Most physicians that I know would agree wholeheartedly with Nick Jacobs’ post, “I hate business plans.”  A surgeon protested, “Can you believe that I went into the COO’s office all excited about a new device that would speed recovery and shorten length of stay, and do you know what he told me? ‘Fine, go write a business plan.’”

“I’m not that stupid,” he continued. “I knew that the main reason he said that was to get me to leave his office and never bring another idea to his attention again!”  As he told his buddies in the physicians’ lounge, I wondered how many other physicians learned the same lesson.

My anger over the way that the situation was handled led me to write an article (Cohn KH, Schwartz RW. Business plan writing for physicians. Am J Surg 2002;184(2):114-120 cohnbusinessplan3_31_02.pdfcohnbusinessplan3_31_02.pdf)  to demistify the process for physicians who had not attended business school and to encourage them not to be put off.  Just because they do not have the training to do the cash-flow analysis does not mean that they cannot explore the:

• unmet need that their proposed innovation will fill
• estimated patients per year their service will draw
• alternatives to their proposal and the reason that their service offers an advantage
• definition and measurement of success
• resources (labor, funds, equipment, and supplies) they will need to start
• obstacles they might encounter and how they can overcome them

 As I wrote the article, I felt that physician involvement in writing a business plan was a great way to focus, clarify, and justify a request for scarce resources.  It also offered a way to plan proactively for an uncertain future rather than to react to competitive market dynamics.  If done well, it might even improve transparency, trust, and collaboration between physicians and hospital leaders.

I tested my hypothesis with a urologist at a community hospital in Connecticut.  For two months, we met every other week for dinner and talked about his idea to accelerate diagnosis and treatment for patients with prostate cancer.  We drafted a business plan that we shared with senior leaders at his hospital.  His business plan became the blueprint for a multidisciplinary cancer diagnosis and treatment center that is currently up and running.  The case is included in the article.

What do you think:

• Can we empower physicians to write business plans
• Does joint physician-administration thinking about the concept, market, competition, strategy, finances, operations, and implementation improve our chances of success
• Would you want to work in an environment where hospital leaders helped physicians write business plans

 As always, I welcome your input.

Kenneth H. Cohn