New competitive strategies for the practice of radiology in a changing economic environment.

Traditional strategic planning in managing American businesses recently has been called into question by a number of authors [1 ]. Strategic planning worked well through the 1940s, 1 950s, and 1 960s, but since the mid-i 970s corporations relying heavily on strategic planning often have fallen short of their goals and lagged behind competitors that emphasize strategic planning less [1 ]. Strategic planning before 1970 pursued a hierarchical sequence beginning with the selection of objectives and implementation of the appropriate strategy, and then went on to resource allocation, usually in the form of a war chest of cash, in order to acquire the necessary talent or manufacturing base. This approach worked well before 1 974 because the environment was stable , and long-range forecasts often proved to be accurate. Thus, the strategic plan could be used as a road map with a specific set of instructions designed to be executed at the appropriate time. Recently, change and increasing competition have been the major characteristics of the health-care industry. The objectives/strategy/liquid-assets approach is not suited to the current type of environment. Planning in an uncertain environment should begin with the development of entrepreneurial and technical skills and proceed to the development of strategy and objectives. Strategic planning is a process that is evolutionary and continuous, but the first step is to prepare brief statements regarding the Time frame of the planning horizon, the Objectives to be obtained, the Environment, and the seven Ss, originally developed by McKinsey & Co. (a management con-suiting group in New York): Strategy-What medical services are we going to offer? To whom? For instance, will we provide primary care well-patient screening imaging services, research to the National Institutes of Health, or postgraduate medical training? Systems.-What is the incentive system? Is it merit based, socialistic, or based on billing or hours spent in clinics? What is the evaluation system? What is measured, how, and how frequently? Examples of this are a semiannual self-review form listing revenues generated from clinical work, research, teaching, and other activities; papers presented and published ; and teaching and administrative activities. Skills-What are the skills, training, and experience of the physicians and staff? Structure.-What is the supporting organizational struc-ture? Is it a loose professional organization of generalists, of subsection specialists, or is it organized around technology or organ systems? Superordinate values (i.e., most important service).-What one word or phrase would you put on every …