The COVID-19 pandemic has hit physicians’ practices hard. I have many physician clients that have temporarily closed their practices to non-urgent patients. Others have put most of their patients on telemedicine visits. The business of outpatient medicine may have slowed considerably but it has not stopped completely. As the world gets a better grasp on the virus, it is safe to assume that your clinic will once again be busy. Consequently, in this age of COVID-19, some physicians are taking this opportunity of decreased patient load and fewer clinic hours to focus on strategic planning and other business initiatives they have been putting aside.
What is strategic planning?
Strategic planning is the process by which practice leaders determine what the practice intends to be in the future and how it will get there. To put it another way, they develop a vision for the practice’s future and determine the necessary priorities, procedures, and operations (strategies) to achieve that vision.
Included in the planning are measurable goals which are realistic and attainable, but also challenging. The emphasis is on long-term goals and strategies rather than short-term (such as annual) objectives.
Strategic planning assumes that certain aspects of the future can be created or influenced by the practice. There is broad agreement among healthcare leaders that planning is a critical component of good management and governance.
Strategic planning helps assure that a practice remains relevant and responsive to the needs of its patients, and contributes to practice stability and growth.
It provides a basis for monitoring progress and for assessing results and impact. It facilitates new program development and enables a practice to look into the future in an orderly and systematic way.
From a governance perspective, it enables physician-owners to set policies and goals to guide the practice. And, it provides a clear focus for the practice administrator and staff for program implementation and management.
Strategic planning for physicians is an ongoing business process
If you have not done strategic planning in the past two years, then your practice is long overdue. This is particularly important during and after the COVID scourge as it is anticipated that aspects of medicine and healthcare delivery may be altered, sometimes radically, as a result of the pandemic.
To be of long-term value, the strategic plan must be treated as an ongoing business process. It must evolve and change to reflect changing market and industry conditions.
As a physician owner, you have an endless to-do list, a full calendar, and many people to talk to. Sometimes it makes you wonder how you are going to get it all done.
However, as the practice grows and the healthcare environment becomes more complex, the need for strategic planning becomes greater. Creating a strategic plan and thinking strategically are not about doing more. They are about focusing on how you spend your time so that you are more effective in reaching your goals and getting to where you want to go.
That said, no physician practice has an unlimited amount of time, money, or people resources. Strategic planning can help you make the most of the resources you have, allowing you to have more enjoyment in your work while you are doing it.
Why you should have a strategic planning session now
Here are eight reasons for getting your team together (virtually, of course) for a strategic planning session:
You will create a clear vision for what success looks like in the future. If you don’t know where you’re going, how are you going to get there?
You can identify priorities for the short and medium-term. You know that you can not do everything at the same time. So focus on what needs to be done now and then do it well.
You will work to get alignment and buy-in around direction and strategy. Having these conversations will move your team from implicitly to explicitly being on the same page. The clarity will energize the whole team.
4. Identify Challenges.
You will be able to create an opportunity to talk about key issues facing the business (competition, changing trends, etc.). You want to ride the waves, not get smashed by them. Being reactive throws off your plans, and takes your eye off your goals.
You’ll create a clear roadmap for the rest of the organization. Your staff wants to know where the practice is going and how they can contribute. An engaged staff is 20% more productive than one that is neutral (or, worse, disengaged). Your staff wants to win and this is how you can help them.
6. Open Communication
You’ll create space for people to share what’s going on with them and what they want to see as the future of the organization. It will open lines of communication and improve teamwork.
You’ll empower others to take on tasks that will move the practice forward. As a physician owner, that means less firefighting and more focusing on what you do best: patient care, leading, and executing.
8. Values and Culture
You’ll create the culture, values, and behaviors that you want to foster within your practice. When your values are clearly articulated, your team will understand what you expect from them on a day-to-day basis. Culture and values are the glue that keeps a strategic plan together.
Planning in a changing environment
Most practices understand the need for annual program objectives and a program-focused work plan. Many find it practical to define objectives for a 12-month period and to design strategies and programs to meet them.
Longer-range planning (planning beyond the next year or two) often seems more difficult and less rewarding. With the healthcare industry changing so rapidly and with as yet unknown consequences as a result of the pandemic, how can we expect to develop plans that will remain relevant? With so little control over external events, how can we hope to influence them in a way that benefits our patients?
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In fact, planning is no less important in a changing and uncertain environment. It may well be even more important. Practices need to be very clear on community needs and then work to address them through similarly clear practice missions, priorities, and objectives.
