In this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with Bob Bush, a seasoned healthcare executive and MGMA leader, to explore one of the most overlooked — and perhaps most critical — aspects of medical practice management: succession planning.

Drawing from decades of experience, Bob shares practical strategies for identifying future leaders, avoiding operational disruption, and building a sustainable organization. The conversation also touches on leadership development tools, lessons learned from real-world failures, and how proactive planning can prevent chaos when key team members leave.

Whether you're leading a large medical group or a smaller outpatient practice, this episode offers actionable insights to help you future-proof your organization.

Key Takeaways

[05:10] Getting to know Bob Bush

•  Bob shares highlights from his healthcare leadership career, including his role as CEO of a large physician group 
•  Reflections on MGMA involvement, career growth, and lessons learned across leadership roles

[05:55] Why succession planning is NOT optional

•  Waiting until a crisis hits (retirement, illness, sudden departure) can paralyze operations 
•  Succession planning should start on day one, not during an emergency

[06:27] Succession planning goes beyond leadership roles

•  Critical roles include HR, payroll, IT, and front desk staff 
•  Every “mission-critical” position needs a backup plan 

[09:03] Lessons from failure: what happens without a plan

•  Real-world example: a physician-led practice collapses operationally when the leader is suddenly absent 
•  No shared access, no cross-training, no backup = total shutdown 

[12:32] The retirement reality check for leaders

•  Retirement is a 5-year transition process, not a switch you flip 
•  Leaders must plan for purpose, identity, and daily structure post-career 

[15:35] Practical tools for succession planning (visit the video version of this interview on YouTube to view Bob's screenshares)

•  Build a simple spreadsheet tracking: 
  •  Key roles 
  •  Potential successors 
  •  Risk level of departure 

[19:46] Identifying future leaders within your organization

•  Use structured tools like the 9-box talent grid
•  Focus development efforts on high-potential, high-performing employees

[23:55] From recruiter to practice leader

•  A pivotal career moment led Bob from physician recruiting into practice management 
•  Early mentorship sparked his long-term involvement with MGMA

[26:10] Why MGMA certification and continuing education matter

•  Demonstrates commitment to the profession, similar to physician board certification 
•  Requires ongoing continuing education to stay current 
•  Bob shares his role in helping develop certification exam questions and shaping industry standards

[00:33:18] The human side of leadership transitions

•  Loss of daily interaction can lead to isolation 
•  Staying engaged (consulting, volunteering, part-time work) is key to well-being 

Resources 

• MGMA Member Webinar: Is Your Practice Ready for its Next Chapter of Leadership? (on-demand access available through MGMA) 
• Book Recommendation: The Ruthless Elimination of Hurry by John Mark Comer 
• Podcast Mentioned: Midlife Chrysalis
• MGMA Member Tool: Succession Planning Template