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Create Shared Vision with Physicians, or Fail

 |  By David Miller  
   December 12, 2016

The Problem

Health system leaders understand that physicians are critical of value based purchasing success. Without physician support it is impossible to reduce variation around best practices, improve patient experience, and create better access to data, but many hospital physician networks are a loose amalgamation of providers who still operate as if they were in independent practices.

Creating a shared vision is the first step in propelling physician groups to develop as a competitive force, evolve into a valuable asset, and respond to and shape the market.

Physicians often have a good understanding of how a group needs to evolve in order to thrive.  They understand how variability in care represents an opportunity to improve, and why physician leadership is crucial to meeting health system and patient needs. However, they are often frustrated because there is no forum in which they can focus this insight and influence group direction.    

The Process

Throughout 2016, HSG has worked with seven health systems to address this challenge. Our approach is to start by assembling a group of formal and informal physician leaders and tasking them with defining what the group will look like in 10-15 years. In doing so, we encourage the physicians to describe the group that they would proudly associate.

Developing such a document is an iterative process. We start with interviewing key players, analyzing data, reviewing the health system strategy, and employing our knowledge about group success factors. 

From that foundation, we create an initial draft vision that is reviewed by physician and administrative leaders. The drafts are edited …and edited …and edited again. The editing process focuses on content, presentation, and clarity rather than wordsmithing. Invariably the physicians identify issues that reflect a sense of service to their patients. The points of interest and emphasis also change with each version as the leadership group internalizes the content. 

The process also increases the sense of ownership. We recommend presenting the draft vision statement to the entire physician group, with physician leaders conducting the discussion. Inevitably, the front line physicians add further insights to create greater ownership.  

From the final vision statement, we find it helpful to extract core strategies and discuss them with the physicians as well. This makes the process more tangible because the physicians see how specific actions tie to the final vision.   

The Results

The results from our work with clients have been rewarding. Those include:

  • Greater engagement by physicians and formal definition of leadership roles and expectations.

  • Accelerated ownership by the physicians with examples of specialty departments focusing more aggressively on reducing variation in care and moving toward best practice.

  • Recommendations from physicians that quality metrics become a bigger part of the compensation system.

  • Groups referring to the vision as their “Constitution,” a document that helps guide decisions and focus actions.

  • Greater development of Physician Advisory Councils, with those groups owning the implementation of the vision.

If you wish to see case studies from our first two projects, visit

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