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Practicing Independence

Chapter 6

The Future of Independence

Staying ahead of the tide

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 is something you do now, while you still have time to shape the outcome, rather than when you are ready to retire.

From the Operator's Chair

Practices crumble when a senior physician retires without a plan. Staff scatter, patients are left without continuity, and decades of community trust can evaporate in months. Protect the Breakwater: the barrier around 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 without scrambling: a lost physician, a revenue drop, a system failure?
  • If a critical person left tomorrow, does someone already know how to step in?

Succession planning is about resilience more than retirement. 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 is responsible leadership, not morbid planning.

Every critical role in your practice should have a name next to it: someone who is ready now, and someone who could be ready in one to two 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.

Download these worksheets (PDF)

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.
1

Know it

Rate each statement honestly. This is a stress test, not a report card. Scale: 1 = Not at all, 5 = Completely.

1.We could survive the loss of our top revenue-producing physician for 6 months.
2.We could survive a 15% revenue drop for 12 months without layoffs.
3.Our key processes are documented and could be run by someone else.
4.We have a succession plan for every critical role.
5.Our technology systems have backups and disaster recovery plans.
6.We have strong relationships with at least 3 payers (not dependent on one).
7.Our staff morale is strong enough to weather a difficult quarter.
8.We have legal and compliance counsel we can reach within 24 hours.

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.

10.What's our single biggest vulnerability?
2

Own it

Discuss as a team and prioritize the top 3 vulnerabilities to address.

1.Top 3 vulnerabilities
#VulnerabilityImpact if Not AddressedOwnerDeadline
1
2
3
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
Chapter 5