Despite years of upheaval, many medical practices go without formal succession plans for leadership

Unplanned exits happen all the time — look no further than the U.S. presidential race for a prime example.

While leadership roles in medical groups and health systems don’t have massive campaigns to decide a winner like political races, succession planning to find the right person for the job can require months or years of planning.

A July 30, 2024, MGMA Stat poll found that just more than one in three (36%) of medical group leaders report having a succession plan for leadership positions, while 57% did not and another 7% were unsure. The poll had 235 applicable responses.

These findings closely mirror similar polling from late 2022 that found 35% of medical groups have succession plans for leadership positions, while 61% did not and 4% were unsure.

What we learned

There is no clear approach to how many leadership roles require succession plans, judging from the respondents to this week’s poll:

• Many respondents noted they only plan for president and/or chief executive officer roles.
• Several other medical group leaders noted they only have succession planning for physician leadership and no plans for other executives.
• Other respondents noted they will do succession planning for department leads/managers, or anyone at the vice president level and higher.
• Some organizations have succession planning for key roles such as director of operations, patient access manager, nursing director and other upper management roles.
• In larger systems, the process might include recruiters based with a parent company who can search the organization’s other facilities as well as vet external candidates.

Many of these respondents made it clear that building a bench of future leaders among their current staff is important. One individual told MGMA they are trying to add internal succession planning for all leadership roles, noting they are “working hard to try to develop and grow leaders from within our organization.”

For all those intentions of building internal leadership development and internal search teams, most practice leaders noted their organizations rely heavily on external recruiters when it’s time to search for leadership candidates, regardless of whether they have formal succession planning.

Future-proofing your practice

As Tina D’Amico, MHA, CMPE, wrote in MGMA Connection magazine, planning for succession is something practice administrators “approaching the end of their full-time work cycle” should be doing for their own roles, with planning starting years in advance.

As she points out:

• In a mid-sized practice, “the partners must trust and respect who they chose as the managing partner, and the managing partner must trust and respect the administrator’s opinions,” as that balance “is necessary for effective decision-making, relying on each other’s expertise and judgment.”
• Partners should openly share their plans for retirement, cutting back on office hours or changing their on-call schedule, “regardless of how vague or distant these plans may be.” These discussions should be on the agenda for annual partner meetings, and the administrator should feel confident and comfortable sharing plans without fear of retribution.
• When focusing on developing a “second-in-command” assistant administrator to step up, it’s important to slowly integrate job duties and responsibilities while also teaching protocols for unlikely scenarios. “Have them problem-solve ‘what-if’ scenarios,” D’Amico suggests.

Do you have any best practices or success stories to share on this topic? Please let us know by emailing us at connection@mgma.com.

JOIN MGMA STAT

We depend on a strong feedback loop with you to provide great resources, education and advocacy for medical group leaders. To be part of this effort, sign up for MGMA Stat and make your voice heard in our weekly polls. Sign up by texting “STAT” to 33550 or visit mgma.com/stat. Polls will be sent to your phone via text message.

Additional resources

• Access our member-benefit Professional Development and Succession Planning Toolkit, including a succession planning template, talent grid profile and professional development dashboard.
• “Succession management: An essential strategy for organizational success” (Insight article)
• “The necessity of succession plans” (Insight article)
• “Successfully navigating physician succession planning” (Podcast)
• “Succession Planning for a Small Rural Medical Practice” (Fellowship paper)
• “Succession Planning in a Single Owner Physician Practice” (Fellowship paper)