Planning for succession training

Many practices are facing a succession crisis and either don’t realize it, haven’t acknowledged it or, perhaps worse, aren’t willing to fix it. Absent a formal plan, the default strategy becomes simple: Throw the keys on a desk and turn off the lights once your senior docs retire. This may sound extreme, but it’s what will happen if younger talent – in sufficient numbers to sustain a proper work/life balance – don’t replace those who are leaving.

Check out the chart below and you can get a sense for the pending turnover. These data come from the latest MedAxiom physician survey and represent over 2,000 practicing cardiologists. Thus, the data should be quite representative of the nation as a whole. As can be seen, nearly one in four (22.13 percent) practicing cardiologist is over the age of 60. Over 60 percent are over the age of 50. Based on historical trends, this means nearly half the current workforce will need replacement in the next 10 years.

Often in my travels to groups around the country I hear “this younger generation just doesn’t want to work like we did.” This may very well be true. There are perceptible generational differences in the tolerance for work/life balance; current fellows coming into the profession expect (demand) protected time off and a healthy work/life relationship. Who can blame them?

In response, groups can either dig in their heels and only consider candidates who are clones of the founders (which makes a difficult search nearly impossible) or be malleable and create an environment attractive to the graduating stable of fellows. The latter won’t be easy because of pride, tradition (“by god, I never got to go home!”), heavy workloads and tight budgets. However, given the current high demand for cardiologists nationwide and the impending exodus of older physicians noted above, the groups that do this well will have a huge advantage over those who can’t. Succession planning for this latter bunch will be lights off.

Which brings us to leadership -- a necessary ingredient to any successful group. In fact, a recent national poll of practice administrators ranked physician leadership the number-one concern, even ahead of declining reimbursements. Most groups I visit have strong leaders in place…today. However, these physicians tend to have a lot of gray hair and wrinkles. Granted, you want experience at the top, but is there a new group of doctors willing and able to take the reins when the time comes – which by the data is soon? If the answer is no, it’s time to create a formal leadership training and succession plan. Here’s how.

Start by examining your current leadership body, whether that’s a formal board, executive committee or just an advisory board, and take stock of each member’s attributes. Create an actual grid with ages, estimated years to retirement and basic skill sets. Not everyone brings the same assets to leadership. You may have your strategy guru, a voice of reason, the skeptic, the numbers guy and the healer. Together they create a powerful leadership team. With this cataloged, you can search out the important attributes – along with an estimated timeline – that need to be replaced and then start formally searching for that talent.

You basically have two pools from which to pull new leaders: current group members and new recruits. For the latter, start incorporating leadership into your recruitment process. Instead of simply looking for doctors who have the right clinical training, ask questions about his/her interest in participating in the business side of the practice. Not everyone has to be a leader, but with the grid above you’ll know when and what you need. You can’t find if you don’t even look. The same goes for your current group members. Spend some time identifying who might be a good leader and actively pursue them for the role.

With both groups, when new leaders are identified, assign them to a mentor and start grooming them for their future role. It’s critical that you choose mentors who are the embodiment of what you are seeking. Make sure, also, that the mentor is willing. If he or she looks at this as a chore, your results will be less than desirable. The protégé should attend meetings with his/her mentor, debrief afterwards and generally download the information and qualities you need to replace. If current leadership is compensated for its role, you may need to consider compensation for the protégés, too. Create an environment for success.

Another leadership training idea is to spread out committee participation, including the chair position. Committees may at times be frustrating, but offer a great training ground to learn the politics and communication skills requisite for solid leadership. Similarly, as ad hoc tasks come up – which they often do – assign the project manager role to your leader-in-training. You’ll soon have a stable of talent on the bench, ready to get into the game.

In summary, succession needs are coming – the data are irrefutable. Groups that can be attractive to young talent will have a competitive advantage over those that don’t, and creating a formal succession and leadership training plan will increase your odds of success. Let’s keep the lights on.

Joel Sauer is vice president of consulting at MedAxiom, a subscription-based service provider and information resource for cardiology practices. Prior to joining MedAxiom, he was CEO of a large Midwestern multi-specialty physician group. Through his leadership, the group expanded from a single specialty practice of 15, to over 225 physicians with over 600 employees in nearly every medical specialty.