Practicing Independence: A Field Guide for Independent Medical Practices

What This Workbook Is

Practicing Independence is not a collection of abstract theories from a business school classroom. It is a practical, no-nonsense field guide forged in the trenches of real, independent medical practices. Built on a simple, powerful premise: independence is not a state of being; it is a practice — a set of disciplines, rhythms, and choices that create the financial strength, operational resilience, and cultural fortitude to stay in control of your own destiny.

Six Chapters, 18 Structured Worksheets

Each chapter follows a consistent Know It / Own It / Do It structure designed to move your team from insight to action:

• Chapter 1: Foundations of Independent Practice — Define your Independence Aim, build feedback systems, map broken processes, and establish 90-day focus cycles
• Chapter 2: Financial Clarity — Master the 5 core financial metrics, build dashboards that drive real decisions, analyze payer contracts, and stress-test your finances
• Chapter 3: Operations — See your practice as a system through process mapping, implement standard work and daily huddles, and run PDSA improvement cycles
• Chapter 4: Leadership & People — Conduct leadership self-assessments, clarify decision-making authority, and build staff development and retention systems
• Chapter 5: Growth & Strategy — Assess growth readiness and evaluate strategic partnerships and alliances
• Chapter 6: The Future of Independence — Run a resilience audit and build a succession plan

Includes Practice Health Scorecard

A comprehensive diagnostic tool that consolidates every self-assessment into a single view of your practice health across all six dimensions. Complete it after working through all chapters, then revisit quarterly to track progress.

How to Use It

Gather your leadership team, physician partners, practice manager, and anyone who influences strategic decisions. Block 90 minutes per chapter. Work through one chapter every 1-2 weeks. The value comes from the honest conversations, not the speed.

Who This Is For

Practice administrators, managing partners, physician-owners, and operational leaders at independent medical practices who are ready to measure what matters, fix what is broken, and build systems that the leadership team can run on their own.