How to get started on your strategic plan

Many practices face similar issues

No matter what the specialty or the size of the group, most physician practices face similar issues, Dick Hansen asserts.

He should know. Hansen, a Palo Alto-based health care consultant for the Medical Group Management Association, facilitates strategic planning initiatives for 20 to 25 physician groups each year.

Physician’s Managed Care Report asked Hansen and other consultants what components to include in a strategic plan. Here are some of the key areas mentioned:


On the clinical side, this could include purchasing new equipment, offering new services, or coming up with new product lines. When you examine business operations, you may want to improve insurance billing and collections, or it may be as simple as dealing with an incompetent clerk.

Financial aspects.

If expenses are rising and reimbursements are declining, decide how to handle it. You could decide to trim costs or boost revenue. Look at the financial arrangements you have with physicians. If you’re considering purchasing new equipment, look at whether the practice can handle a capital investment at the time.

Marketing program.

Look at what your practice is doing to market itself, not just to insurance companies but to patients and other physicians. Come up with a plan to monitor your referral sources and put the information to work for you. Keep tabs on who is referring patients to your practice. Be specific. For instance, instead of listing "doctor" as the referral source, list the practice or the physician by name. Monitor it from month to month, and take action if their referrals drop off.

Survey your referring physicians personally to find out what they like or dislike about your practice. The doctor-to-doctor relationship is important here, Parshall says.

Meet with your managed care plans’ medical directors, find out about their future plans and take the opportunity to educate them about your specialty.

Customer service.

Referrals by current patients are the lifeblood of any physician practice even if you are part of an insurance company provider panel. De-cide whether you need to do a patient satisfaction survey and come up with a program to improve service. Look how your patient load is changing and how you should respond to it. For instance, if many of your patients are demanding baby boomers, decide how you will meet their demands.

Retirement of senior physicians.

If your practice has a number of older physicians, this could be a key issue for the future, Hansen says. Strategic planning gives you the opportunity to set out your expectations for physicians who want to retire or cut their hours. Don’t put yourself in the position of one practice, which was short a physician for six months when a senior physician gave the group only 90 days notice of retirement.

Many groups specify that physicians should give at least 12 months, and preferable 24 months notice for retirement. Physicians who fail to give the proper notice may get less buy-out money, he says.


If the issue is growth, adding new physicians, or adding new sites, plan how you will go about it. A project for recruiting new physicians often takes a lot of discussion and planning for a group practice, Hansen says. "Everybody wants to interview the candidates, but it’s just not practical for each candidate to be interviewed by 10 to 15 people," he adds. One technique that has worked well is to appoint a committee to interview each candidate but invite anyone else from the practice to join them at lunch or dinner.