Setting Goals
Goal-setting has been marketed as the magic bullet for productivity. Set a big audacious goal, write it down, make it SMART, and success will follow. In a typical O&P practice, you know it’s not that simple. Between patients, patient fires, and daily drama, goals can feel like just one more thing you’re failing at.
The encouraging part is that you’re not the problem. A lot of the goal‑setting advice we’ve all absorbed over the years actually works against us. With a few simple adjustments, goals can start to make your practice feel calmer and more effective instead of more chaotic.
The hidden problem with “more goals”
One theme that comes up again and again in the literature is goal overload. When people juggle too many goals at once, they don’t spread effort evenly—they tend to obsess over one and neglect the rest. In a business context, that often means chasing whatever is easiest to measure (like volume) and ignoring harder‑to‑track things (like quality or staff wellbeing).
Sound familiar?
In O&P, that can look like:
“We want to improve outcomes, reduce denials, grow referrals, and implement digital scanning this year.”
Everyone nods, then quietly defaults to “get patients delivered and claims out the door,” because that’s the one goal that screams the loudest every day.
The research is pretty blunt: when goals compete for the same limited time and mental energy, something will lose. If you don’t choose what loses on purpose, reality will choose for you—and usually not in your favor.
Step 1: One primary goal per season
A healthier approach is to think in seasons and pick one primary practice‑level goal at a time.
For example, for the next 90 days:
“Our primary goal is to reliably collect one simple outcome on our new transtibial patients.”
That doesn’t mean you stop caring about everything else. It means:
When there’s a conflict (you can’t do all the things), this is the goal that wins.
You design meetings, huddles, and small experiments around this one priority instead of trying to inch 12 different goals forward by 2%.
Research on multiple goal pursuit suggests that deliberate prioritization, actually naming one goal as primary, helps people handle conflicts better and avoid the “everything is important, so nothing moves” trap. In a typical O&P practice, that’s the difference between progress and failure.
Step 2: Make the goal about behavior, not just the scoreboard
Classic goal‑setting advice focuses heavily on outcomes: hit X revenue, Y new referrals, Z% fewer denials. Those are important, but they’re lagging indicators. You can’t force them directly.
The more helpful question in a busy clinic is: what repeatable behavior would make that outcome more likely?
Examples:
Instead of “increase referral volume 10%,” try “have one 15‑minute, data‑backed check‑in this month with each of our top three referrers.”
Instead of “reduce redos,” try “for 60 days, review redos as a team once a week and identify one preventable cause each time.”
The psychology research backs this up: when goals are tied to specific, controllable actions, people are more likely to follow through and less likely to beat themselves up for things they can’t control. For your team, that matters. They can’t control whether a local hospital merges or a payer changes its policy. They can control who they call, what they measure, and how they standardize good habits.
Step 3: Plan for the friction up front
Another pattern in the research: people underestimate how much friction will show up between a goal and reality. Competing demands, temptation to put things off, fatigue, all the normal stuff.
In your world, that friction looks like:
“I meant to capture that outcome measure, but the patient was late and then the waiting room blew up.”
“I meant to meet with Dr. Smith, but two rush deliveries landed and I spent the afternoon firefighting.”
Instead of pretending that won’t happen, build the friction into the plan. Two simple moves:
If‑then planning: “If the patient is late and we’re rushed, then we will skip the extra education but not skip the outcome measure.” That sounds trivial, but those little rules reduce in‑the‑moment decision fatigue.
Default time blocks: For example, “Every other Thursday from 12–12:30 is reserved for reviewing our goal. We do not schedule patients then.” You’re not hoping to “find time”; you’re protecting it in advance.
In an O&P practice, those tiny structural decisions matter more than motivational speeches. They acknowledge that you’re human and build a pathway for success.
Step 4: Limit the blast radius
The “goals gone wild” critique from the management world makes a point that applies directly to O&P: poorly designed goals can produce unintended consequences. If you over‑emphasize volume, quality can suffer; if you obsess over one narrow metric, people will naturally game it. So when you set a goal, ask one extra question:
“If we hit this goal, what might break somewhere else?”
Examples:
If you set a goal around “fewer redos,” do clinicians start avoiding appropriate adjustments because they’re afraid to “ruin the numbers”?
If you push “more evals per day,” does documentation quality or patient education slide?
You don’t need a PhD model to manage this. Just:
Name one or two guardrail metrics.
For a throughput goal, a guardrail might be “no change in patient satisfaction or outcome scores.”
For a cost goal, a guardrail might be “no increase in falls or returns.”
Check them occasionally. If your main goal is improving but a guardrail is clearly worsening, you adjust the goal rather than patting yourself on the back.
This is where your clinical instincts shine. You already do this with devices—you don’t make “one more alignment tweak” if it blows up comfort or stability. Apply the same thinking to your practice goals.
Step 5: Make room for being human
One of the quieter findings in the goal‑setting literature is that missing a high, specific goal can hit people’s confidence hard, which then makes future change even harder. In a small practice, that looks like staff quietly thinking, “Here we go again; new initiative, same story.”
You can counter that with two simple habits:
Normalize iteration: Instead of “we failed to hit 100%,” frame it as “we learned that this version of the goal doesn’t fit our reality—here’s how we’re adjusting it.”
Celebrate process wins, not just the finish line: Recognize “we actually measured AMP on 60% of patients this month” before you ever get to 80 or 90%. You’re reinforcing the behavior, not just the final number.
The aim is to build a culture where goals are tools for learning, not weapons for blame. That kind of environment is much more likely to sustain the kind of steady, incremental improvement your practice needs to survive whatever CMS or the payers do next.
If you step back, none of this is exotic. It’s the same logic you use clinically: don’t overload the patient with instructions, focus on one or two high‑value behaviors, plan around predictable barriers, and adjust based on what you see, not what you hoped for. Setting goals in your practice should feel the same way—simple, grounded, and human enough to work.