Case Study: Results with Maximum Change

DocBy Dr. Philip A. Foster

Background
A premier interventional pain management and ambulatory surgery center in middle Tennessee focused on helping adults with musculoskeletal or neuropathic conditions regain strength, mobility, and function while avoiding narcotics or major surgery. This highly regulated medical practice (the practice) is headed by an acclaimed physician and leader in the field of interventional pain management.

The practice was in process of becoming an accredited surgery center. With the expansion, the stakeholders were seeking additional surgeons to join the practice. During disclosure it was determined the practice was losing on average $110,000 a month in revenue and this would limit interest by investing physicians to join.

Diagnosis
We focused on four main areas of concern: Front-office mismanagement, workplace conflict, disengagement of the stakeholder/leader, and back-office mismanagement.

Front-office (intake) mismanagement included customer service, scheduling, purchasing, intake (pre-authorizations), pre-billing, co-payment, proper paperwork and compliance.

Customer Service: Reception is the first experience patients have with the practice. Going to a doctor, specifically for chronic pain is not a pleasant experience to have. It is important that reception work to ease tensions and to be a friendly reassuring face of the practice. At the time of the review, the practice had a front desk staff that was lacking in the area of customer service. Some areas of concern include: long wait-times for patients, improper interactions with patients, phone etiquette was rough and sometimes even costic. Some patients were turned away because they arrived without the proper documentation or referrals.

Compliance issues: HIPAA violations were observed. Specifically the positioning of computer monitors and conversations overheard from the waiting room.

Scheduling conflicts: Patients sat in the waiting area for extended periods of time and on occasion some may have been turned away altogether. No front office manager or practice manager who can delegate work and maintain workflow. Very little accountability of time, resources, scheduling, etc on a regular basis.

Expenses: Reception oversaw the purchasing and expenses within the organization. There was no inventory control over oversight and expenses were out of control.

Workplace conflict is not uncommon as it typically involves differences of opinion, style, or approach that are not easily resolved. In the case of this practice, there were layers of conflict. There were conflicts between co-workers as well as conflicts between the stakeholders and employees. The greatest level of workplace conflict in the practice was between the stakeholders and employees in that there were proper ways to do the work and then there was the way the employees wanted to do the work.

Disengaged leadership is a challenge that many organizations face today. What we know about leadership is that it is a participation sport. An engaged leader is about being visible, present, and connected with the employees. Engagement requires strategy and the ability for a leader to recognize their personality and how that plays out in the office setting and among their followers. Disengagement of leadership does not necessarily note a lack of skills or ability.

Leadership engagement takes a lot of time an energy – something many leaders feel takes away from their core responsibilities. In the case of this practice – engagement of the physician requires time that the doctor feels is better spent with patients.

Back-office: Billing issues. Medical billing is in constant fluctuation and is based on a complex set of variables. The billing department was missing opportunities to bill and thereby left a great deal of money outstanding.

Treatment Plan
To begin the process, we conducted several days of in-person observations over a one month period. Some of the observations were done without the knowledge of the staff. The first day of observations, Dr. Foster arrived and sat in the waiting area to casually observe the interaction between staff and patients. On another occasion staff was directly observed. One observation was made in secret. Dr. Foster entered from the back door and sat in a back office down the hallway from reception so that he could audibly observe what was going on in the office.

Dr. Foster met directly with a compliance consultant and the physician/stakeholder of the practice to get input from both parties as to the problems at hand. The compliance consultant was spot on in their observation. The physician focused concerns on what they believed the issues were. Physician felt as if their position within the organization was taken for granted. Physician felts as if the staff was running the show and not him.

An organizational culture assessment was conducted to determine the culture of the organization. The assessment was conducted by use of a questionnaire which requires individuals to respond to six questions. The purpose of the OCAI is to assess six key dimensions of your organization’s culture. Each of the six key dimensions has four alternatives and two columns for each alternative marked now and preferred which indicates how we think it should be in five years in order to be successful as an organization. The OCAI is based on a theoretical model known as the Competitive Values Framework which is used to interpret a wide variety of organizational phenomena such as the organizations core values, assumptions, interpretations, and approaches that characterize the organization. Overall, the survey results indicate:
Respondents would like to continue to develop sense of a team. Continued training, team-building and coaching is recommended.

Respondents would prefer less adaptability, flexibility, and creativity. Organization must determine the level of adhocracy desired and develop plans to train and equip the staff in areas where uncertainty, ambiguity, and information overload is possible.

