Photo Credit: Getty Images. Dr. Bethany Fishbein shares tips for conducting practice post-mortems to pinpoint areas of needed improvement
The power of practice post-mortems
By Bethany Fishbein, OD
Sept. 10, 2025
We deal with issues in our practices every day that can feel significant, but they are rarely matters of life and death.
The term “post-mortem” might sound dramatic—its Latin translation is “after death”—but in a business setting it means analyzing the outcome of a situation after it occurs, especially when something didn’t go as planned.
What is a Post-Mortem?
In modern usage, a post-mortem is a structured method to learn from experience. A good post-mortem gives team members a safe space to speak honestly about challenges, share thoughts without fear of blame and view mistakes as opportunities for growth. This nurtures psychological safety—a sense that it’s OK to be open and vulnerable—which encourages everyone to share what really happened and reflect on improvement.
Why Use Post-Mortems?
This is an essential tool for your leadership toolkit. It’s simple, free and doesn’t require any special equipment. You can use it after a bad hire, a staff meeting that felt “off,” something new that fell flat or even following a success, such as your best trunk show ever.
Any time you have something to reflect on, a post-mortem offers a framework to pause, review and identify lessons that can help your practice become even better as you move forward. Even a few minutes of reflection can shift how you approach your next project, conversation or decision.
The Process: Pause, Reflect, Improve
Pause
Think about your own practice. Maybe your associate just had a difficult patient encounter, your manager finally fired a problematic employee, you finished the first week with a new EHR, dropped an insurance plan or added a new instrument that changed your pretesting flow. For many, the main emotion is relief, and the instinct is to move on without looking back.
However, even when your team is eager to put the discomfort behind them, slowing down and examining the situation—either soon after or once emotions settle—can have significant benefits.
Plan to hold a post-mortem with those who were key decision-makers or directly involved within a few days of the event. This could be a solo reflection, a one-on-one or a small group discussion. Typically, 15 to 30 minutes is enough.
Reflect
The goal here is to create space for candid, non-blaming feedback from everyone involved. The focus is on improvement, not fault. Consider these guiding questions:
- What happened? Sometimes, venting about the situation is needed before moving forward.
- What worked well? With hindsight, what did we do right that we can repeat in the future?
- What didn’t go well? What needs to change or be avoided next time?
- What were the root causes behind what didn’t go well? For example, if a new hire didn’t succeed, was the hiring or onboarding process a factor?
Improve
Lingering on what went wrong is unproductive. This step turns insight into action so you can make meaningful changes.
- What will we do better next time?
- What can we apply from this to strengthen our processes or systems?
- What can we do now to make sure these changes take effect?
A Real-World Example
Recently, we used this process in my practice after discovering that an off-site employee was clocking in for eight-hour shifts but frequently working less than half that time, which we found unacceptable. She was good at her job, which made the situation more complicated. Her supervisor, who had advocated for her raise and additional hours, felt blindsided by the situation and struggled with feelings of anger and guilt after we let her go.
I organized a short post-mortem to help him process what happened and identify opportunities for improvement. Through reflection, he recognized that hiring someone with her experience paid off by reducing training time and rapidly elevating performance.
He questioned our onboarding process, and together we discussed whether we set clear expectations about work hours versus task completion. He admitted he hadn’t monitored her time closely enough at the outset—a factor that might have allowed us to address the issue earlier and avoid a breach of trust.
This led to several immediate improvements: We are reconsidering how long specific tasks should take, recognizing that remote employees may work faster than those in the office. For our next virtual assistant hires, we plan to implement a guaranteed minimum number of paid hours, ensuring income stability and adapting to scaling needs. We added a new page to our virtual assistant manual to clarify our expectations: If someone has too little or too much work, they should let us know right away.
We also scheduled a meeting with the rest of our remote team to reinforce the expectation that employees are actively working while they are clocked in. We offered “amnesty,” inviting anyone who needs more work to speak up, and let them know that we will be monitoring more closely going forward.
From Reaction to Reflection
Making post-mortems routine allows you to stop repeating mistakes and start embedding wisdom in your leadership. You become the kind of leader and team that learns and improves, rather than merely reacting. For the small investment of a few minutes, the impact can be significant.
You will make better decisions, build stronger relationships, and, most importantly, create a workplace culture where honesty, reflection and growth are embraced every day.
Read another article by Dr. Fishbein here.
Bethany Fishbein, OD, is a practice owner, practice management consultant and certified executive coach. She can be reached at bethany@leadersofvision.com
