December 2002 Bulletin

Planning a practice retreat

Set strategies, long-term goals

By Sandra Lee Breisch

Does your medical group or institution have a clear vision for the future? Are your long-range goals set to improve your bottom line? Have you held any problem-solving sessions lately?

If not, maybe it’s time to schedule a retreat.

"Retreat planning should become a top priority–even in tough financial times," stresses Barry C. Dorn, MD, a practicing orthopaedic surgeon and president/CEO of Health Care Negotiation Associates (, a Boston company that helps practices resolve conflicts that can impact efficiency, quality of care and patient safety.

Retreats can help identify your strengths and weaknesses with collaborative relationships that include your executive team, board or medical staff leadership.

"You don’t want to miss an opportunity to hold a retreat. It’s an opportunity to forge a stronger relationship with these key players so you can find ways to expand and maximize your business." explains Dr. Dorn. "For example, every institution knows its mission statement is to improve the health care of the community. However, it can’t do this unless it has an effective bottom line. And the same thing applies to medical groups who can’t just say, ‘let’s practice orthoapedics,’ and not think about what they’re going to do in the future. We all know that if what we’re doing is not working real well, then we need to determine how to do it better."

According to Dr. Dorn, retreats help physicians think out of the box, brainstorm and come up with better ideas. "A retreat will also enable everyone to put ideas on the table that otherwise might be hidden underneath the tablecloth," he says. "And because health care, reimbursements and the product that orthoapedists deliver is changing so much, it’s critical that physicians think, ‘what can we do differently?’"

Once an institution or medical group decides to have a retreat, they should plan it in advance–at least three months to a year. They should also identify all the key players who will attend the retreat. "This could include board members, physicians, nurses, practice administrators and other key persons who work in concert with each other," says Dr. Dorn.

Choosing the facilitator

Organizations should choose a facilitator who will work best for them. "The key persons in the medical group or institution should interview several retreat facilitators," says Dr. Dorn. "Once they decide on who will be their facilitator, they need to give him/her a clear picture of what their concerns and issues are to help formulate reasonable goals for the retreat.

"Make sure the facilitator is a neutral person. Also, choose someone who can work toward your goals. For example, if diversity is a big issue, the facilitator should be experienced in this regard."

Identify goals

Retreats can be held for various reasons such as focusing on leadership development, decision-making or medical staff education and development.

Key players who’ll attend the retreat should meet a few times with the retreat facilitator several months to a year ahead of time. "This gives your institution or medical group ample opportunity to identify strategic initiatives and other strategies that will be discussed at the retreat. You can define goals, review organizational information and derive consensus for strategic planning," explains Dr. Dorn.

Keep in mind that although each person plays a different organizational role, his/her goal is the same: to improve the health of the community. "People also need to understand each other’s self-interest. For instance, what do the board, administrator and practitioner need so they can work well with one another," explains Dr. Dorn.

Location and length

All retreats should be held off-site–far enough away where people can be isolated from their normal routine–but not so far that it’s a major inconvenience for people to get there. "Hold the retreat at a nice place where participants will feel comfortable and can have social interaction and camaraderie," says Dr. Dorn.

Weekend retreats are ideal, but if that’s not possible, a one-day retreat with a social evening the night before should be planned. "The evening before should be a social gathering where the participants can meet with the retreat facilitator," says Dr. Dorn. "This gives the facilitator a chance to put a face with the name and saves a tremendous amount of valuable time during the retreat. This social time prior to the retreat really breaks the ice."

What comes out of the retreat?

A retreat will add a level of clarity and reality to the wants and desires of the group. "For example, many groups will determine that they should expand certain ancillary services, but it might cost too much," points out Dr. Dorn. "Retreats are also a good time for problem-solving and reevaluating each person’s role in the organization to see if they’re doing the job right or if it needs to be changed."

Oftentimes, a retreat will uncover negative things. "For example, you’ll discover whether or not your group practice or institution is operating under a formula for disaster," says Dr. Dorn. "Perhaps your practice administrator may not be on the same page with you. And since many practices go along with their administrator, they don’t always know if that person has his or her self-interests in mind–rather than the group’s."

Finally, a retreat will help practices resolve any conflicts in their organization that can impact the efficiency, quality of care and patient safety, notes Dr. Dorn.

Barry C. Dorn, MD, is a practicing orthopaedic surgeon and president/CEO of Health Care Negotiation Associates, He is also the associate director of the Program for Health Care Negotiation and Conflict Resolution at the Harvard School of Public Health, He can be reached at (781) 861-6116 or at

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