What a productive strategic planning meeting looks like

Part 2 of 3: These four steps will help make your time and energy well-spent and productive.

By Peter Wasserman, MD, MBA

You have now committed to the time involved in producing a strategic plan and have arranged a special meeting at a golf resort an hour from town. All the owners and top administrators will be there for the entire meeting, and you have arranged for non-owner doctors and lower-level administrators to come for relevant sections of the meeting. Administrators will come armed with the relevant information as well as your mission statement and list of values. All the owners have reviewed the agenda in advance and have vowed to remain positive. It’s now time for the strategic planning meeting.

This second of three articles on strategic planning will focus on the strategic planning meeting. The meeting will follow the COAST and 4C’s model (box, facing page). It is time to get into the heart of the process. Remember that strategic planning attempts to answer three questions:

• Where are we now?

• Where are we trying to go?

• How are we going to get there?

1. DEFINE YOUR OBJECTIVES.

What is your goal? Is it to make more money? To become more efficient? To put your organization in a better position for the future with Obamacare?

Whatever you decide, these are your objectives — answers to, “Where are we trying to go?”

Remember, these are the goals of your organization, which may not be your individual goals. If you are the owner of a one-doctor practice, this is easy because your goals are identical to the objectives of the organization.

If multiple owners are involved, this is where it can get tricky, because negotiation becomes important and compromise is crucial. It is critical to be united on your objectives before moving on to the next phases of the strategic plan.

It is also important to have an idea of the time frame. If your objective is to become the largest provider of eye care in your region, how long are you giving your organization to accomplish the mission? Knowing the time frame helps you create a relevant strategy and tactics to accomplish the mission, and it is also important when we discuss “control.”

2. KNOW WHERE YOU’RE AT.

To accomplish your objectives, you first need to know where you are starting from. This answers the question, “Where are we now?” You need to be honest and reasonable in your assessments to come up with the right plan. If you believe you are the best surgeon in the state and everyone will flock to you if you just advertise your name, then good luck to you. (As an aside, is there any surgeon who believes he or she is not better than average?) Three types of analyses are useful: SWOT, PEST and competitive analysis.

• SWOT. This involves looking at your strengths, weaknesses, opportunities and threats. Look both inside and outside your organization. Let’s look at each component individually:

— Strengths could include an efficient staff, pleasant office, good location, strong referral base, good reputation in the community or whatever else you feel is relevant. This is the fun part of the meeting where you can feel good about your organization.

— Weaknesses come next and obviously are not as fun, but just as important. They could include lack of space, difficult surgical scheduling or long wait times, among others. Remember to be honest in your assessments, but not personal if at all possible.

— Opportunities are the options you see readily available, such as the ASC opening next door and asking you to join.

— Threats are the realistic worries that keep you up at night, whether a reduction in Medicare fees, a key member of your staff leaving or your optometric referral sources deciding to send patients elsewhere.

• PEST. This is an external analysis of the world around you. It can be global, national or local. PEST stands for political, economic, social and technologic changes that could influence your practice.

— Political could include the start of Obamacare with ACOs and new Medicaid eligibility, new optometric privileges in your state or a new mayor who believes traffic is already too busy on your street to allow further development.

— Economic could involve possible insurance reimbursement cuts or the loss of a major employer in your area with subsequent job losses.

— Social could mean an increasing Medicaid population or possibly baby-boomers wanting to look younger and desiring cosmetic procedures.

— Technologic includes mandated EHR, but could also include new diagnostic tests or procedures.

• Competitive analysis. Who are your competitors? Competitors include not just other ophthalmologists, but perhaps also optometrists, opticians, on-line optical shops, family doctors, pediatricians or anyone who can provide care as a “substitute” for you. Competitors can also be complements for your practice, providing referrals or the possibility of a joint project to benefit both parties.

Once you have identified your relevant competitors, you should list what each is doing in your market that could have any effect on your practice. Next comes the fun but scary part: Put yourself in your competitors’ shoes. Try to think like them and come up with their next moves and how they could affect you. Just don’t go overboard and become paranoid in the process.

3. DRAW YOUR ROAD MAP.

Now is the time to come up with strategies to fulfill your objectives, answering the question, “How are we going to get there?” While keeping your prior analyses in mind (your strengths, weaknesses, opportunities and threats), let your imagination run wild. List as many options as you can think of, from realistic to fanciful. Try to think without constraints, what used to be called “out-of-the-box thinking” (until the term became so overused that it is now in-the-box).

In the meeting, list all the options on large sheets of paper that can be spread out across the room before crossing out any suggestions. Remember to remain positive (or say nothing), even if you think your partner’s idea makes little sense, because it can be crossed out later. Encourage suggestions, don’t discourage them, because one idea can spark other ideas that might be useful, if not now then in the future. Encourage all participants to add their thoughts.

Once all possible strategies are listed, the next step is to lump similar options together, which can be done on those large sheets of paper you have all around the room.

Once you have this revised list, it is time to define your desired strategy or strategies. The best way to do this is to prioritize the options. This can be done through an oral vote or secret ballot, depending on the number of participants and the possibility of conflict within the group. Now is the time to be realistic, both in terms of chance of success and the number of strategies attempted. Don’t try to do too much at once; it is better to successfully execute one strategy than to miss on several.

4. DEFINE YOUR TACTICS.

Tactics are the list of operations to successfully execute your desired strategies — the specific actions your group or office personnel will perform. It is imperative that it is clear who is doing what and by when. For example, if one of your tactics is to increase your radio marketing, someone needs to be assigned the task of doing the necessary research by a certain date, and then reporting back to the group. I cannot emphasize this enough: If the group does not establish accountability, set a firm date or fails to follow through on communication, all the prior strategic planning is for naught.

You are not acting in a vacuum. Expect competitive reactions. How will your competitors respond? Considering their potential responses, does your tactic make sense? If so, how will you respond to their reaction? If you advertise more, will competitors advertise more, causing you to advertise even more, and so on, until the only beneficiaries are the local media outlets?

As another example, if you decide to start selling hearing aids, what will be the response from the local ENT group? Are you prepared to weather the storm? If not, think twice before hiring the audiologist. OM

Next month: I will discuss the 4C’s: contingencies, continue planning, communicate and control.

About the Author
	Peter Wasserman, MD, MBA, is president of Concord Eye Care, PC, a multi-subspecialty ophthalmology practice in Concord, N.H. His e-mail is info@insight-healthcare.com. Disclosure: Dr. Wasserman is founder of Insight Healthcare Solutions, LLC, an ophthalmology consulting firm (www.insight-healthcare.com).