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Anesthesia Succession Planning: The New Old Challenge

May 20, 2024

Many anesthesia practices benefit from particularly strong leadership and management. Often, this is provided by an individual who is particularly well regarded by the membership and the medical community. Many practices put their trust in an individual who is qualified to guide the practice through the ever-evolving challenges of American medicine and speak for the practice with confidence and conviction.

As most providers would attest, this is a rare quality; and when a group has such a leader, he or she tends to stay in office for an extended term. The two main questions facing most practices today are (a) what if there is no such natural leader in the practice, and (b) what happens when the true leader decides to step down or retire?

Method of Selection

The practical reality is that anesthesia practices chose their CEO, president or managing partner in one of two ways: they either endorse the natural leader with an annual vote of confidence or they rotate members through the key management positions. A practice that has a strong natural leader has a high likelihood of success until that leader decides to step down. Rotating members through management on a regular schedule poses numerous challenges. Temporary offices tend to be just that: temporary. What makes for success in any business is focus and discipline. Corporate memory can be an essential key to survival in the current market.

Changing leaders can work in practices with a strong culture of customer service where the expectations and requirements are clearly defined and accepted by the members. Factional disagreements or disputes can prove very disruptive if there is not a strong leader to keep members focused. Many a practice has ultimately decided to sell out or become hospital employees as a result of a lack of consensus and commitment.

Strategic Intent

Many advisors have urged their clients to focus on the critical issue of succession planning for good reason. A good strategic plan must be constantly refined and pursued. This requires three things: a vision, a strategy and the ability to communicate compellingly. These are qualities that not many providers possess. Some might even argue this is endemic to the specialty where the primary objective is service to others. It is often said that anesthesia providers are the unsung heroes of the operating room. Their focus is mainly on the care of surgical and obstetric patients rather than on practice management. Although it is true that a growing number of anesthesia providers are getting MBAs and looking to improve their knowledge of medical economics, this does not necessarily give them the requisite skillset to inspire others.

We would agree that succession planning is the key to survival of all anesthesia practices. It has been said that the only constant in medicine is change. Just as anesthesia providers must always be anticipating potential complications in the administration of anesthesia, practice managers must always be anticipating and preparing for unanticipated challenges to the practice. Anyone who thinks managing an anesthesia practice successfully is easy is either a poor manager or a poor judge of the job. This is why effective leadership is so important.

Defining the process for selecting a leader is typically part of the practice by-laws. Such issues are particularly well suited to strategic planning retreats, which would provide the opportunity to have a focused discussion on restructuring the practice’s governance for the future.

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