Strategy formation involves understanding the environment and strengths and weaknesses of a practice to develop a game plan to achieve goals. It starts with the creation of a mission statement that defines a long-term vision of what the practice seeks to be and the markets it seeks to serve. Once the mission of the practice is understood, the target markets and competition must be analyzed prior to defining the goals. Once a strategic plan is developed, communication with all employees is crucial. Everything that the practice does should be in support of the strategic plan and in pursuit of obtaining the goals contained within. Once created, the strategic plan is the foundation of the practice and should only be changed for compelling reasons such as a competitive threat, environmental changes, or trends in purchasing behavior. Reviewing the strategic plan once a year, making periodic reappraisals and fine-tuning adjustments as the environment changes is crucial. This helps ensure that the practice avoids complacency and affirms that it is in the right business and achieving the desired results.