Interviewee Name: Roger Dacre, Medical Doctor
Company Name: Dr. Roger I Dacre
Website: http://www.doctordacre.com
Avil Beckford: Tell me a little bit about yourself.
I was born in London, England and when I was about six years old my parents moved to Barbados. A year or so later they sent me back to attend boarding school in the UK. I attended medical school in the UK, in London, England and then I emigrated to Canada and did residency or specialty training in family medicine at McMaster University in Hamilton, Ontario, Canada. After that I worked for 10 years in my own family practice in Cambridge, Ontario and moved to Toronto about 16 years ago. I opened the practice that I am practicing in now and was practicing there initially alone, and subsequently over the last 10 years with Dr. Lise Paquette.
Avil Beckford: What’s a typical day like for you?
Usually I try to get to the office before 8 o’clock in the morning and I do the electronic and fax paperwork that is needed to be checked before starting to see patients around 8:30 in the morning. I generally see patients between 8:30 and 12:30 pm and I stop for lunch. My ideal day involves taking a 45-minute walk and then I restart seeing patients at 1:30 in the afternoon and I continue to see patients until 5:00 pm or 5:30 pm. The rest of the evening, unless I’m on call, is spent either for personal time or about twice a week I attend either a medical training meeting or medical administrative type meeting.
Avil Beckford: How do you motivate yourself and stay motivated?
I embrace the ethos of providing quality care. It’s a very conscious attempt to continue to motivate myself through continuing education. Either learning things that I don’t know or teaching things that I do know to people who wish to learn them. When I’m looking at the same problem for a subsequent time, I try to place it in a context that’s specific to that person to make it different and knew to me as well as to that person.
Avil Beckford: If you had to start over from scratch, knowing what you know now, what would you do differently?
I would try to avoid moving practice after 10 years. When I moved from Cambridge to Toronto, I basically had to start again. It was if it was the first day of work again. Family medicine like many personal service industries is very much based on the trust and relationship between myself and in this case the patient and that just isn’t something that you acquire overnight. You only acquire that over the passage of a number of meetings and the development of the relationship. That is something you can’t buy from someone else, so you have to earn it for yourself.
Avil Beckford: What’s the most important business or other discovery you’ve made in the past year?
It’s kind of a business and personal discovery. I’ve always been proud of the way I treated the staff in my office and I see it as a matter of pride for me that I treat my staff with kindness and respect. I always assumed that this would produce a good outcome. I found that doing that does not always produce a good outcome. There are factors in the staff rather than in me that might indicate that the outcome wouldn’t be good.
Avil Beckford: What’s one of the biggest advances in your industry over the past five years?
It’s difficult to single out one particular thing because this is an industry which is crawling with innovation. It really is. I tried to think of three of the ones that affect me, but there are many in the industry as a whole. They are treatments for anticoagulation, the treatment for obesity with bariatric surgery (you are operating on obese people to help them lose weight), and treatments for diabetes. If you were to look at five years ago and look at now, these three areas are completely different than they were five years ago. I have to completely relearn all areas on a regular basis.
Avil Beckford: What are the three threats to your business, your success, and how are you handling them?
- I’m in a business which is funded by the government and consequently one of the big risks to us is government whims or changes in government policies as a result of elections and the fact that governments are fighting with how to use limited resources.
- The second issue is organizational fads. There seem to be an unlimited number of ways to organize the delivery of medical care and none of them seem to be superior to the other ones and you get people either civil servants or government ministers, or academic people all trying to impose their own particular fad on the rest of us.
- The third thing is regulation which is both good and bad. Regulation in our industry seems to result in shortages of lots of things, and it stifles innovation because anything that’s outside the normal range is suspicious to regulators.
Avil Beckford: What’s unique about the service that you provide?
I can’t claim that the services I provide are unique, but I try to be noticeably outside the norm in terms of my commitment to providing not just good diagnostic care, but efficiency in the way the office is run.
Avil Beckford: What do you observe most people in your field doing badly that you think you do well?
I think that many of them have very poor office organization and pay little attention to customer service. I have colleagues who think it’s a matter of pride about how long people have to wait in their waiting room rather than a matter of shame.
Avil Beckford: Describe a major business or other challenge you had and how you resolved it. What kind of lessons did you learn in the process?
