What Does The American Revolutionary War and Practice Governance Have In Common?


Good anesthesia practice management includes proper governance.  Practice governance must act to help an anesthesia practice succeed as a business and succeed clinically.  This post offers some perspective on when it is time to self-assess your governing body and why you should take these triggers seriously.

What are some triggers for self-assessment?

  • Mergers & acquisitions
  • Growth of the practice
  • Influx of new and younger doctors
  • Regulatory requirements
  • Change in practice status of board member (active to retired or semi-retired)
  • Significant growth in the number of physicians or CRNAs
  • An increase in the number of practice locations
  • Incurring internal strife, due to inadequate governance system in place
  • Inability to make decisions in a timely and efficient way
  • Relying too heavily upon one or a few busy physicians to deal with non-clinical issues (at times, this is by choice)

The list is by no means exhaustive. It illustrates some of the internal and external changes that might precipitate governance review and rule changes.

Why your practice should yield to a self-assessment?

A conventional approach of ability, affability and availability is not enough to guarantee a successful anesthesia practice.  Especially not when increased competition for service locations, threat of hospital employment, group mergers, and acquisition discussions are all on the table.

The best board members are sensitive to what non-governing members think of how the practice runs. The best board members do not take the attitude that, “I was elected to do a job, let me do it.”  They are not like King George whose actions angered the colonists and led to the king’s overthrow, but more like Mayor Koch of New York City fame who would constantly ask constituents, “How’m I doing?”

America_Revolutionary_WarHere’s why you need to acknowledge the triggers above as an opportunity for self-assessment.

  1. So you can be proactive decision makers for your practice.
    Americans kept experiencing late deliveries from the British and frustration grew. There is great deal of risk in letting group members stew over a concern they’ve brought up and not being prepared to respond. Even worse, ignoring the concerns. The board should never be the last to recognize or respond to a trigger.
  2. So there is equal representation of individuals or divisions within the practice.
    Taxation without representation was a major pain point for the colonists.  Make sure the governing board is made up of board members that represent all major aspects of the group.  Triggers involving new divisions, locations, or agreements may be cause for adding or removing board members or a restructure altogether.
  3. So you maintain respectful control and cooperation over members of the practice.
    King George ignored warnings and ultimately lost all control over the colony. Your responsibility as leaders to your anesthesia practice is to guide, listen, and make decisions on behalf of the best interest of the group and it’s members. With that, respect and cooperation from the group will follow.

While some triggers may be more minor than others, consider everything as a whole.  Minor irritants may lead to enough dissatisfaction that to cause a mutiny.  Taking a close look at how well your practice is governing itself and being receptive to new ideas is crucial to the future of the practice.

It’s beneficial to have an anesthesia practice management company or in-house practice management team play particular notice to how well practice governance is taking place in your group.  A keen practice manager will be on the look out for triggers like the one’s mentioned above and have valid reasons to back up any suggestions being presented.







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