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Why You Shouldn’t Let History and Momentum Dictate Your Medical Business Structure
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| Physicians bemoan the commoditization of healthcare and, especially, their role in it.
But often this thinking is akin to seeing their practice and, especially, their specialty as if it were a
train on a track. They see themselves headed down that track and, parallel to it and only feet away, as if within a large freight yard in a metropolitan city, are their colleagues and competitors, all headed in the same direction.
The only solution they see, if they see a solution at all, is to improve their existing business
structure and existing business relationships. While many simply bemoan the fact that the train is
not running properly, others take significant action to get the train moving faster or to improve the
experience offered on that train.
There’s nothing inherently wrong with that; in fact, I’ve been preaching the notion of creating an
experience monopoly for close to a decade.
But that’s no longer enough.
As medicine becomes more and more commoditized, forward thinking medical group leaders must understand that there’s nothing but the existing weight and momentum of their group and its past holding them to that track.
What if that train could be placed on an entirely different track running in a different direction, or
what if, instead of the track, the train could run on roads, making right turns and left turns at will?
As you are certainly well aware, together with increasing commoditization we have increasing
regulatory constraints, from national prohibitions such as Stark and the federal antikickback statute to state prohibitions on feesplitting. But, to strategic thinkers, those are simply inconveniences that must be taken into account or avoided completely.
Toss all of the metaphorical trains off the track. Uproot all of the metaphorical rails. Put the pieces back together some other way or add new parts or leave some out – see what new structures can be built.
So for example, what new business arrangements could be created between, say, a multispecialty medical group that includes surgeons practicing at multiple hospitals, and an enterprising anesthesia group with tremendous, if until now underutilized institutional knowledge about where best to schedule cases, about how to wring more efficiency out of surgical scheduling, and the like?
Or, what types of structures could a pain medicine group create that would include chiropractors?
Or, what if an orthopedic group purchased a small, out of business hospital and just skipped
treating any Medicare patients at the facility?
It might be hard to believe, but, as an entrepreneurial attorney, my suggestion is that you forget all the rules. Well, at least to begin with. Forget that you’re a “suchandsuchologist” or a “thisnotthatedist” and then, without preconception, imagine what structures can be built. It’s no longer
painting by numbers or writing within the bounds of the lines, it’s finger painting like you’re once
again 5 years old and anything is possible.
Only after that do we even begin to adjust for compliance constraints.
The structures of the past aren’t serving you well. The government and those running larger entities are attempting to impose their own new structures on you.
So why keep heading down the wrong track?
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| | Wisdom. Applied. 187: All That Glitters Isn't Always Gold. Is Your Contract Merely Sparkly? Not only is all that glitters not gold, shipping containers thought to contain nickel might just contain carbon steel. |
| | All Things Personal
I stood in line to order. No problem. I expected it. But when I finally got to the counter at the BBQ joint (consistently on "top" lists) the young woman taking orders looked as happy as an ice cube in a hot oven.
"I'll have the brisket and the turkey, please, and for the sides, I'd like . . . "
"Stop!" she said.
"Double coleslaw."
"No," she said.
"What, you don't have coleslaw?"
"I need to know whether you want the brisket chopped or sliced before you can tell me what you want as sides."
*********
The food was great, but I left with a bad taste my mouth. Ms. Upside-Down-Smile irked the shit out of me.
Does the owner know the true value of a customer? The lifetime value of a customer, that is?
It's easy for the owner to picture the $4.27 in profit the restaurant made on my lunch. It's a lot more difficult to conceptualize the notion of the lifetime value of the customer - how much in profit the average customer will bring over his or her lifetime of patronage. But it's essential, because it tells you what you can spend, both in money and in effort, to get, and to keep, a customer.
The same concept can be used in the context of the lifetime value of a patient, of the lifetime value of a referral source, of the lifetime value of a relationship with a facility, of the lifetime value of . . . any number of things essential to your business.
Over the past few years, I've driven by that BBQ joint at least 16 times around lunchtime. Since having the unpleasure of meeting Ms. Have-a-Bad Day, I've just kept driving.
Am I being petty? Have I cut off their brisket to spite my mouth?
Maybe, but am I any more petty that your customers, clients, patients, and referral sources? I think not.
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What tailored content would you most like to see during this time? How can we focus on solutions to your most pressing
strategic concerns?
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| | Podcast Compilation Greatest Hits - Manage Your Practice Edition
We've curated our most popular podcasts on managing your practice into our second compilation album.
Sit back, enjoy, and think about your future.
Listen here. |
| | | | | | We all hear, and most of us say, that the pace of change in healthcare is quickening. That means that the pace of required decision-making is increasing, too. Unless, that is, you want to take the “default” route. That’s the one is which you let someone else make the decisions that impact you; you’re just along for the ride. Of course, playing a bit part in scripting your own future isn’t the smart route to stardom. But despite your own best intentions, perhaps it’s your medical group’s governance structure that’s holding you back. In fact, it’s very likely that the problem is systemic. The Medical Group Governance Matrix introduces a simple four-quadrant diagnostic tool to help you find out. It then shows you how to use that tool to build your better, more profitable future. Get your free copy here.
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| | | Whenever you're ready, here are 4 ways I can help you and your business:
1. Download a copy of The Success Prescription. My book, The Success Prescription provides you with a framework for thinking about your success. Download a copy of The Success Prescription here.
2. Be a guest on “Wisdom. Applied. Podcast.” Although most of my podcasts involve me addressing an important point for your success, I’m always looking for guests who’d like to be interviewed about their personal and professional achievements and the lessons learned. Email me if you’re interested in participating.
3. Book me to speak to your group or organization. I’ve spoken at dozens of medical group, healthcare organization, university-sponsored, and private events on many topics such as The Impending Death of Hospitals, the strategic use of OIG Advisory Opinions, medical group governance, and succeeding at negotiations. For more information about a custom presentation for you, drop us a line.
4. If You’re Not Yet a Client, Engage Me to Represent You. If you’re interested in increasing your profit and managing your risk of loss, email me to connect directly. |
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