Practice Management
Governance Structures Help Medium-to-Large Practices
by
John Reidelbach
Governance within a group is very critical to the success of a practice. If your practice seems to be stagnant and not making enough progress, it might be time to implement a governance structure. One of the many pitfalls of medium-to-large practices today is the lack of communication between physician leaders and the management team. A well-planned and methodical governance structure alleviates this and many other problems within the practice, and it does not require a tremendous amount of time on the part of any one physician shareholder in the group. Furthermore, it provides downstream communication for all employees about current and future operations, and growth plans for the practice.
In larger practices, this committee should have a balance of junior partners and senior partners. In addition, the practice manager, chief executive officer or chief operating officer should participate in all executive committee meetings in a non-voting capacity. This will assure the understanding of communication from the top down. The purpose of this committee is to discuss the issues of the practice regarding operations, finance, human resources, risk and liabilities, growth, planning, etc. This committee should meet at least monthly at a time when all members are available.
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Most practices enjoy growth and success over many years due to the diligence of physicians working long hours, as well as having a successful management team in place. However, when practices reach a size of greater than five physician partners, it is time to establish singular roles for the physician partners. This is for the benefit of the practice and to assure that one physician partner is not left carrying the burden alone. There should be a plan for a governance structure at the earliest stages of a practice, otherwise its implementation later on can be overwhelming.
Formation of an Executive Committee The first step is to establish an executive committee that includes the majority of the physician partners when the practice is small. However, there should be no more than five on the executive committee, no matter the size of the practice.
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The Triangle Physician | JUNE 2010