Having a vision helps you navigate change

Practice Pointers. By Karen S. Schechter, amednews contributor. Aug. 27, 2001.

PRACTICE POINTERS

Answers to questions about the business side of your practice

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Question I am a partner in a three-physician internal medicine practice. My partners and I feel that it is time to consider including another physician, to increase the size of our office and/or open a second office in an underserved area. These ideas will cost us a lot of money.

My consultant has suggested that we develop a business plan. However, to do that, you have to know where you want to be in the future. How can we know this when the industry continues to change on a regular basis?

Answer Your consultant is correct with his suggestion to create a business plan. However, before you can begin making projections and running the numbers you must be able to convey your vision for the practice.

A vision serves as a guidepost for every business decision you and your partners make over the next several years. Once you commit to a vision for your practice, the rest of the business plan falls into place.

So how do you create a vision? It is not something you can necessarily think of overnight. It is more than a mission statement. It takes a lot of thoughtful work and energy to define a vision that reflects what you and your partners stand for and where you want the practice to be in the future.

There are many methods and schools of thought devoted to this topic. One that we use as a model for our clients is based on a book called Built to Last: Successful Habits of Visionary Companies by James C. Collins and Jerry I. Porras.

The authors identify four components of a vision: core values, core purpose/mission, an organizational goal that extends into the future, and a description of what the organization would look like once the goal is achieved.

Getting to the core

Core values are those untenable values that will be the foundation of the organization, regardless of what direction it takes. When defining the core values for your practice, each partner must honestly answer some key questions, including:

What are (and have been) the values of the practice?
What are your personal values?
Do the two agree?
Would you continue to maintain these values for your practice even if it meant passing on a potentially good business opportunity?

The core purpose is the practice's mission or reason for being. Part of the core purpose will most likely be found in each partner's individual reason for practicing medicine in the first place.

For example, many physician practices' mission statements include "to provide quality patient care." When deciding on your practice's core purpose, you and your partners will want to delve into that statement and ask yourselves why. You may still use those words in the final core purpose. However, you and your partners will have a better understanding of each other's motivations.

Next you will want to define the practice's primary goal. It should be measurable and have a specific time period. Most important, it should support the practice's core values. If it does not, then you need to rethink the goal.

Finally, each of the partners should have the same clear picture of what the practice will look like when the goal is finally achieved. They should be able to describe it to staff, patients and other stakeholders. Stakeholders in a medical practice include the physician owners and management. It should also include the staff.

It is very important that you obtain buy-in from the stakeholders of your practice. This is achieved by including them in the information-gathering process, by soliciting their thoughts on core values, core purpose and a major goal for the practice.

We recommend that an outside party facilitate this process. It is usually best to go somewhere off-site for a few three- to four-hour meetings.

The visioning process is not an easy assignment and will take several hours of thought and discussion. The value of this process will be evident when you begin to complete the rest of the business plan. As the industry changes, so will your plan.

However, if you continue to refer back to your vision, then you will know that the decisions you make in response to the changes will be what are best for you.

Practice Pointers is provided by the St. Louis-based accounting and management consulting firm Stone Carlie & Co. LLC. The author and publisher are not rendering professional advice and assume no liability in connection with its use. Consult with professional advisers regarding your specific situation. Readers are invited to submit questions to the Business Editor (bob.cook@ama-assn.org).