Chapter 6
The Future of Independence
Resilience — stress-test your practice and build the succession pipeline that outlasts you
75 minutes with your leadership team
The future of your practice depends on two things: the systems you build today and the people you develop to run them tomorrow. Succession planning isn't something you do when you're ready to retire - it's something you do now, while you still have time to shape the outcome.
I've watched practices crumble because the founding physician retired without a plan. The staff scattered, the patients were orphaned, and decades of community trust evaporated in months. Protect the Breakwater - the barrier that protects what matters most. That means building a practice that can outlast any single person, including you.
Two questions this chapter answers
- Could we survive a shock - a lost physician, a revenue drop, a system failure - without scrambling?
- If a critical person left tomorrow, does someone already know how to step in?
Succession planning isn't about retirement - it's about resilience. What happens if your practice manager gets a better offer next month? What happens if your lead physician has a health crisis? The practices that survive these shocks are the ones that have already identified who's next, what they need to learn, and how they'll be developed. This isn't morbid planning - it's responsible leadership.
Every critical role in your practice should have a name next to it: someone who's ready now, and someone who could be ready in 1-2 years with the right development.
Worksheets
A preview of the first worksheet is below. Members get every worksheet, plus saved answers and the 90-day action plan.
Worksheet 6.1
Resilience Audit
- Lesson:
- Stress-Test Your Practice
- Purpose:
- Identify your practice's vulnerabilities and build a plan to address them before they become crises.
- Participants:
- Leadership team, practice manager, and senior staff.
Section 1
Know it
Rate each statement honestly. This is a stress test, not a report card. Scale: 1 = Not at all, 5 = Completely.
Total Score: ________ / 40. 32-40: Strong resilience — maintain your systems and keep stress-testing. 24-31: Moderate resilience — address the lowest-scoring areas this quarter. 16-23: Vulnerable — prioritize resilience-building immediately. Below 16: Critical — your practice is one crisis away from serious trouble.
Section 2
Own it
Discuss as a team and prioritize the top 3 vulnerabilities to address.
| # | Vulnerability | Impact if Not Addressed | Owner | Deadline |
|---|---|---|---|---|
| 1 | — | — | — | — |
| 2 | — | — | — | — |
| 3 | — | — | — | — |
Section 3
Do it
This week and beyond - turn this into action.
Action 1: Address your #1 vulnerability this quarter
- Define the specific risk
- Assign an owner
- Set a deadline
- Report progress at each monthly leadership meeting
Action 2: Schedule a semi-annual resilience audit
- Retake this assessment every 6 months
- Compare scores over time
- Celebrate improvement and address persistent gaps