Respondents would prefer a greater focus internally and less externally. Appropriate balance between external and internal focus is required. Given that the organization relies on referrals and relationships external to the organization. A fitting policy and procedure for handing external interaction is recommended.

Respondents desire greater emphasis on hierarchy. Developing policies, procedures, and clear lines of authority and duties would be helpful to the members of the organization.

What was revealed
Insurance calls by reception should not be conducted during busy times of the day. Insurance calls should be conducted by someone who will not be continually interrupted.

For HIPAA compliance, front desk computer screen should be positioned so that it cannot be seen by anyone standing at the reception window.

Pre-screening of patients should be conducted via a checklist and that no patient should be given an appointment without proper paperwork submitted. Specifically, referrals and pre-authorizations from insurance should be completed prior to patient arrival as to limit the patients stay in reception waiting.

Pain patients should not be left waiting for a doctor because the doctor is stuck speaking with a drug representative. Drug rep visits should be handled by the practice administrator and any specific meetings required of the doctor should be set at “non-busy” times of the day.

Patients seem to wait a long time – practice should track check in time against wait time.

There is a strong need for weekly intense coaching and mentoring on customer service, time management and even practical computer and office skills.

Front office should have a day-to-day office manager or practice manager that can delegate work and maintain workflow. There appears to be very little accountability of time, resources, scheduling, etc on a regular basis.

Job descriptions should be developed and tied heavily to performance. Such performance measures should be: patient wait time, efficiencies, demeanor, and number of compliments or complaints – just to name a few. Currently raises and bonuses in general are not tied to any such performance metrics.

Practice should have front office staff that is cross-trained in the event of vacation, sick day, etc.

Numerous complaints from referring colleagues. Such complaints can be tied to performance. It would be helpful to poll referring agencies at least once a year asking one or two simple questions to make sure that we are hitting the mark on customer service, etc.

Tracking wait time and scheduling are keys to the overall performance of the practice. The practice is losing money due to inefficiencies in use of physicians time, scheduling and wait times.

Bonuses should not be an expectation of any position – however, if bonuses are to continue they should only be tied to performance as based on the positions job description and performance ratings.

Results
Based on observations, discussions with the stakeholders and the organizational culture assessment, we developed an intense coaching plan for the staff as well as the practice leadership. Weekly coaching for employees was focused on workflow, time management and customer service.

Ultimately, It was noted that the position and the practice outgrew one of the staff members capabilities. This particular staff member had been with the practice for many years. After intensive coaching and little improvement, the staff member was ultimately released with a generous severance package.

At our recommendation, two staff trainings were conducted over a one year period. The first training was focused on Customer Service and all staff members with the exception of the physician were in attendance. The second training, held after several changes in staffing, was team building. Again all staff were present with the exception of the physician. The team building process would have been much more powerful if the stakeholders had been present.

After training, coaching and changes in staff, practice went from a loss of $110,000 a month to a 45% increase a month in revenue within 7 weeks. Additionally, expenses went down by 18% with the recommended changes.

For more information on Maximum Change Coaching and Consulting, please visit our website at http://www.maximumchange.com

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The Open Organization – 2nd Edition

OpenOrgCover2ndEditionIn 2014 I published what is thought to be the seminal work on the subject of Open Organizations. My goal was to present a text that provided a template for developing an Open Organization.

Nearly a year after my book was published, Jim Whitehurst CEO or Red Hat published his book The Open Organization. Igniting Passion and Performance. What I love about Jim’s book aside from the cool title is that he approached the subject from his perspective as a leader leading an Open Organization. Jim’s book put skin on the idea of Open. I would argue that Jim humanized the concepts. It is one thing to write about an organization from a case study perspective and an entirely new experience when the writer is living it out in real time.

Since the publication of my book, I have continued researching and writing on the subject of Open. I am proud to say that I am now an active member of the OpenSource.com group as an Ambassadors and Open Evangelist. Because the idea of an Open Organization is still evolving I felt it time to produce a 2nd edition of my book and address some of the changes. While most of the text remains the same and changes were mostly mechanical in nature, there are four major changes in this edition. They are:

  1. The book is now in softback and the price is much more reasonable than the original text. $30.00 on Amazon.
  2. More detail was added to Chapter 4 under the heading of Meritocracy. I begin to address some of the early challenges researchers have noted in Meritocratic organizations.
  3. More detail was added under the heading of Holacracy in Chapter 4. Where in the early text I recognized Holacracy as a form of Open, I have since stepped back from that idea and no longer consider it to be a pure Open system.
  4. In this text I begin to more deeply address the concepts of a distributed workforce. The implication of a growing distributed workforce is central to the expansion of the 21st century workforce.

