ABSTRACT
This chapter defines desired organizational outcomes that require positioning the practice as the provider of choice for its defined area of service. The chapter provides current leadership by physicians and potential for leadership through governance and reviews the organizational and decision making structure of the practice. It analyses competitors to determine current comparative organizational position and establishes desired structures in the practice with benchmarks for comparison. The business and organization of medical practice has initiated a period of fundamental change. Physicians are consolidating frequently into group practices, many medical practices are affiliating with hospitals or managerial companies, and physicians in most geographic areas have started a conversion from traditional fee-for-service economics to the very different servicing and financial demands encountered with systems for prepayment. The health care organizations that have evolved outside of a medical group structure are reluctant to seek and support the best leadership and participation by physicians that is possible at the level of organizational governance.
