BLOG: Develop a simple, pragmatic strategic plan for your practice in five easy steps, part 1

ByJohn B. Pinto

It’s easy to get hung up about the preparation of a strategic plan for your practice. I’ve had hundreds of clients nod their heads and promise to write up their strategic intentions, or promise to edit my first draft of a plan for their practice, only to return months later to find this chore undone. And of course, this is not accounting for the vast majority of surgeons who don’t have someone to help them craft their plan or to even keep after them to get the job done.

Most surgeons seem to feel a little guilty when asked about the existence of a strategic plan for their practice. Perhaps they feel diminished as entrepreneurs to be lacking this basic cornerstone of business development. I hope this isn’t the case for you, but on the off-chance you do feel this way, I’ve prepared this multi-part blog to give you a simple five-step process to put forth a plan for your practice. Let’s start with ...

Step one: Decide if and why you need a strategic plan

Let’s commence with a little B-school heresy: I think it’s a myth that you must have a strategic plan for your practice. This is obviously and empirically true. Here’s the evidence. Exhibit one: The vast majority of ophthalmic practices — like the vast majority of small, closely held businesses — don’t have a formal, written strategic plan. With few exceptions, they don’t get into trouble. Exhibit two: The vast majority of practices that do write down a strategic plan don’t look at their plans very often. Absent the urgings of their practice consultants or administrators, they rarely edit their plans, once written, much less use them.

This doesn’t mean you shouldn’t have a plan. Here are some possible, excellent motivations that may exist in your setting:

You may be at a crossroads in your professional career, either ready to kick it up a notch (common in your 40s) or down a notch (common as you reach your late 50s or 60s).

You may have grown your practice over the years by opportunity rather than by plan. As a result, your business is a hodgepodge of unrelated satellites and patient services, with no clear sense of direction or focus. As a result, profits are low, and your practice team is both exhausted and confused about the future.

Your informal, nonwritten planning may have resulted in “mission drift” or, worse, frank failure. It’s much easier to stay on course if you have a defined, measurable target. The metrics for this can be case volumes, market share, revenue scale or raw profitability.

Your market environment may be changing. This is true for nearly every eye surgeon today, in both good ways and bad. New procedures are being made available, and the public is more informed than ever about the latest breakthroughs. Adversely, fees are falling, and we are on the leading edge of the next wave of health care reform.

You and your partners or managers may disagree about the practice’s strategic destiny. The act of collaborating on a plan may help gain consensus, or at the very least highlight the areas of greatest discord.

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But not every practice needs a plan. Examples include:

“Hobby” practices, owned more for pleasure and satisfaction than profit by doctors who are already financially independent.

Practices in noncompetitive markets, generating much more than a living wage for their less ambitious surgeon-owners, with no need to press forward.

Captive practices that are encapsulated and well fed as a department within a multispecialty group, staff-model HMO or training center, which in turn probably has its own institutional strategic plan.

Here are some poor reasons to write a plan:

You read once in an article somewhere that every business should have a strategic plan.

You went to a professional seminar that said you must have a plan.

You think that taking the time out to write a plan might help allow you to procrastinate rolling up your sleeves and digging into unpleasant, faltering operational details.

If, after finding your practice in the above lists, you decide you do indeed need a plan, consider that in the vast majority of cases, a document stretching no more than three to five pages will serve your needs just fine. If you agree that’s the case, then please read on, starting with the next installment of this blog post.