Originally published in Independent Practitioner Today in March 2023, our Managing Director Jane Braithwaite summarises the ten main considerations to ensure your group has maximum potential for success.

What makes a successful group? The guidelines for creating and maintaining a successful group reflect similar ones that would be set for any team of people working together.

Undoubtedly, a successful group is one motivated by the shared core values of its members. When your group shares the same sense of purpose, they celebrate and champion each other, creating a culture of excellence within the business.

1) Agreed goals and objective

When the group was formed, the group members agreed on the group’s goals and objectives. Each group member documented this agreement in writing and signed to signify their understanding and commitment. This important document is referred to as their contract and they took advice from their accountant and lawyer to ensure all eventualities were catered for. This activity gives the group clear direction and a common aim to work towards collectively. When any change is made to the group – for example, a member leaving or a new member joining – the contract is updated to reflect this. Clearly defined goals enable everyone within the group to maintain a clear vision of what the group is aiming to achieve.

2) Leadership

A group is usually a partnership where all members are of equal standing. But a successful one will have nominated one individual to act as the group leader or managing partner. This is often the group founder, the person who originally created the concept of the group, or it may have been a joint decision, choosing the individual with the greatest leadership skills. The leader is trusted and respected by the group members and encourages everyone to work collaboratively. The leader also encourages a positive work environment and work ethic. Ultimately, the leader is required to ensure good decisions are made in a timely manner. This is especially important when consensus cannot be reached promptly.

3) Communication

Every month, the group members meet to discuss the performance of the group. They communicate openly with each other, sharing their thoughts, opinions and ideas and they take time to consider what others have to say. On a daily basis, the group members are open and honest in their communications, highlighting concerns or issues and enabling them to be addressed before they become bigger problems. Everyone trusts one another and feels able to speak up. This continuing open dialogue helps ensure that conflict is mostly avoided, but when conflict does occur, it is handled professionally.

4) Clear responsibilities

Everyone recognises that running the group is equivalent to running a business, which brings additional responsibilities. The group has identified the relevant management roles and responsibilities and has allocated these fairly across the group members. Everyone contributes their fair share towards the workload of running the group and each individual understands their responsibilities and where they fit in with the overall running of the business. This helps to prevent overlap, miscommunication and misunderstanding. They take ownership of their area, are committed to their work and they care about the success of the group overall.

5) Clearly defined financial model

When the group was formed, its financial model was clearly defined and described in the contract that each group member signed. Each individual has clarity on how their financial rewards will be calculated and, therefore, clearly understands how their work contributes to their financial success. Rewards are fair and unbiased and represent the hard work and contribution made by each individual. The agreed financial model is motivating and increases job satisfaction. The agreements made were realistic and expectations were met. It was understood that, like any business, the group would take time to establish itself and the financial rewards may take time to build. The group regularly discusses and reviews financial performance throughout the year to ensure a clear understanding of progress made and how this impacts each individual to avoid any surprises at year end.

6) Decision-making

When important decisions need to be made, the group members can openly discuss their views and contribute to making the best decision for the group overall. When there is disagreement, the group members actively listen to each opinion and aim to compromise to reach an agreement. When needed, the nominated leader of the group can make the decision, and the group members respect and support the decision. A lack of decision-making can be damaging. It is critical that people communicate their concerns, have a clear vision of where they are headed and make decisions. Not everyone may agree on the decision, the tactics or how to work together, but still the team must make a decision and move forward.

7) Consistent standards of patient care

The group members share a common view on the level of care that their patients should receive and aim to deliver a similar patient experience. When the group was formed, the clinicians discussed their views on patient experience and agreed on standards of care that the group would commit to delivering and they adhere to these expectations daily. This enables them to feel comfortable referring their patients to their colleagues within the group for additional treatments and to care for each other’s patients during periods of absence and holidays. When a patient complaint is made, the group reviews the complaint together and investigates the causes openly and honestly. There is no blame, so the discussion focuses on how to manage the situation to achieve the best outcome for this particular patient and how to learn from this event and improve processes to prevent a recurrence. All group members commit to continual learning to ensure their knowledge is up to date. They share their expertise widely within the team and aim to enhance every­one’s skill sets.

8) Organised, disciplined and well-managed

Each clinician professionally manages their own practice. The administration is well managed and patient communication is exceptional. The business itself is also run in an organised and disciplined manner. Each group member manages their responsibilities diligently and delivers their work to the agreed deadlines. Each group member is respectful of others by attending meetings on time and submitting their contributions on time. Regular meetings are held to ensure everyone is on the same page and deadlines are being met,

9) Supportive

The doctors perform well as a team and the group exhibits a collaborative work environment. Each group member has a positive attitude and work ethic, and the group is efficient and productive. No single individual dominates discussions and each person has an equal opportunity to be heard. The culture of the group is supportive, with each group member actively supporting others when needed; for example, when one individual is under pressure with their workload or facing a difficult clinical decision. Each clinician has different expertise and experience, utilised across the group through collaboration. This diversity is respected and embraced to offer patients the best possible care.

10) Enjoyment

Within a truly successful group, the doctors enjoy their work and they enjoy working together, having a sense of achievement and of fun. They enjoy the company of their colleagues and value their discussions, both clinical and business related. Positive relationships built across the group help create a relaxed environment and reduce conflict. The group members have constructive chats about work-life balance and they encourage one another to maintain a healthy balance, recognising this helps prevent burn-out and ensures they are all able to perform to the best of their abilities.

Jane Braithwaite
MD of Designated Medical

If you need any advice, please contact the team at Designated Medical.

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