Succession is more than an exit; it’s leadership in its final, most public chapter. Two clarifying questions can keep you grounded and confident as you plan what’s next—so you make better decisions with fewer regrets and truly finish well.

By Editor-in-Chief, Concierge Medicine Today

Two Questions (your homework!)

1) An Integrity Question — Am I being honest with myself, really?
Name the real reasons you’re exiting (energy, family, health, calling, finances, burnout). Write down a finish-line dateand your non-negotiables.

2) A Legacy Question — What story do I want to tell?
In one sentence each, define “finishing well” for you (or your family), for patients, for your team, and for your successor. Then design your plan backward from the story you want them to tell a year after you leave.

The Excellence-First Playbook (aka “do these and sleep better” steps)

1) Build a strong, accountable transition team
Don’t delegate your future to a circle of well-meaning physician friends. Assemble proven professionals with clear roles: recruiting, legal, tax, finance/bookkeeping, practice valuation. Appoint one project lead (not you) to own timelines and decisions.
Standards to adopt: choose advisors for expertise, define decision rights, meet on a cadence, and track milestones.

2) Start recruiting early (24–36 months)
Put your practice promise in writing: access/availability, communication standards, panel size, pricing. Decide if the successor inherits a panel or builds their own, and model attrition.

3) Know your numbers (really know them)
Annual/monthly/quarterly costs, salaries, staffing, tech/SaaS, upcoming capex, current revenue streams, and 2–5 years of financials—clean, explainable, and trend-aware. If you had to pitch your economics in five slides, could you?

4) Valuations—understand the why behind the how
Reality check: what you think it’s worth ≠ what someone will pay. Obtain multiple valuations and insist on the methodology. Choose a path—associate-to-owner, platform partnership, regional alignment, executive-health—and structure win-win terms (continuity metrics, retention targets, thoughtful earn-out).

5) Communicate early & often (when the time is right)
Share the why, the timeline, and what won’t change. Excellence + clarity = trust and retention.

Marcus Buckingham (strengths principle): Don’t try to install what’s missing; build on what’s strong.
Hire/hand off to a successor whose strengths match your practice promise.

Andy Stanley: “Direction, not intention, determines your destination.”
Put dates, owners, and next steps on paper—or drift will decide for you.

Your 90-Day Starter Plan (simple, doable)

• Set a target transition date and name your project lead.

• Answer in writing the Integrity and Legacy questions.

• Draft your practice promise (what won’t change).

• Meet three successor candidates.

• Order 3–4 valuations and tidy up financials (learn the valuation logic).

• Publish a communication cadence for staff/patients; begin legal, tax, and document review.

Bottom Line

Clarity now beats regret later. Design the exit you’ll be proud to remember—and the one your patients will be grateful to retell.

Not legal, tax, or accounting advice; do your own due diligence.