Strategic Planning for Larger Groups

Once a group grows to a certain size (say 25-30 physicians) it becomes increasingly difficult to conduct a planning retreat that meets the following criteria:

1. All physicians attend the retreat.
2. There is an in-depth and complete discussion of the important issues.

The problem is group process – with 50 people in the room it is nearly impossible to have the complete debate and discussion among all members. What often happens is that 5-6 individuals debate the issues while everyone else watches.

If you have to have all the physicians in the room, these problems can be mitigated by:

1. Using the retreat as an information sharing only meeting.
2. Using sub-groups to discuss issues.
3. Using a rigorous process to discuss and debate motions that were developed prior to the retreat.

However, we have we have utilized the following approach to large group strategic planning efforts that balances the desire for involvement with the ability to have beneficial in-depth discussion on the issues.

Step 1: Survey/Interviews

Typically all physicians are surveyed to obtain their input on:

• Strengths and weaknesses of the group.
• Opportunities and threats the group faces.
• How they would like to see the group evolve.
• The issues that should be addressed during the planning process.
• Other questions that the client would like to be asked.In addition to the surveys, we typically conduct individual interviews with those that will attend the “Board+” Retreat (discussed below).

Step 2: “Board+” Retreat

A sub-set of the group then meets to discuss key issues and develop plans for the group. Typically this group is composed of the Board and other key leaders. It is best to keep this group to 15 or less. The meeting typically lasts 1 to 2 days, with 1 ½ days being the most common. This group develops what I call the “draft” plan for the group. At this meeting the attendees:

1. Develop or update the group’s mission/vision.
2. Review environmental opportunities and threats.
3. Discuss internal strengths and weaknesses.
4. Create clear goals and objectives.
5. Work to resolve key issues facing the group

Subsequent to the retreat, a “draft” plan is developed that is a written summery of the conclusions reached at the retreat.

Step 3 – Full Group Meeting

Following the Board+ Retreat, a meeting of all physicians is conducted and the results of the planning retreat presented. At this time all physicians will be able to give their feedback about the results of the planning process.This step is usually completed at an evening dinner meeting. It is important to note that the goal if this step is not to re-do the work at the retreat.   Instead the larger group is asked 3 questions:

• What did you like about the plan?
• What did you not like?
• What wasn’t considered that should have been?

Operationally, the physicians sit at small tables of 6 or so, with at least one person who was at the retreat at each table. You also should try to spread out the “nay-sayers” so they don’t get negative momentum going.Once again, this meeting is to allow the shareholders to have one more chance to provide input into the planning process.

Step 4 – Board Adoption

At a Board meeting the Board members review the results from Full Group Meeting and decide whether or not the “draft” plan should be adjusted. The final plan is then adopted by the Board.

This process balances the need for input, in-depth discussion and decision-making.

 

Please contact me if you’d like to discuss this post.

Will Latham
wlatham@lathamconsulting.com