Transforming a practice to form strong realtionships and exceed their growth goals.


Suburban Pediatrics is an independent pediatric medical practice group with 19 providers who have expertise in specialties related to children’s health and well-being, including behavioral health/ADHD, eating disorders, lactation services, international adoption, sports medicine and the complex care of chronic conditions. Suburban has 68 total employees and is based in the northern suburbs of Cincinnati, Ohio. Suburban became a client in 201x.


As Suburban looked to grow its business from x physicians to 20 by the year 2020, it faced the reality that its current management and administration structure could not serve the needs of a larger medical practice. Additionally, because the lead physicians understandably did not have a background in management, they realized that additional help was needed to streamline its operations.


Aliniti® helped map a high-level strategy for the organization that allows for growth and restructured its current organization to a new design that enabled the managing physicians to focus on leadership and patient care. With counsel from Aliniti, Suburban also created new vision and mission statements and established clear core values for their organization.

Aliniti® also helped Suburban define, benchmark and create roles, including the addition of a managerial role for the administrative side of the business (practice administrator) and set them up for success with training on performance management and metrics.

To help Suburban Pediatrics, our team:

  • Developed an organizational strategy to serve a large, growing medical practice.
  • Defined a clear mission and vision for Suburban and core values to support them.
  • Designed an organizational structure to deliver on the strategy, including redesigning and benchmarking roles across all areas of the practice.
  • Provided support to the management team in the implementation of performance management procedures.
  • Facilitated leadership training to educate and empower management.
  • Guided the company through change management regarding new employee roles and compensation structures, organizational structures including direct reporting and implementing a new focus on core values.
  • Positioned the company to acquire another medical practice and training newly acquired employees (and to an extent, patients) on the company’s mission, values, and culture.


“As we discussed our mission and vision with Alinit’s team we were thinking about mission and vision and how we wanted to grow. We want to remain independent from a hospital system and retain control of the type of health care we provide and our own company culture. We worked with Alinti on how we could achieve those goals. Our goal was 20 providers by 2020, and we’ve already met that goal.”-Robert Wallace, M.D., lead physician.

“The Aliniti® team has completely transformed our practice; now we can form relationships with other practices and grow.” -Ronna Schneider, M.D., lead physician

Mapping out a Strategy

“Our growth problem started 17 years ago when there were six providers. Since then, we grew to 20 providers but were still managing things the way we did when we had 6 providers.”

 The leaders of Suburban are experts in medical care, but admittedly not in management. To create a high-level strategy map for growth and to establish goals, Pinnacle helped the lead physicians think differently about their employees and patients, and their relationships with each.

Together, they created mission and vision statements and outlined the core values of the organization. With Pinnacle’s assistance, they presented the new strategy to all employees and helped the leaders develop and implement the necessary changes to achieve the organization’s outlined goals and values.

From Flat Structure to Foundation for Growth

“We needed more structure and more leadership.”

 Like many medical practices, Suburban started with a very flat structure, including three individuals sharing the role of office manager, each with a focus, and the remaining employees in patient care.

The current health care industry necessitated a strategic choice by Suburban that is faced by many organizations: Acquire or be acquired. As Suburban hired more medical practitioners and looked toward future growth and acquisitions, they realized their flat organizational structure could not support the organization’s or the employees’ needs.

As the company grew, a new, more complex structure was needed to both empower employees to do their jobs and to free up physicians to practice medicine and deal with the larger organizational concerns and leadership needs.

Defining Job Roles and Measuring Success

“In order to scale the business, we needed the right people in the right positions.”

The first necessary change for Suburban was to review existing job roles and map out a new organizational framework that could serve the practice today and in the years ahead as they scale their business.

Aliniti® benchmarked and defined job roles, created performance metrics and outlined a performance management model, including key performance indicators and alignment recommendations for the organization to meet those indicators. They also trained Suburban’s management team on how to implement the performance management model, with emphasis on leadership and providing constructive feedback.

Another key to the organization’s future success was the creation of a practice administrator, a new position for the practice which previously relied on a very flat structure reporting to the managing physicians.

Aliniti® defined the role and helped Suburban find the right candidate through recruiting and vetting of candidates and then followed through to onboarding of the person in the newly created role.

Eliminating Competition Among Employees

 “We are trying to avoid a competitive environment; that’s not the culture we want.”

The medical care landscape has evolved into a productivity model that creates competition among physicians to meet billing goals in order to get paid their expected salary, increasing stress on the practitioners.  A key component of the Suburban model was to forgo the industry’s status quo and eliminate those stresses for practitioners through a set salary, which enables them to focus on patient care.

Change Management

Since they began working with Aliniti, Suburban underwent the restructure of their own practice; now they are ready for the acquisition of another. Though there have been challenges through the changes, the management team agrees it’s been worth it.

“It’s all positive, but there have been bumps in the road. In order to move forward, we have to unify. Thank God we had the structure in place at the time of the acquisition or it would have been really messy.”

As expected, some employees left the company when new roles and payment and reporting structures were introduced. Quickly, though, they were able to identify which employees were excited about the new direction for the company and were appreciative of how management was transparent with them on how they made their decisions regarding employment and salary.

The end result was a team comprised of longer-term employees and new employees committed to the company’s future vision.

“Now we are set to grow and move forward, even though, as they warned, there were pains in the process.”