have options. The person you’re avoiding usually doesn’t. That’s the asymmetry that makes this expensive in a way you can’t see on any report.
And you’re paying for it in your own head. Ask yourself how many hours you’ve spent thinking about this, rehearsing conversations in the shower, drafting emails you didn’t send. Multiply by your hourly value. That number is real and it’s already been spent.
It might not be who you think
Two complications, because I’d be doing you no favors with a clean version of this.
Sometimes the person is a partner. Which is worse, because you can’t manage them and you can’t replace them. Nothing I write here is going to hand you an easy answer for that one. But the same rule applies — the conversation you’re not having is more expensive than the conversation you’re dreading, and partnerships that survive do it by having the hard talk about three years earlier than the ones that don’t.
And sometimes the person is you.
That’s the one nobody wants to check. Everything you do goes through you. The approvals wait on you. The decision that unblocks four people is sitting in your head, and you’ve been calling it being careful or maintaining standards or not being ready yet.
If your team’s most common blocker is waiting for your response, you don’t have a personnel problem. You have a bottleneck, and it has your name on it.
Worth checking before you go fix anyone else.
You are trained for this. Genuinely.
Here’s what makes me a little crazy about this one.
You deliver bad news to strangers for a living.
You sit down with a person you barely know and tell them their labs are worrying. You tell someone their drinking is the thing. You tell a patient that the plan they’ve been on for a year isn’t working and you need to change it. You do it kindly, clearly, without flinching, and you’re good at it — good enough that they usually thank you.
Then you walk down the hall and can’t tell your office manager that the front desk is costing you new patients.
It’s the same skill. The only difference is that you’ll see this person tomorrow.
Which is exactly the reason it can’t wait — you’ll see them tomorrow either way.
What to do today
Not the conversation. Something smaller, because if I tell you to go have it you’ll put it off and feel worse.
Write the name down. On paper, for your eyes only. That’s it. You’ll notice how much resistance there is to doing something that costs nothing.
Write one sentence describing what’s actually happening. Active voice. A subject and a verb. Not “there have been challenges with consistency.” Something like: Sarah isn’t returning new patient calls the same day, and we’re losing people.
Ask whether they know. This is the question that changes the shape of the whole thing. Most of the time, the person has never been told directly. They’ve been hinted at, worked around, and quietly resented — but never actually told, plainly, in a sentence.
If they don’t know, you don’t have a firing decision. You have a conversation you owe them.
Then put fifteen minutes on the calendar. Not a meeting about the problem. The conversation itself, with a date on it.
And if you find yourself scheduling a meeting to plan the conversation — you’ve read the issue about fake decisions. You know what that is.
And where I come in
Nowhere, and I want to be clear about that.
I can’t sell you anything that fixes this. There’s no feature, no automation, no setting. If you came to me tomorrow and asked me to build the wall, I’d probably build it, because you’re the customer and it’s a reasonable request.
It still wouldn’t work.
The only thing software does here is make it possible to avoid the conversation for another eighteen months, at which point you’ll have the same conversation with more scar tissue and fewer good people in the building.
What I can tell you is that I’ve watched this specific thing sink practices that had everything else right. Good clinicians. Real demand. Solid margins. And one unaddressed person, protected by three years of nobody saying the sentence.
Write the name down. That’s all I’m asking today.
Email me and say blocked, and I’ll help you find your first thing.
John Cummings
Founder, BodySite.com
P.S. — On Tuesday I’m publishing something new. I sat down with a practitioner on camera and we worked through what’s actually blocking her practice, unrehearsed, with no idea where it would end up. She was more candid than most people are in private. If you’ve ever wondered what this looks like when it isn’t an article, that’s the one to watch for.
Catch up on the series: Episode 1 — Stop looking at the car · Episode 2 — What should I do first? · Episode 3 — Just start with breakfast · Episode 4 — Your patient forgot in the parking lot · Episode 5 — If it didn’t hurt, you didn’t decide