Strategic Planning for Physician Leaders – Make it Meaningful

It’s NOT a management exercise. 

It IS the roadmap to how you do the work and realize the vision.

It SHOULD BE a powerful way to build teamwork around a shared vision

The most successful strategies are visions, not plans.”

McGill management professor Henry Mintzberg

(This content is a summary of a discussion we recently led for the Academic Orthopaedic Consortium during their Mid-Winter Business webinar – attended by over 150 physician and administrative leaders from leading academic programs.)

In a recent survey of Department Chairs, strategic planning was listed as the second most important key to success, following “Culture.”  Chief Administrative Officers listed it as THE most important key to success.

They overall message that came out of this discussion:

The process you use is far less important than the way you approach the work. Done correctly, the process allows you to create momentum around a shared vision of success, to engage physicians, and to bring structure to how you make real progress.

Why do Physicians Hate Strategic Planning?

Most of you do NOT have a great reaction when someone asks you to participate in a strategic planning initiative. Strategic planning has a well-earned reputation: 

We’ve all been through long, boring, sessions that are not productive and there’s no follow through.

  • There’s a lack of role clarity – Particularly for physician leaders who may not have ever envisioned that strategic planning is actually part of the job.
  • People don’t feel empowered to drive the changes they know are needed; and
  • It takes way longer than it should!

It’s not just you – nearly 70% of strategic planning initiatives are seen as a failure.  One of the key reasons for this failure?  Too much focus on the PROCESS of planning, and not enough focus on creating a shared, realistic vision of what you want to accomplish and how to EXECUTE on a plan.

Giving someone a plan is far less effective than aligning your team on a vision or endpoint — meaning, getting people clear on where they need to go as the starting point.”      

“Why 67 Percent of Strategic Plans Fail”. Tanya Prive, Inc

“Why 67 Percent of Strategic Plans Fail”. Tanya Prive, Inc

The Process – Keep is Simple, But Get Help if You Need It

The basic steps of strategic planning are not complicated but it definitely helps to have the help of people who can deploy an efficient and effective process.  You can organize the process a number of ways.  The steps we like to use:

  • Planning
  • Understand the Current Status
  • Establish the Vision and Goals
  • Develop the Strategies/Initiatives
  • Communicate the Plan (or get approval if that’s a requirement)
  • Implement the Plan
  • Review and Revise

See our blog on the value of communication, relationships and creating a sense of confidence . . .

Keys to Success

Planning – Identify the stakeholders and the planning team.  Take time to understand the history of the Department and who will support, or resist, the process. Engage both groups, early, with informal discussions.  Get help– internal or external resources.  Most physician leaders have not done this work – give them the tools and support they need to succeed.

Current Status –You need an objective analysis of the operational/process barriers to success, as well as the overall organizational/market dynamics, and the cultural/communication/relationship challenges.  The latter, if not addressed, will make this process a complete waste of time.

“The strategic planning process will NOT fix cultural issues, but cultural issues WILL impede effective strategic planning.”

The Vision – Do NOT take this for granted.  A generic statement about “outstanding patient care, engaged physicians, attracting and retaining talent……” is NOT sufficient. The specifics of what this looks like is where you run into problems.  Often, you find out a few months into this work that key physician leaders differ on what success really looks like – and this derails the entire endeavor.  Have these difficult discussions early.

Strategies –Be brutally honest about what is realistic.  If the larger organization has started down a path – you are NOT likely to divert it from that path. Do not let your group get caught up in wasting time lamenting that direction. Spend that time and energy working on strategies within that context.

Give people a structure and support to change what they can, and they are less likely to perseverate on the things they cannot change.

Communication and Approval – This work does not start AFTER you’ve developed the strategies.  In fact, it starts during the planning stage.  By the time you put this plan in front of your Department the response should NOT be a surprise and, ideally, you’ve pre-emptively addressed and mitigated most concerns, and everyone understands their role.

Implementation – Make it crystal clear from the get-go that the Strategic Planning process is not an exercise – it’s HOW we get consensus on the vision, commitment to that vision, and commitment to doing the work.  This is where many organizations drop the ball.  They don’t plan for the implementation. What structure and resources are necessary to implement the plan?  The plan should drive HOW the Department does it’s work and runs the business.  Make no mistake. Each department is a multi-million dollar business venture – run it accordingly.

Review and Revise – At least annually, you need to re-evaluate the situation and revise the plan accordingly. For instance, next year, having made progress on year-one initiatives, it’s time to identify new goals or completely new initiatives.  But – the Plan is really a living document as it is guiding the work being done each day.

Don’t Allow People to NOT be Engaged

Perhaps the most common thing we hear from physicians, even physician leaders, about strategic planning:

“I know there’s a plan, but I wasn’t engaged in developing it.  I don’t really know what it is, or my role in implementing it.”

This should never happen.  You may not have the ideal strategic planning process.  You might pick the wrong initiatives and goals.   These are all forgivable and can be expected.  But if there are people who don’t understand it the vision, or their role in the plan,  then you missed the mark and were likely more focused on process, than on PEOPLE.

How do you get people engaged in the process?

  • Engage them in developing the vision.
  • Tie this work DIRECTLY to that vision. 
  • Challenge people, and empower them to lead – to drive the change they seek.
  • Be sure that physician leaders, especially, understand that this is part of the job description.  
  • Be honest about what is NOT going to change….but give them the power to change what they CAN control.  You’d be surprised how people come together to do the work, and stop lamenting what they can’t change –  when you give them the structure, authority and support to make REAL change where they can.
  • Provide the tools and resources to support the work.
  • Create the structure, and accountability  to make real progress.

Part of the Larger Approach to Department Success

The best strategic plan in the world doesn’t guarantee success. We look at it as one of four areas that drive Department Success:

  • Strategic Planning and Tools
  • Culture – (Keep an eye out for a summary of Alan Friedman’s AOC presentation on culture.)
  • Support Physician Success
  • Support Leaders

To learn more about how we support Department Success, visit us at www.j3phealthcaresolutions.

To learn more about how we support AOC members, visit