In today's dynamic healthcare environment, critical strategic decisions regarding service/product mix, market development, and physician relationships cannot be delayed. In many instances an organization's strategic planning process comes to a standstill and remains in a strategic impasse for an extended period of time. It is imperative to identify early in the process if the organization is headed towards an impasse, and take steps to minimize the resulting standstill. While there are many variations, there are three fundamental causes of such standstills: process problems, no clear "best" option, and great plans, but no money. Identify the common causes of a strategic impasse and heed suggestions for managing them.