One often hears people say that increasing the size of one’s organization increases resiliency. But is this true? If so, why is this true? Exactly how does largeness add resiliency?
Table of contents
Start with simple math
When one analyses the risks involved in running a mental health practice, chief among them is the risk that several staff people suddenly leave. I have explored the challenge of several quitting at once in this post: Growing pains: Overcoming crises–When several clinicians leave.
Consider these scenarios. Suppose one owner has ten clinical staff in practice and three leave within a couple of months. That means that 30% of the income goes away.
Of course, some of the payroll expenses for those employees go away as well. Nevertheless, the organization is sized for ten and is most efficient at that size. The ratio of income to expenses is out of wack.
If another owner has 30 clinicians on staff and three leave in a short period, only 10% of the team is going away. The income loss is less noticeable, and tolerating the expenses is more comfortable.
So just from a mathematical point of view, size adds resistance to the organization.
Increased size adds efficiency and reduces costs
Another reason that increased size adds resiliency is that when one already has created systems for one employee, adding another is less costly. For example, the first time the owner hires an employee, many new tasks must be worked out.
- How do I calculate pay for an employee?
- Who is going to do payroll?
- What software am I using for these records and calculations?
- How do I train a new employee?
- What is the supervision plan?
The second hire is much more comfortable. Having done it once, I redo the process with some refinements. Every time we add someone, the process gets even more refined. By the 100th hire, there is a well-oiled machine in place for every aspect of the hiring process.
Read more about recruiting, interviewing, and hiring:
- Recruiting the best employees for your mental health practice
- Conducting excellent job interviews for clinical staff
- Hiring new clinicians: Building a staff one hire at a time
This principle, that practice makes perfect, is the same in all areas of practice. The first time is always the hardest. With rehearsal, we get better at everything.
Size add institutional knowledge
Additionally, the accumulation of experience adds an institutional knowledge that is a large part of what a business is. In the post, The ultimate guide to starting your own practice, I spend some time talking about what a company is. In that post, I say that a business:
- produces or creates a product or service
- consists of a team of people working together (personnel)
- creates consistent methods for creating their product or service
- has consumers who know about the product or service (marketing)
- has enough paying customers to be viable (billing and collections).
Doing all these tasks requires the accumulation of lots of institutional knowledge about each job. No one person needs to know it all. Instead, the company draws on the accumulated bits of knowledge that each person has as situations present themselves.
Larger sized organizations have more practice at all the tasks that are needed to function well. Again size adds resiliency.
An increased size adds more people resources to help out
As we grew in size, we were also adding staff and developing their capacities. (See Staff development in mental health practices for ways to do that.) More teammates meant we had more people to draw on when there was a need.
I can think of many examples where we trained one clinician to take on a supervisory or coordinator role. As that person either moved on or just wanted a break, we had many others we could invite to pick up where the other left off.
Momentum adds good things
I had not anticipated one aspect of what our size did for us. When we reached a noticeable size, other organizations reached out to us to collaborate on projects. Our size had attracted unanticipated attention and put us in a positive light.
One example may clarify what I mean. A CEO of a large psychiatric hospital said that her bosses had asked her to put a new office in the town where we had a satellite office. The hospital would have become a direct competitor. She informed me that she resisted because she knew we were there.
Now was that the complete story? One is never sure. Nevertheless, her choice might have been different had we not had dozens of conversations and collaborations over the years. Our size helped us have a relationship with her, and that paved the way for less competition for us.
The added value of ballast
One last point. The increased size adds a steadiness, a ballast, to everything you do. We can take more risks because failure does not risk the survival of the organization. Yes, mistakes and failures still cost us in time and money, but none of them put the organization at serious risk.
There is a margin for error in larger organizations that is not there in smaller ones.
So why does size adds resiliency?
To summarize, size adds resiliency in several ways. Largeness gives us efficiency and cost savings. We accumulate institutional knowledge and staff resources as a result of increased size while adding ballast and unanticipated good things.
For more on the more hazardous size for organizations, see this post: “Most hazardous practice size? Ten people.”