A strategic plan you will actually use

Why a plan, and why now

A strategic plan, designed to work alongside your marketing plan, your financial plan and your operational plan, is a component of a comprehensive business plan. It lends stability and intentionality to the direction of the practice.

Physicians face new and complex challenges: pressure to reduce the cost of care while increasing access, downward pressure on fees from third-party payors, increased competition among physicians, and the movement toward strategic alliances. Where practising quality medicine once assured a practice's success, it no longer does.

Building or even maintaining a practice has become a function of business acumen as much as clinical skill. That trend is not going to reverse.

What strategic planning is

Formal strategic planning is one of the critical processes businesses large and small use to deal with tomorrow. Changes occur too quickly for reactive management to survive.

By contrast, strategic planning provides a proactive, orderly and systematic review of the organisation and the environment in which it operates and expects to operate. It involves developing the best available projections of how that environment will change, identifying the external factors most likely to drive the change, and assessing the internal conditions that affect the practice's ability to adapt.

In the end it means identifying goals and objectives for the practice and its physicians, working out a plan to accomplish them, and putting mechanisms in place to measure progress.

• An integrated set of actions aimed at developing sustainable, competitive advantage for the practice.
• An orderly review of the organisation in the context of its environment, with a projection of how that environment will change.
• A plan for how to accomplish the goals and objectives that the assessment defines.
• Achievement that is the result of carefully developed plans rather than a good quarter.

Why it so often does not happen

The need is clear, the process is well understood, and the potential value is significant. Yet many medical groups have never conducted a strategic planning session or even considered one. The first step for an outside advisor is recognising the reluctance — and understanding where it comes from.

• Physicians and managers have more pressing issues, so planning waits until a crisis makes it unavoidable.
• Many owners are reactive by nature, and planning asks them to work against that instinct.
• The process demands honest self-assessment and objectivity, which is uncomfortable.
• Some believe planning is expensive or a waste of time — a view that reflects a misunderstanding of the benefit side of the equation.

The five steps

Each step produces a document. By the end you have a plan with named owners, dates and measures — not a binder that goes on a shelf.

• Physician and staff interviews.
• Internal environmental analysis.
• External environmental analysis.
• The strategic planning retreat.
• Creation of the action plan.