You might be wondering what comes next. I will continue to publish articles, blogs, and videos on the evolution of Open Organizations. I am also writing my next book which will focus in on some key elements of the 21st century organization.

To get a copy of The Open Organization 2nd Edition – visit Amazon HERE.

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Dr. Philip A. Foster is considered a Thought Leader in Business Operations, Organization and Strategic Leadership. He is a prolific writer, International Lecturer and Best Selling Author of “The Open Organization” – now available on Amazon. Philip is certified in both Leadership and coaching. He is the Founder and CEO of Maximum Change Consulting, serving clients from around the world. He holds a Doctorate in Strategic Leadership with emphasis in Strategic Foresight from Regent University, Virginia. You can contact him at http://www.maximumchange.com

3 Reasons You Need a Consultant

business_management_consultantsIf you own a business of any size there will come a time when you will need some advice. Perhaps you have a simple question or a complex issue. Either way you clearly know that it is not wise to go-it-alone. While there are a multitude of reasons you might need the service of a consultant, I wanted to highlight three key reasons you need a consultant.

First, there is a fresh new perspective to the problems you face. If you believe you know the answer then, by-all-means, go for it. Recently I received a request to quote on a project for a potential client. The client began to tell me what they thought the problem was and how they wanted it fixed. I asked them the tell-tale question “what if that isn’t really the problem?” They were adamant that the problem was the problem and that if I wanted the business I needed to quote the job as they requested. I softly pushed back and told them that I could not engage a project where I was given a predetermined problem and a predetermined solution without at least testing their hypothesis. While it is not a bad thing to think you might know where the problem is, it is not good to assume that there might not be more to the issue that you are able to see. This is why you need a fresh perspective. I’ve seen clients like the one described here. They will burn through thousands of dollars and numerous consultants, looking for the one that will prove them right. But, what if they are wrong? The business won’t grow, change, and improve without the humbleness to realize an outside perspective is not a bad thing.

Second, a consultant brings insight. I have over 24 years of leadership and business experience in an array of industry silos and business structures. I have two other colleagues I work with that equally have the same amount of experience. A consultant’s insight is not just from their work background but is built on every consultant assignment they have completed. In my case, I have literally thousands of client hours in experience. Because I have a fresh perspective, I am able to offer new ideas and insight toward the appropriate solution. As a leader, I want – No, I need to surround myself with people who have insight. I never want to be the smartest person in the room when I am trying to come up with solutions. Insight is a powerful tool when used.

Finally, a consultant helps you develop alternative solutions. Considering the client example provided above, the client clearly didn’t want to hear about alternative solutions. They had their mind made up about the problem and had a clear path to the solution. For the client, this is a train wreck waiting to happen. Business leaders need alternative solutions. What if I were to ask you how would you prepare your organization for a future 10 years from now? Would you know what to consider? Would you know how to build a scenario profile? Perhaps you do… but do you have the time to research all of the potential disruptions on your event horizon? Or, do you have the know-how to facilitate and analyze a cultural assessment or leadership profile for your team? Perspective leads to insight and insight leads to alternative solutions. It is the knowing of which tools to use and how best to operate them.

The best consulting relationships I’ve entered are collaborative. When you can work with the client to create effective lasting solutions – it is powerful. You need a consultant because you need a new perspective. You need a consultant because you a fresh insight. You need a consultant because you need lasting solutions to your challenges. Wise counsel is a good thing. For that reason alone, it is always good to have a consultant available to you.

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Dr. Philip A. Foster is considered a Thought Leader in Business Operations, Organization and Strategic PIC3Leadership. He is a prolific writer, published author and lectures internationally. His most recent book “The Open Organization” is now available through Ashgate Publishing.  Philip is certified in both Leadership and coaching and serves as Adjunct professor at Middle Tennessee State University, Murfreesboro, TN. He is the Founder and CEO of Maximum Change Leadership and Business Consulting, serving clients from around the world. He is a Doctor of Strategic Leadership with emphasis in Strategic Foresight and holds a Master of Art in Organizational Leadership, both from Regent University, Virginia. He can be reached at philip@maximumchange.com or (615) 216-5667.