The challenge of delivering patient care will probably become greater with changes in the healthcare industry related to the pandemic and its economic consequences. Because of this, strategic takes on critical significance for practices.
Planning is designed to help a practice define its vision for the future and then determine systematically how it will get there; understanding obstacles and figuring out ways to overcome them.
Strategic planning in a crisis
It is very difficult to plan in a crisis, and unrealistic to look five years ahead unless a practice has some confidence that it will exist next year and that most of its key staff and its physicians will continue to be affiliated with the practice. Leadership also needs time to plan. As I mentioned above, the “pause” we are experiencing in outpatient care right now may provide an opportunity to engage in this type of planning.
Moreover, while planning provides increased practice definition, a sound base for planning should include consensus around a well-defined mission statement and/or practice goals. These must often be developed as a foundation for longer-term planning.
It is also difficult to plan if the practice is so young or its leadership so new that they do not have a good sense of the community and of the competition. Most new practices find that they do best by first attempting to reach consensus on a practice mission statement and then doing shorter-range planning, usually for a single year. Learning from that experience, they can begin a longer-term planning process.
Strategic planning doesn’t have to take a lot of time away from a physician’s practice
Strategic planning doesn’t need to take a lot of time away from the practice. The focus and the results will speak for themselves.
Before the COVID-19 outbreak, we conducted a lot of strategy discussions with physicians onsite. Recently, we have shifted to doing these discussions virtually.
The key is to have an outsider facilitate the meetings to avoid confirmation bias. Confirmation bias is a bias that involves favoring information that confirms your previously existing beliefs. For example, you believe that all medical visits must be conducted in person so you aren’t willing to consider virtual visits.
The facilitator will also ensure that your planning meetings stay focused. They make sure everyone has time to share their thoughts. And, their goal is ultimately to leave you with a clear plan on how to move forward.
Strategic planning can help physicians be better prepared for market changes
Medical practices that consistently apply a disciplined approach to strategic planning are better prepared to evolve as the local market changes and as the healthcare industry undergoes reform.
The benefit of the discipline that develops from the process of strategic planning, leads to improved communication. It facilitates effective decision-making and a better selection of tactical options. It also leads to a higher probability of achieving physician owners’ goals and objectives.
Strategic planning can be a challenging process, particularly the first time it is undertaken in a medical practice. With patience and perseverance, as well as a strong team effort, the strategic plan can be the beginning of improved and predictable results for the business.
At times when the practice gets off track, a strategic plan can help direct the recovery process. When strategic planning is treated as an ongoing process, it becomes a competitive advantage. It is an offensive assurance of improved day to day execution of the business practices.
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Why use a consultant?
The use of a consultant can help in the process and in the development of a strategic plan. As an outsider, the consultant can provide objectivity and serve as the “devil’s advocate,” as well as a sounding board.
In the end, however, the plan must have the authorship and ownership of the physicians and managers who must execute and follow the strategic plan. It must be their plan.
The bottom line for strategic planning for physicians in the age of COVID-19
The world is shifting before our eyes because of the COVID-19 pandemic. Physicians’ practices are unlikely to escape unscathed. This can be frightening but you can prepare for it by initiating a strategic planning process.
Strategic planning, when treated as a work in progress, rather than as a binder on a shelf, or a file in a computer, provides a medical practice with a real and lasting competitive advantage. A living strategic planning process will help direct the business to where you desire it to be. Strategic planning is your medical practice’s road map to your vision of the future – a world that is post-pandemic.
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First published on Jan. 19, 2017, as “Strategic Planning for Medical Practices in a Time of Change,” this post has been extensively revised by the author to reflect the challenges of the COVID Age.
Nick Hernandez, MBA, FACHE
Nick Hernandez, MBA, FACHE is the CEO and founder of ABISA, a consultancy specializing in strategic healthcare initiatives.
Since founding ABISA in 2007, his emphasis has been on developing and maintaining a strong relationship with physicians and identifying areas for business opportunity and support. The company’s client list includes physician groups, hospital systems, healthcare IT organizations, venture capitalists, private equity firms, and hedge fund managers.
Nick is a graduate of the United States Naval Academy and a former Captain in the U.S. Marine Corps. He holds MBA degrees in both Operations Management and Information Technology & E-Business Management from Wake Forest University. He is Board Certified in Healthcare Management and has been named a Fellow of the American College of Healthcare Executives.
He is a frequent guest lecturer and is often quoted in the national media. He has consulted with clients in multiple countries and has over 20 years of leadership and operations experience. Nick is a Subject Matter Expert in business strategy, practice management, telemedicine, health IT, and oncology.