In 30 years of working closely with physician groups, we’ve noticed that the top-performing practices almost invariably have a clearer sense of who they are, what they do, and why they exist. Practices struggling to survive—or even those that just seem to muddle along—almost always have an underlying problem with their vision, their sense of what they are all about, and where they want to go.
Now before you move on in search of something more practical for your practice, take a few moments to think about your practice’s vision and mission. If you generally view discussions about vision and mission statements as just a lot of “feel-good” talk better left around the campfire at the corporate retreat, then we suspect you don’t fully understand how well-crafted vision and mission statements can energize and drive your practice forward. You can’t get much more practical than that!
Connect or Disconnect?
Practices with vision problems generally make one of two major errors. First, there are many groups that have never bothered to take the time and energy to hash out an appropriate vision statement. Then there are those that have gone through the process—perhaps even bringing in an expensive consultant to lead them—and have nothing tangible to show for it (except a nicely bound report and maybe a lovely, framed epigram on the reception-room wall).
Groups that don’t bother articulating their corporate vision risk fragmentation among the principals—the partners. Most highly educated, skilled professionals have a personal sense of who they are, what they want to do, and where they want to go. Successfully completing medical training requires an above-average sense of direction. Each doctor has a strong sense of ethics and values. But there’s no guarantee that your partners’ personal vision and mission match yours. In fact, it’s likely you have some significant differences.
On the other hand, sometimes one or more of the partners reads a convincing article or attends a medical-management conference where an “expert” has touted the benefits of developing a vision and mission, fundamental steps in strategic planning. The presenter offers examples from well-known medical organizations or major corporations, and their inspiring statements capture a physician’s (or administrator’s) imagination. He or she returns to the practice and convinces the partners that this is the way to go.
So the partners reluctantly agree to hire a facilitator and reserve a Saturday away from the office. The consultant does his or her thing, and actually does a good job helping the partners harmonize their diverse opinions and find enough common ground to hammer out vision and mission statements for the practice. So far, so good.
But no one in the group knows exactly what to do with these fine statements after they’ve been so carefully crafted. Consequently, the partners begin to wonder if the whole exercise amounted to much more than just another pointless experience. They see no connection between the lofty statements and the challenges of running a busy medical practice from day to day.
In each case, practice success is threatened by a kind of disconnect. The former suffers a disconnect among the partners; the latter, a disconnect between theory and practice. No wonder so many physicians look skeptically at vision and mission statements.
A Few Fundamentals
Before we go any further, let’s take a moment to review the definitions of, and differences between, vision and mission statements. It’s easy to get them confused.
Essentially, a vision statement describes what your practice hopes to be and where it wants to go. A mission statement generally describes what your practice plans to do and who it serves. The vision answers “Where and what do we want to be?” The mission answers “What do we do?” and “What makes us different?”
Table 1 relies on Diffen.com’s excellent differentiation. You can access the article at www.diffen.com/difference/Mission_Statement_vs_Vision_Statement .
Understanding these differences poses something of a challenge—the finished products look very similar sometimes. Business leaders often ask, “Where do we begin? Do we form a vision statement first, or a mission statement?” The answer depends on where your organization is in its development and life cycle.
A startup business naturally would start with a vision statement. Its founders have only the future to think about, so they ask, “What do we want to be? Where do we want to go?” Then they craft a mission statement that essentially describes how they plan to get there.
An established business, on the other hand, already has a mission—whether or not it has ever taken time to put it down on paper. Therefore, a “going concern” should first articulate its current mission before trying to design a vision statement. The vision statement answers, “Where do we go from here?”
The (Often) Missing Link
The best-worded mission and vision statements have no practical application if you stop here. At this point, your organization has only identified its destination and generally outlined its direction. Like an epic expeditionary force, you must now plot your course in detail and build the strategies that will ensure your progress—and eventually, your arrival.
Your strategic planning now must take the sometimes challenging step to formulate goals, beginning with broader objectives, becoming increasingly narrow and more detailed. Each level refines and defines everything the organization does—and why it does it that way.
If you adhere strictly to the principle that each stage builds on the previous process, you will eventually create a framework that helps make sense of the diverse, and seemingly chaotic, decisions, policies, procedures, and services you provide day in and day out. The mission statement rests on the vision statement, and the strategic goals grow out of the mission statement. Service goals, practice policies, and procedures all flow from that.
The practice’s core values—prioritized, of course—are interwoven throughout. Thus you finally create a sensible, integrated system of policies and procedures that supports your grand vision and mission. You have to be able to draw an unbroken line from the lofty vision statement to the nitty-gritty, daily procedures you and your staff employ every day.
Can your staff explain the reasoning behind your practice policies and procedures? Have you emphasized the sequence in your training, when you give directions, or when you personally provide service of any kind to the patients?
It’s critical that your staff members understand what your practice is all about. What are your priorities? What kind of image do you want to project? What does your ideal patient (or referrer) experience look like?
“Real life” is messy. You can create thorough and detailed policies and procedures in the sterile environment of a board room, but day-to-day operations present challenges and exceptions that call on staff members to make judgment calls. Informed, empowered employees will always provide better service. They can make sound decisions on the spot, fixing problems and coming up with creative solutions that impress patients, family members, and referring physicians. They can recover from mistakes. They can make you look good.
So if your receptionist is looking across the counter at a worried mom with a feverish child, and the mother can’t pay her office copay, what do you want your receptionist to do? While this example seems a bit simplistic, it illustrates the principle shown in Figure 1.
Figure 1. Each strategic-planning stage builds on the previous level.
If your front-line staff members understand your most important goals and values, they can represent you, the physician, much more effectively (and accurately). Deliberately incorporate your vision and mission into every aspect of your training, your leadership, and your example, and you will discover the practical aspects of those esoteric statements.