Where have all the employees gone?

Empty office with boxes and one chairIn a recent Wall Street Journal Article “U.S. Could Face High Unemployment Through 2030” (Read Here), it argued in part that by the year 2030, unemployment could be as high as 11 percent. If you have followed any of my writing for the past couple of years, you would know that I had already sounded the alarm. In fact, with the current trends forecast out we are facing an unprecedented time in the availability of a skilled and qualified labor force. By one estimate, we can expect less than 35 percent of the workforce in full time positions by the year 2040. The numbers are staggering. With an estimated population in the United States in 2040 to be roughly 382.2 million, we are looking at 65% of the population without full time work. The chart below offers a rough estimate of what can be expected within the next 26 years:

Cohort (2040)

Number in Millions Percentage

0-19 (too young to work)

84.05 22%
Unemployed 42.04 11%
Employed Full time 133.8 35%
Other 94.02 25%
70+ (retired) 28.29 7%

 

You may be asking why this is important today? I can offer an analogy based on industries, government, communities and individuals that did not prepare for the future. If we consider the auto industry for a moment, specifically focused on areas in which large manufacturing facilities were located. Detroit is a good example of how the industry changed and within a short period of time, the regions that supported the factories fell into demise. While there are many reasons why this happened, the fact remains that there was little attention paid to the future much less scenarios asking the question “what if the factory closed tomorrow.”  If you are a business leader you might want to ask yourself what a reduction in your workforce would look like. Start to look at what it would take to run an international, multimillion dollar organization with 50 percent less staff. How will a small or midsize corporation survive if they cut their human capital in half?

There are many pressures creating this reality. Truth be told, this is not something that just started happening in the past few years. In fact, the workforce began shrinking in the late 1980s and early 1990s. We have been on a slow decline for over 20 years. Pressures include a decline in fertility in the United States, a growing unskilled labor force, and a dysfunctional immigration policy that inhibits the entry of skilled labor while freely accepting unskilled labor without question.

How will we respond to these changes over the next 20 years? We can already see the results of this coming crisis. Technology is beginning to embrace robotics. Not just machines, but also software. Technology companies are developing artificial intelligence at a staggering rate. New technologies are emerging such as self-building robots and 3D-Printing just to name a few. Deficits include retooling and educating a growing unskilled labor force.  Organizations will begin to embrace more egalitarian structures in an effort to create efficiencies while maintaining a smaller organizational footprint. We will begin to see the freelancing and consulting as a growth industry. Remote workers will complete their tasks through the “cloud” and via video conferencing. This could have an effect on business travel and how we engage clients face-to-face. Clients will expect quicker response at a lower cost threshold.

While these are all assumptions, the idea is to think strategically about the future. Asking tough “What IF” questions and developing responses to mission-critical threats in the not-so-far-off future.

 

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Dr. Philip A. Foster is considered a Thought Leader in Business Operations, Organization and Strategic PIC3Leadership. He is a prolific writer, published author and lectures internationally. His most recent book “The Open Organization” is now available through Ashgate Publishing.  Philip is certified in both Leadership and coaching and serves as Adjunct professor at Middle Tennessee State University, Murfreesboro, TN. He is the Founder and CEO of Maximum Change Leadership and Business Consulting, serving clients from around the world. He is a Doctor of Strategic Leadership with emphasis in Strategic Foresight and holds a Master of Art in Organizational Leadership, both from Regent University, Virginia. He can be reached at philip@maximumchange.com or (615) 216-5667.

