The plan we would build with you if you walked into our office today. Take it home and run it yourself. 

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Your performance reviews are probably making your billing team worse. Not because you're giving bad feedback. Because the format itself is designed to produce defensiveness, not change. 95 percent of managers are dissatisfied with their review process, and 90 percent of HR leaders say it doesn't produce accurate performance information. And in an independent practice, it's usually worse than that: an annual conversation that changes nothing, a reaction to a problem that arrives too late, or no review at all. 

In this episode we replace the annual review with three evidence-based tools. All of them work in a two-person billing office. None of them require an HR department. 

Why the Traditional Review Fails.  Retrospective, evaluative, high-stakes formats activate self-protection, not development. The employee being evaluated for past performance is managing her reputation, not learning. The billing manager whose Friday claim-scrub pattern gets addressed in an annual review will comply for six weeks and drift back by week eight. Because the review addressed the behavior but not the cause. 

The SBI Model.  Developed by the Center for Creative Leadership. Three parts, order matters. Situation (specific observable moment). Behavior (what happened, not who she is). Impact (specific consequence, ideally with a dollar figure). One SBI conversation takes about four minutes and can happen at a desk immediately after the event. 

The GROW Model.  Four questions, in order, without skipping any. Goal (what does excellent look like, from her perspective). Reality (where is she now against that standard). Obstacles and Options (what is in the way, what could change). Way Forward (what specifically will she do, and by when). Compliance fades. Ownership compounds. 

The IDP.  A one-page Individual Development Plan capturing the outcome of a GROW conversation. Goal, current reality, top obstacle, one specific commitment with a date. Reviewed together every two weeks. After three of these, the billing manager has a roadmap to excellent performance that she helped build. 

Sticky Phrase: Coaching compounds. Compliance fades. 

Three Actions This Week 

• Run one SBI conversation on a specific, recent, observable billing event. Under five minutes. Watch what happens. 
• Run one GROW conversation with your highest-potential staff member. Fifteen minutes, four questions in order. 
• Build a one-page IDP for your billing manager. One page, shared before the next meeting, reviewed biweekly. 

Episode breakdown 

00:00 — Your reviews are making your team worse 

03:00 — Why the traditional review fails 

07:00 — The SBI model 

13:30 — The GROW model 

20:00 — The IDP 

23:00 — Three actions this week 

26:30 — Free resource + close

Resources block 

👉 30-Day Revenue Recovery Plan (free) 

https://eligibility.natrevmd.com/nrc/-30day-revenue-recovery-plan

Website: natrevmd.com 

Trusted Resources: natrevmd.com/trusted-resources/ 

Referenced in episode: 

Center for Creative Leadership — SBI Feedback Model 

Lattice — What Is the GROW Coaching Model 

Coaching for Performance by John Whitmore (foundational GROW text) 

The four-episode culture-and-people arc: 

EP197 — Culture is a revenue decision: https://podcasts.apple.com/us/podcast/197-the-%2440-000-hire-with-the-perfect-resume/id1624182351?i=1000777698531

EP198 — The mindset you hire is the culture you build: https://podcasts.apple.com/us/podcast/198-%24300-000-in-old-ar-is-at-risk-during-your-next/id1624182351?i=1000778180219

EP199 — The first 90 days decide the next three years: https://podcasts.apple.com/us/podcast/199-you-are-destroying-half-the-value-of-every-hire-in-90-days/id1624182351?i=1000778687186

EP200 — This episode (series close) 

Next episode: EP201 — The one payer contract negotiation move most independent practices never make. What the team you built can produce when the contracts underneath them are set correctly.