I had a critical employee who left suddenly. We were left with having to recreate the skills that were needed for that role. In small businesses I think that sometimes you can have part of the process knowledge of the business in the hands of just one employee, and if that employee is gone you have to learn it all from scratch and sometimes that’s difficult. When this employee left we realized that we had invested too much in one position in terms of the process knowledge of our practice. We have replaced that role with two people doing part-time work, and my partner and I have decided to take a more active role in running certain parts of the business for the future.
There was a lot to learn from that. We realized that we needed to have little manuals. We already had manuals to describe all the little functions that are needed, but we realized that we needed to be more careful and that those manuals were kept up-to-date, and that we had multiple staff members who are able to perform the different functions.
Avil Beckford: Tell me about your big break and who gave you.
In a way, it’s a bizarre story in that I don’t remember who gave me in what I consider in retrospect to be my big break. But I was at a social function, and I had just failed to get into medical school, and one of the people at this social function was describing the name of one of the teaching hospitals in England, which had a particular interest in people who were applying for the second time to medical school. I used that information to put that particular medical school at the top of my list of five places that you are allowed to apply to at once. And I actually got into that particular medical school the following year. I don’t know who it was, and it gave me the opportunity to get what I considered to be my big break, which was my chance to learn medicine.
Avil Beckford: Describe one of your biggest failures. What lessons did you learn, and how did it contribute to a greater success?
It’s similar to the other question in that my failure to get into medical school the first time, I consider to be my biggest failure. I had been predicting that I would get in and it was a big surprise that I didn’t. What it taught me is that I’m responsible for my own successes and I need to believe in myself and in my ability to pick myself up when I’ve had a reverse and make the thing happen.
Avil Beckford: What has been your biggest disappointment in your life – and what are you doing to prevent its reoccurrence?
Probably my biggest disappointment at the moment is the way I’ve been handling my employees and certainly I know when I had a small practice there used to be a blurred line between the boss and staff relationship and friend relationship and as the office got bigger, we’ve made an effort to keep it more professional, not unfriendly, but just not the same way. I always thought that good behaviour would be rewarded with gratitude and I realize looking back at everything that went on this year and three years ago when a similar thing happened that it is my lack of inattention to the signs that this is happening. I’m trying to learn to be more objective in the way I look at the relationships with my staff. We have not taken the annual review as serious as we should and so we are going to put a lot more effort into doing that in a more professional way in the future.
Avil Beckford: What’s one of the toughest decisions you’ve had to make and how did it impact your life?
There were two really. One was the decision to emigrate to Canada from the UK and the other was to move from Cambridge, Ontario a small town of 120,000 to Toronto. They have had a very big impact on my life because they completely transformed the environment in which I practice medicine.
Avil Beckford: What are three events that helped to shape your life?
- The most significant was qualifying as a doctor.
- The second was choosing and qualifying as a family physician as opposed to some other type of doctor.
- The third one was a personal one, which was coming out as a gay man.
Avil Beckford: What’s an accomplishment that you are proudest of?
I think it’s a dynamic accomplishment in the sense that it’s the accomplishment of bringing freshness to my practice of medicine.
Avil Beckford: How did mentors influence your life?
Looking back on my life I didn’t realize that the first three of the mentors I would describe were mentors but they were. The first was one of my teachers in primary school, I say primary and middle school. His name was Mr. Arthur and I think he taught me that it was okay to be inquisitive, and it was okay to be an individualist outside of the mainstream. So that was a very important lesson to learn. The next mentor I had was Keith Warshaw who was my tutor in high school and he taught me that the world works in a certain way and you have to look at how it works and you can’t break the rules without realizing there will be consequences. He wasn’t saying the rules were right or wrong, he was saying they are there and you have to pay attention to them. I then had a mentor in medical school and she really taught me that it’s really important to do the work that needs to done rather than to think that you can take short cuts to it. And finally Dr. May Cowan, who was my professor at McMaster University who I still turn to for advice even today, and she just taught me so many things about how to be a good family doctor.
Avil Beckford: What’s one core message you received from your mentors?
The message was that quality and achievement comes from honest work.
Avil Beckford: An invisible mentor is a unique leader you can learn things from by observing them from afar, in the capacity of an Invisible Mentor, what is one piece of advice that you would give to readers?
I would say to people, you need to decide what you want to do and aim to learn and practice this with integrity.
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