4 Steps to Organizational Success | STEP 3: Process Improvement

4_Steps_to_Org_SuccessNo one knows your business better than you, right? This is a trick question because, while you and your team know your business, if your methodology is flawed then the way you do business is broken. This is why the organizational analysis in STEP 1 becomes so important. Case in point: I recently spoke to an organization that requested I conduct a survey of their customers to reveal a predetermined outcome. While it is always a good idea to get feedback from customers in STEP 1, it is only part of the equation. It is liken to changing the oil in your car in hopes it will fix the broken radiator. If you don’t look at the whole picture and address the actual problems that exist, your organization will flounder and perhaps fail. STEP 2 becomes a painful outcome of a failing organization because change is not easy on any day. Add to this a heightened level of dysfunction and you’re in for a treat. STEP 2 is about changing beliefs and broken actions. As I’ve written previously, change takes time and the process of change cannot be rushed. Once your organization has moved through the first two steps of the Organizational Success Model, you are now ready for STEP 3: Process Improvement. As a result of the analysis and alignment process, the organization’s best practices and deficits are now clearly exposed. We are then able to begin considering the “How” of what organizations do and develop scalable processes and best practices to generate positive outcomes. The key to this step rests in the idea of scalable. Scalable is when a process can grow and contract with the organizations life cycle. Unfortunately many organizations are still using systems and processes that are out of date and have not kept up with the organizations growth, changes in laws or even technology. Process Improvement requires someone with an unbiased view of the organization to observe and report those areas that appear to be in deficit. Process Improvement also requires speaking with the individuals in the company who actually do the work and asking them questions like, “what would you do to improve this process” or “what would you change in this process to create efficiencies?” Unfortunately what I’ve discovered is that many leaders believe they know better than their followers on how things are done. The key to success in STEP 3 is locked in the engagement of the followers. When you include them in the change process, they are more apt and able to assimilate the changes required to achieve success. Effective leadership is really in the empowerment of your followers to do their job. It means getting out of their way and letting them do what they do best. If you believe your organization would benefit from an honest assessment of your operations, we are ready to help! Our team has over 60 years of leadership, management and organizational development experience. If you believe your organization could benefit from our 4-step process, please contact us today for a FREE consult.

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Dr. Philip A. Foster is considered a Thought Leader in Business Operations, Organization and Strategic PIC3Leadership. He is a prolific writer, published author and lectures internationally. His most recent book “The Open Organization” is now available through Ashgate Publishing.  Philip is certified in both Leadership and coaching and serves as Adjunct professor at Middle Tennessee State University, Murfreesboro, TN. He is the Founder and CEO of Maximum Change Leadership and Business Consulting, serving clients from around the world. He is a Doctor of Strategic Leadership with emphasis in Strategic Foresight and holds a Master of Art in Organizational Leadership, both from Regent University, Virginia. He can be reached at philip@maximumchange.com or (615) 216-5667.

No More Employees

11_LargeOpenSpaceIt would seem strange to concern ourselves with the labor participation rate 20 years from now. However, as a practitioner of Strategic Foresight, it is just as important to examine the here and now as it is to explore the trends for the future. This creates a textured picture of what the future may hold and it helps organizations navigate potential disruptions in their future. These disruptions could have an adverse effect on whether an organization is able to reach their preferred future. There is more to an examination of labor than how it may or may not affect industry. The flip side to these discussions is in how it may or may not affect labor itself. I’ve written several blogs on the subject of the manager-less organization of the future. In doing so, I’ve had to consider the complete texture of a potential future. Asking “What if” to explore the potentials of the future we are able to imagine disruptions with depth and certain context.

WHAT IF there were fewer employees in the future? What would that look like? What would that mean to industry, education and the economy? These are serious question worth the exploration. In my previous writings I’ve explored the trends which may create pressure on a future workforce. One particular trend that caught my eye is the result of a prediction I read. In 1989 it was predicted that by the year 2000 there would be less than 50% in full time employment. In 2011, I read a Gallup poll that indicated this number was actually closer to 45% in full time employment.

Playing these trends out another 20 years, we can begin to imagine the year 2034 as it relates to labor. Assuming a trend in which full time employment is 35%, we will find slightly over 128 million individuals employed full time. Considering a near 366 million population in 2034, that leaves over 192 million individuals in part-time, less than full-time or not in the workforce at all.

This is a lot of meat to consume. The bottom line, we will have a whopping 65% of individuals in part time, less than part time or unemployed. What does this mean for industry and what does it mean for labor itself? For industry, it means that they are going to have to do more with less. Technology will play a key role in the organization of the future. From the Internet of everything to automated processes, we are going to see technology continued to grow and influence our future. This will likely mean that the geographic footprint of corporate offices will decrease. In the technology field alone, developers are creating artificial intelligence that can write mundane coding assignments. Software automation is already developing so that it can anticipate how to respond to social media posts. We are looking at a future in which calling a company and expecting to speak to a human will be diminished. We will have more automated attendants and processes to interact with Artificial Intelligence. The manufacturing sector will likely continue to see an increase in automation of mundane tasks as they also drop to a just in time manufacturing within a smaller factory footprint. The advent and improvement of 3 dimensional printing with bring manufacturing of day-to-day objects into the home, making consumers makers.

