July 01, 2004
5 min read
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Practice retreats offer the benefit of professional renewal

Organize a practice retreat to define essential business goals and plans, all while fostering teamwork and having a little fun.

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The Portuguese have a lovely, melodic yet aching word that, even when pronounced poorly by an English speaker, sounds exactly like what it means on the streets of Lisbon. “Saudade” refers to a special kind of nostalgia for a past happiness that one perhaps never really possessed.

Saudade is as good a word as I can muster for the feelings of a vast number of eye surgeons today who gaze wistfully, and with no small measure of depression, at the past and feel that the best business years of their practices are behind them. They often look only at the fees they once received instead of examining the balanced ledger of benefits present in modern practice and appreciating the happiness and success that can still be found.

Such surgeons need professional renewal. And one of the best formal tools for business and professional renewal is a practice retreat.

A retreat can be anything from a half-day of private contemplation about the future of your career to an orchestrated, moderated, week-long, all-hands event at a faraway destination resort. Most practices stake out the middle ground: 1 to 3 days, fairly close to home, held over a weekend to minimize lost production.

In my experience, more doctors and administrators consider and reject holding a practice retreat than ever go forward with this valuable business tool. This happens for a number of reasons. Concerns about cost and time top the list. Indifference is a close second – if you are already burned out or confused about where you should take the practice, it’s hard to muster the enthusiasm for a conference.

Some practices are not really sure if or how they should organize a retreat session. Small practices think that corporate retreats are only for the big dogs. Big practices think they’ve become too large and cumbersome to have retreat-style meetings, or they choke on the necessarily higher cost of getting 15 or 20 principals together for a multiday event.

What follows are some helpful tips gained from moderating a few hundred of these sessions through the years.

Making it happen

Deciding who should attend depends on the goals of the retreat and the openness of your practice. Increasingly, lay managers are being let into the boardroom to help the owners make decisions. So having a retreat that includes both doctors and managers is the most common approach. On the other hand, if the goal of the session is to refine a succession plan for two senior partners, the only participants you really need at the retreat are the administrator, a financial analyst and the principals.

Book the retreat well in advance so that every participant can arrange their personal affairs as needed. Everyone involved should stay for their full allotted time and should not have to be distracted by being on call if at all possible.

Although it requires more time and cost, it really does take 2 nights and 2.5 days to foster the desired sense of being cloistered and part of a close group, especially when you are coming from behind in the area of team development; 4 or 5 days are even better, but impractical in most cases.

The most common and workable format for a 3-day session is to start on a Friday evening with a social dinner followed by a couple of light, warm-up working hours. On Saturday, start early, work through lunch, then adjourn at 1:30 p.m. or so to let everyone participate in some social or sports activities. Even if only half of the group enjoys golf, tennis, fishing or whatever your venue offers, there is a lot of growth, education and comic relief that emerges when you pair “experts” and “amateurs” as teams for a little friendly competition. Hold another short business meeting after a purely social dinner on Saturday and find a bit more time on Sunday morning, adjourning at noon on that last day. This format, with about 15 net work hours over 2 leisurely days, is a much more successful formula in my experience than burning the team out with 12-hour work days.

Working out the details

It is certainly very helpful to take over a meeting facility rather than being lost on a larger property. I have found that with enough advance planning you can rent an entire bed and breakfast property for less cost and with a more intimate environment than a plastic 2,500-room resort. We’ve used everything from doctors’ rustic vacation cabins to swank midtown Chicago and Manhattan hotels. In the latter case, group recreation more often focuses on fine dining or a night at the theater than quail hunting from Jeeps or standing around a Georgia piney woods bonfire smoking cigars and swilling genuine moonshine. (Both are true stories that will have to wait for a future column or memoir.)

You don’t have to get on a plane to hold an effective retreat, although some boards treat themselves to an exotic destination every year. More often than not, there is a wonderful and unique setting within an hour’s drive of your practice.

Try to build your retreat around a defined theme, such as teamwork, profit enhancement, crisis resolution or the development of a long-term strategic plan. Be sure to write out and, as a group exercise, review at the outset the specific goals of the session. Try to avoid the easy trap of saying, “Well, we’ve got a couple of days … let’s cram in everything.”

If you have a mixed retreat of MDs and ODs, owners and nonowners, and lay managers, and you don’t intend to keep everyone together at all times, arrange formal breakout sessions so that during “work time,” everyone is working. Try to avoid the embarrassment of having to announce, “We’re going to talk about super-secret stuff now, so will all the nonowners please leave the room?”

I sometimes find that a retreat that includes doctors and their spouses makes for a nice format and can increase the social cohesion of the group. Holding a brief joint session for 30 to 60 minutes toward the end of the proceedings, so the spouses can hear a synopsis of how the company is doing, is always appreciated. Obviously, this does not work very well if some of the spouses don’t get along or if any of the partners are uncomfortable with this level of mixing it up.

During the retreat, assign one moderator or chairperson. This person is not there to lecture or hog the proceedings, but to assure that the group stays on task and that everyone gives their input. The choice of an internal moderator (e.g., the practice administrator or managing partner) vs. an outside facilitator is subject to commonsense judgment. Do you need outside expertise, or does your group have all the experts it needs in-house? Can you afford to bring in an outside facilitator? Will the use of a facilitator be beneficial, or will the presence of an outsider inhibit open discussion?

If your retreat is effective, you will not only be discussing topics, you’ll be making dozens of decisions. Someone has to be responsible for taking notes and memorializing the agreed action. This scribe can be the moderator or a drafted participant for smaller meetings. For larger, more formal events, consider bringing a recording secretary. Avoid audio or video recording the session. This will inhibit open discussion and the free flow of opinion that is so vital in these meetings.

After the retreat, be sure to distribute a written summary of the issues discussed and the decisions reached. Consider distributing a questionnaire to all participants while the retreat is still fresh in their minds: Did the event meet or exceed the stated goals? What was done well? What improvements should be made with future events? When should the next retreat be held?

Whether your aim is to solve focused problems or to hash over general issues, practice retreats offer a wonderful opportunity for renewal for partners and senior staff alike. In the months after the typical retreat, participants report that, by getting through the clutter of past issues, everyone involved has a better focus on the path ahead. Often dismissed as a costly or time-consuming luxury — or as sensible for only larger organizations — a formal retreat can help your practice, at any scale, reach new heights.