SA medical practices struggle to find new staff and future practice owners, survey finds.South Australia’s medical practices predict they will face significant challenges in recruiting new practitioners and good staff over the next two years, a national survey of medical practice managers has found.The survey of 130 practice managers by South Australian professional services firm Hood Sweeney in 2014 found the majority (77 per cent) of practice managers expected to face challenges in recruiting new practitioners over the next two years and nearly the same proportion expected to deal with the retirement of the practice owner in the same period. Of the respondents, most represented General Practice (59 per cent), while nearly a third represented medical specialists, and 7 per cent were from allied health. Another 2 per cent were dental practices. Most were large practices (42 per cent), while a third represented medium-sized practices and a quarter were small practices. Hood Sweeney Consulting and Performance Coaching Director, Chris Stewart, said that while many practices understood that they needed to act early to plan for succession, they found it difficult to find appropriate people to take over when the current practice owners retired. Of the practice managers surveyed, two thirds said they would struggle to find good staff and about the same proportion said they faced challenges in encouraging practitioners to buy into the practice. More than a third of practices were engaged in formal succession planning at the time of the survey while another quarter were intending to over the next year. Nearly 40 per cent were actively recruiting new practitioners and another 20 per cent would be recruiting over the following year.

Strategy, succession and governance - key challenges for healthcare practices

Survey findings

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“Almost without fail, every practice that we talk to states that the recruitment of new practitioners and the exit of existing practitioners (under the succession planning umbrella) is one of the biggest issues they are facing and this is clearly supported by the survey,” Mr Stewart said. “There are so many elements to succession and in our experience it needs to be regarded as a process rather than an event. Applying a clear succession framework is essential because there are so many things that need to be put in place over an extended period of time to ensure a smooth process that is not disruptive to the individuals concerned and the operations of the practice,” he said.

The Hood Sweeney 2014 Practice Managers’ Perspectives survey found that while recruiting and succession planning ranked high on the list of business planning problems for South Australian medical practices in the near future, these issues formed part of a broader challenge to implement their business strategies.

The survey found that while most medical practices have a vision and strategy, only around half have the business tools to get there.The survey asked Practice Managers to rate the performance of their practice in four areas: planning, leadership, productivity and relationships. Overall, they rated their practice’s effectiveness in planning at 58 per cent, leadership and productivity at 78 per cent respectively and relationships at 93 per cent.

Planning –clear visions but ineffective monitoringIn respect to planning, nearly two thirds of managers said the practice had a clear vision while nearly a third said they had a business strategy. Yet only around half of the practices reported effective business planning and budgeting processes and only 52 per cent of the surveyed practices actively track their performance against the business plan.

Major Projects

Challenges

Planning Leadership

ProductivityRelationship

58% 78%

78%93%

Four Cornerstones of business success

23%

26%

35%

35%

45%

39%

36%

36%

44%

40%

20%

18%

21%

23%

14%

20%

25%

26%

19%

28%

new clinical equipment

practice refurb.

technology upgrade

governance changes

leadership training

recruitment of new practitioners

formal succession planning

marketing investment

formal business/strategic planning

process improvement

doing now next 12 months

77%

71%

66%

65%

60%

58%

53%

recruitment of new practitioners

retirement of owner

recruiting good staff

encouraging practitioners to "buy-in"

balancing demands of practice

managing growth

responding to reforms

0% 20% 40% 60% 80%

Clear vision Strategy

Actively trackBusiness plan / Budget

75% 60%

52%53%

Planning Leadership

Visibility Communications & decisions

Engagement team

90% 80%

75%

“Setting clear goals and a establishing a shared practice vision are very important but without monitoring and evaluation, it’s only going half way towards achieving success. It’s quite critical to have a structured approach to monitoring the practice’s performance against four key areas of business – planning, leadership, productivity and relationships,” Mr Stewart said. “That’s where it can be very useful to implement an analytical framework, such as our Four Cornerstones of Business toolkit which helps businesses understand where they are in effectively implementing their vision,” he said. “By using these platforms, practices can create clarity and alignment to help with getting a shared understanding and implementing the plans effectively,” he said.

Getting the best from the practice - Productivity and Leadership Most managers rated the productivity of their technology and administrative processes at around 80 per cent effectiveness. Unsurprisingly given the services they provide, most practices performed well in maintaining strong relationships between practice managers and staff, owners, clientele and referral partners. However, practice marketing, a critical element in a very competitive environment, was rated considerably less effective at 65 per cent.

Most rated visibility of practice leadership and decision-making as highly effective. The survey found team engagement was the least effective of the leadership attributes. “We were pleased to see that over 50 per cent of practices are considering some form of leadership development and we are seeing an increased demand for small group and one-on-one coaching sessions tailored to the individual needs of practices, as well as advice on projects and business development,” Mr Stewart said.Most practices realised that they faced challenges in adapting to new business models emerging in South Australia. Hood Sweeney predicts this will intensify as Primary Healthcare Networks (PHNs) and a changing regulatory landscape continue to modify the role of the GP, and demand an even greater focus on patient outcomes. “The recent federal government changes to the Medicare Local network and GP training funding arrangements highlight the government’s focus on reform in the health care sector. Medicare Locals did some fantastic work in relation to health outcomes and those healthcare practices that linked into this framework, or plan on being well engaged under the new PHN model will be well placed to create great value for their patients as well as their own practice,” Mr Stewart said.“Practices need to find new business models to create value in an increasingly competitive environment,” he said.

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The Consulting & Performance Coaching team at Hood Sweeney specialises in improving business performance:

■ strategic planning ■ organisational change management ■ collaboration and stakeholder engagement

frameworks ■ strategic project support ■ business coaching ■ leadership coaching and development ■ corporate governance and board development

Chris Stewart Managing Directorchris.stewart@hoodsweeney.com.au

Simon Starr DirectorConsulting & Performance Coachingsimon.starr@hoodsweeney.com.au

In this context, many practices are already engaged in process improvement (40 per cent) while another 28 per cent are planning process improvements over the next 12 months. Of those surveyed, around a third of practices were upgrading their technology and 21 per cent planned to over the following year. Around a quarter were refurbishing or investing in new equipment.

Work-Life Balance

Strongly agree

Agree Disagree Strongly disagree

25%

44%

22%9%

strongly agree

agree

disagree

stronglydisagree

“Against all of the changes and business demands, it will be important for practice managers to have systems in place to help them achieve these objectives while maintaining a good work-life balance,” Mr Stewart said.

Productivity

Technology Admin processes

Marketing

65%

80% 82%

A significant proportion of practice managers (22 per cent) disagreed that they had a good work-life balance while 9 per cent strongly disagreed that they were effectively juggling their working and private lives. “Our Consulting and Performance Coaching services are proven in a number of settings and we have helped numerous practices get their ‘houses in order’, empowering the Practice Manager to run the practice with greater focus and measurable outcomes. Whether it be strategy, succession or governance, it all comes back to one thing … having a comprehensive planning framework,” Mr Stewart said.

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