Properly done, medical group management is neither a collaborative nor a unanimous process. It is a leadership decision.
The problem is that many groups have created an almost impermeable barrier to true leadership within their entity.
They strive for a consensus, which by its very nature is just another way of saying “watered-down decision.” The fact is that there is no way of reaching consensus unless there’s enough give and take from the original concept to allow enough members to buy-in to the consensus outcome, which is often only the beginning point in another a negotiation, this time with a third party.
Or, they set up a facially strong governance system but then fall back into the consensus trap.
Or, they construct a proper governance structure in which a small group (e.g., three individuals) are the governing board, or in which a “strong leader” (e.g., the president or managing partner), is empowered to make operational decisions, only to have a shareholders agreement or partnership document that gives every owner a de facto veto over major actions.
Every business (yes, your medical group is a business) needs a streamlined way to make day to day management decisions. And, it cannot allow one or two or a few dissenters to hold the group back in the event of major action such as a sale or merger.
The time to think about this is now. Unless now is the eve of an important decision, in which case even now is too late.
