Developing a shared vision statement for your physician network is critical under value-based reimbursement.


Without a shared vision, the likelihood your employed network will get you where you want in the next few years is very small.  Rather than a united group, you will have a confederation of practices.

Why should you care?  If you believe the market and evolving reimbursement strategies will force you to take risk and produce reliable results, you intuitively understand the need to change the mentality of your physician group to match.  If not, move on to the next article.  And we’ll pray you are competing with one of our clients!

Physicians often have a good understanding of how a group needs to evolve to thrive.  They understand how they could better serve patients.  They understand how variability in care represents an opportunity to improve. They understand why physician leadership is crucial to meeting health system and patient needs. All these understandings just need to be melded with industry (and organizational) direction.

A strong, shared group vision, developed in conjunction with physician leaders, will help propel development of a strong group culture.  The vision also helps ensure the culture aligns with the requirements for enterprise success.

Many clients ask us how to approach this issue. Our advice:

  • Assemble a group of formal and informal leaders.
  • Task the group with defining what the group will look like in 10-15 years. In doing so, we encourage the physicians to describe a group with which they will be proud to be associated.
  • Develop a narrative that documents common aspirations in some level of detail. Our latest client’s version yielded a three-and-a-half page statement outlining the group’s aspirations.

The length may cause concerns or feel bureaucratic. However, in our experience, a detailed vision is crucial to getting doctors pulling in the same direction, because:

  • It allows the group to document almost everything crucial to long-term performance; and
  • By leaving less to the imagination, ALL physicians can understand the vision’s intent.

Developing such a document is an iterative process. We start by interviewing involved physicians, executives, and practice managers, focusing on group aspirations as well as perceived problems. This gives us a baseline of understanding and allows us to educate everyone on the opinions of their peers.

Next, we review the hospital and system strategy for elements that translate to the physician group.  We review group and health system data to benchmark performance and define strengths and weaknesses.  Finally, we tap our experience to define success factors from other groups.

From that foundation, we create an initial draft vision that is reviewed with physician and administrative leaders.  And edited …and edited …and edited again.  The editing process focuses on content, presentation, and clarity rather than wordsmithing.  Invariably the physicians identify something that is near to their hearts and reflects a sense of service to their patients that we did not fully capture.  Invariably, the points of interest and emphasis also change with each version as the leadership group internalizes the content.

That process increases the sense of ownership.  To further that ownership, we recommend presenting the draft vision statement to the entire physician group, with physician leaders conducting the discussion.  Inevitably, front line physicians add further insights, leading to greater ownership.

From the final vision statement, the core strategies the group must follow to achieve the vision become fairly obvious.  We find it helpful to extract those strategies and discuss them with the physicians as well.  This makes the process more tangible as the physicians see how specific actions tie to the vision.

Finally, we recommend vision review be part of an ongoing management control system.  At least semi-annually, the vision statement should be reviewed with two questions in mind:

  • Has a change in the market occurred that generates new insights or changes the way we see our vision?
  • Are we prioritizing the correct strategies?

Using this approach, the vision statement becomes a guidepost to maintain focus, drive change and engage the physicians in that change.

Terrence R. McWilliams, MD, FAAFP

Chief Clinical Officer and Managing Director, Employed Provider Networks