Hold a more effective practice retreat for future planning
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“The majority of meetings should be discussions that lead to decisions.”
– Patrick Lencioni
“People who enjoy meetings should not be in charge of anything.”
– Thomas Sowell
This month — it being springtime and all — let’s discuss the concept of practice renewal.
Absent ongoing, energetic efforts at improvement, every practice declines. Future dreams and near-term priorities get blurry. Key staff move on. Processes are forgotten. Systems break down.
Whether it is revving up your personal life or revving up your business, it can be helpful to take a pause, withdraw from daily routine and go someplace quiet to launch new commitments. In the case of a sagging body, a health spa may be indicated. For a sagging practice, a formal business retreat may be in order.
The word “retreat” is perhaps a poor choice for a business exercise that should be about charging strongly into the future. But we will stick with that familiar vernacular.
What is a retreat? A retreat can be anything from a half day of private contemplation about the future of your career to an orchestrated, moderated, weeklong, 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 our 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 is hard to muster the energy for a retreat.
Some practices are not sure if or how they should organize a retreat session. Small practices think that corporate retreats are only for large companies. Big practices think they have become too large and cumbersome to have retreat-style meetings, or they pause at the necessarily high cost of getting 10 or more principals together for a multiday event.
Here are some helpful pearls gained from moderating a few hundred of these sessions through the years.
1. Let’s start with what a retreat is and what it is not. The most common misuse of valuable retreat time is to focus on overly granular near-term tactical matters. Retreats should focus largely on the big strategic picture, deriving answers to questions like these:
- What is our appropriate planning horizon? (For most practices, you should be planning ahead 5 to 10 years.)
- What is our reasonable service area? (Will our service area be static or expand over time?)
- How should our service mix change? (What services should we add? Subtract?)
- What would be our ideal provider mix? (In ophthalmology, this is chiefly the ratio between ODs and MDs in the practice.)
- How fast should we grow? (The average U.S. practice grows about 5% per year. If you can grow faster than this, you will likely gain market share.)
- What should our relations be with local health systems? (Some practices need to orbit their local hospitals closely, while others can be more independent.)
- What is our succession plan? (Will we undertake the traditional route of adding partner-track doctors, merge with local peers or groom ourselves for a private equity transaction?)
2. Who should attend? This 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 doctors and managers retreat 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 at the retreat might be the administrator, a financial analyst and the principals.
3. Although it requires more time and cost, it really does take 2 nights and 2 busy 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 or owner relations. Four or 5 days are even better but impractical in most cases.
4. 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. In the morning, start early, work through lunch on Saturday and then adjourn at 1:30 p.m. or so to let everyone participate in one or more social or sports activities. Even if only half of the group enjoys golf, tennis or whatever your venue offers, there is lots of growth, education and comic relief that emerge if you can 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 working hours over 2 leisurely days, is a much more successful formula in my experience than burning the team out on a death march through 12-hour days.
5. It is certainly 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 a lot less cost and a lot more intimate environment than staying at a plastic 1,000-room resort. We have also used everything from rustic doctor’s vacation cabins to swank midtown Manhattan hotels. In the latter case, “group recreation” more often focuses on fine dining or a night at the theater than quail hunting from a moving Jeep or standing around a Georgia woods bonfire smoking cigars while drinking raw, day-old moonshine. (Both are true events from past client retreats.)
6. You do not have to get on a plane to hold an effective retreat, although some boards treat themselves to an exotic destination every year. Often enough, there is a wonderful setting within an hour’s drive of your practice.
7. Try to build your retreat around a defined key theme (eg, teamwork, profit enhancement, crisis resolution or the development of a long-term strategic plan) and be sure to write out and review at the outset as a group exercise the specific goals of the session. Avoid the trap of trying to cram everything in.
8. If you have a mixed retreat of owners and nonowners and your intent is to not keep everyone together at all times, arrange formal, defined-length, owner-only 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?”
9. Book the retreat well in advance so that every needed participant can arrange their personal affairs to be completely free. Every participant should stay for their full allotted time and should not be distracted by being on call if at all possible.
10. Depending on your preferences, we sometimes find in small private practices that a doctors-plus-spouses retreat is a nice format. Not only can it increase the social cohesion of the group, but 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 well if some of the spouses do not get along or if any of the partners are uncomfortable with this level of mixing it up.
11. 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 (eg, the practice administrator or managing partner) vs. an outside facilitator is subject to commonsense judgement: 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 facilitator actually “facilitate,” or will the presence of an outsider inhibit open discussion?
12. If your retreat is effective, you will not only be discussing topics, but you will 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.
13. 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 and where should the next retreat be held?
- For more information:
- John B. Pinto is president of J. Pinto & Associates, Inc., an ophthalmic practice management consulting firm established in 1979. He is the country’s most published author on ophthalmology management topics, including John Pinto’s Little Green Book of Ophthalmology: Strategies, Tips, and Pearls to Help You Grow and Manage a Practice of Distinction, UP: Taking Ophthalmic Administrators and Their Management Teams to the Next Level of Skill, Performance, and Career Satisfaction (with Corinne Wohl), Simple: The Inner Game of Ophthalmic Practice Success, and Ophthalmic Leadership: A Practical Guide for Physicians, Administrators, and Teams. Available now for purchase at slackbooks.com. Receive 20% off with promo code PINTO20. He can be reached at 619-223-2233; email: pintoinc@aol.com; website: www.pintoinc.com.
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