Faced with the transition to value, clients are raising a relatively new question: “How do we create a shared vision with our physicians, particularly those that we employ?” Healthcare Strategy Group recommends a five-step process.

Step 1: Create Mutual Understanding
First, physicians must understand the environment that the system operates in, and vice versa. The challenges created with the move to value-based will be significant, and all players must understand the implications of that transition. From the physician perspective, this requires significant education on market realities. From the lay system executive perspective, it requires engagement with physician leaders to understand their perspective and ensure its incorporation into potential solutions.

Step 2: Hammer Out a Draft
The second step is to begin articulating a shared vision, engaging physician leaders in that process. We advocate a comprehensive, detailed vision statement that describes physician roles in many areas, such as:

  • decision making,
  • care coordination efforts,
  • organizational structure,
  • IT integration,
  • geographic area covered by the group,
  • physician group engagement with payers,
  • group branding,
  • cultural & behavioral norms,
  • patient experience and access requirements.

This runs counter to the adage that vision statements must be short and memorable. But given the state of the art in most physician groups, we’ve found that descriptive statements more effectively create a common understanding.

Step 3: Share the Draft
The third step is sharing the draft vision statement with the entire physician group. This discussion should be led by physician leaders. During this process, we encourage physicians to describe their “ideal group” — a group with which they would be proud associate. The ideal can’t ignore market realities, but otherwise you should be open to physician thoughts and embrace their input.

Step 4: Implementation
Some physicians will view vision statement development as a theoretical process; thus, step four is a tangible implementation process. Drilling down to a set of actionable steps is required each year. If the vision says the group will set behavioral norms so the responsibilities of being in the group are clearly understood, a physician subcommittee must be tasked with defining those norms and developing a control process.

Step 5: Use the Vision Statement for Control
The fifth and final step is to use the vision statement as a control mechanism. It should be formally reviewed annually, by physician leaders first and then by the entire group. That review should address three questions:

  1. Is the statement still appropriate; if not, how should it be changed?
  2. Has the group made progress toward achieving the vision?
  3. What must we do in the coming year to accelerate that progress?

David W. Miller

Founder and Chairman

Terrence R. McWilliams, MD, FAAFP

Chief Clinical Officer and Managing Director, Employed Provider Networks