How will this play out for labor itself? A larger number of individuals will enter into contract, part-time and self-employment. Individuals will begin to form powerful alliances with complementary products and services.  Individuals will no longer be required to travel to a central office to work. Cloud based connections and remote working with be the norm in 20 years. These changes will require more skilled labor than ever before. The future can be viewed as that of a cerebral economy in which labor is more educated and skilled than in previous decades. The workforce is seen as knowledge workers. Geographical boundaries of work related to country of origin will collapse giving rise to a new understanding of the global economy. While governments remain intact, workers will know no boundaries.

A labor shift of this magnitude has many implications. Individuals will need generalist skills in a given industry as well as a deep understanding of technology. This will require access to high speed Internet and other technologies. While there is no guarantee that any of this will come to be; we do know that the trends are moving toward such realities. The question: how will society and organizations deal with a future much different than the one we have today?

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PIC3Dr. Philip A Foster is considered a Thought Leader in Business Operations, Organization and Strategic Leadership. He is a prolific writer, published author and lectures internationally. His most recent e-book “Organization 3.0 – The Evolution of Leadership and Organizational Theories Toward an Open System for the 21st Century” is available exclusively on Amazon.  Philip is certified in both Leadership and coaching and serves as Adjunct professor at Middle Tennessee State University, Murfreesboro, TN. He is the Founder and CEO of Maximum Change Leadership and Business Consulting, serving clients from around the world. He is a Doctor of Strategic Leadership with emphasis in Strategic Foresight and holds a Master of Art in Organizational Leadership, both from Regent University, Virginia. He can be reached at philip@maximumchange.com or (615)216-5667.

4 Steps to Organizational Success | STEP 2: Alignment

4_Steps_to_Org_SuccessWhen was the last time you checked the alignment of your organization? For many, the answer is likely never! In fact, most probably don’t even know what true organizational alignment consists of. According to Webster’s alignment is an arrangement of groups or forces in relation to one another. In other words, is your organization in alignment with the Mission, Vision and long-range goals of the organization? Most would quickly say yes. But to be honest you really don’t know unless you check the alignment on a regular basis. Most organizations I’ve worked with assume that because the organization is making a profit and nothing has proverbially blown up that their alignment is just fine. As example, we worked with an organization that appeared to be doing great with their alignment. They were profitable and growing. But there was a problem festering under the surface of this wonderful organization. When we conducted the analysis and compared it against the organizations stated values, mission and vision we discovered a problem. There was at least one employee that was very unhappy. The stakeholders in the organization were surprised to find that there was a problem at all. The location was their most profitable and the person that was not happy was their best employee. The organization was out of alignment and it was beginning to spread throughout that location like a virus. Unattended, this could have been the undoing on this particular location. Analysis is the first step in identifying alignment issues. But how do we align the organization? This requires the delicate process of change management. Change management involves proper and effective communication, leadership coaching, and follower training among other things. In some cases, alignment requires a clear definition of what the organization is here for. Alignment takes time and patience. The process can’t be rushed and steps can’t be overlooked. Success comes from a proper alignment and is not always a do-it-yourself project. I know better than to try and do a front-end alignment on my car. I take it to a mechanic who has the tools and expertise to assist me. The same goes for organizational alignment. Don’t go it alone. Most organizations do not have the time or expertise to align their organization. If you’re in that place, we can help.  Our team has over 60 years of leadership, management and organizational development experience. If you believe your organization could benefit from our 4-step process, please contact us today for a FREE consult.

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PIC3Dr. Philip A Foster is considered a Thought Leader in Business Operations, Organization and Strategic Leadership. He is a prolific writer, published author and lectures internationally. His most recent e-book “Organization 3.0 – The Evolution of Leadership and Organizational Theories Toward an Open System for the 21st Century” is available exclusively on Amazon.  Philip is certified in both Leadership and coaching and serves as Adjunct professor at Middle Tennessee State University, Murfreesboro, TN. He is the Founder and CEO of Maximum Change Leadership and Business Consulting, serving clients from around the world. He is a Doctor of Strategic Leadership with emphasis in Strategic Foresight and holds a Master of Art in Organizational Leadership, both from Regent University, Virginia. He can be reached at philip@maximumchange.com or (615)216-5667