The notion of “fuck you” money. The fact that you have enough money that you can brush off someone’s demand or request that, prior to attaining such status, was something internalized via self-talk as required of you as a wage slave or service provider.
You might find that offensive, but that doesn’t mean it’s not true.
The concept isn’t limited to individuals. It applies to business entities as well, certainly to hospital-based medical groups.
At its molten core, the concept of “money” in the phrase is a misnomer. Although dollars are a lubricant, the real issue is freedom or optionality.
Of course, there are degrees to this, from the ability to say no to an entire deal, to say no to a specific proposal or contractual provision, or to propose an entirely different structure for some arrangement, and so on.
The question, then, is how to increase freedom and optionality.
I can’t read your mind as you read my words, but I’d wager that the chances are great that most medical group leaders agree. The problem, of course, is that agreeing in concept is a far cry from demonstrating agreement by way of action, because unless you take action, it’s just more talk.
Having spoken with thousands of medical group leaders over my career, many of their problems relate to the fact that they didn’t create optionality, whether at the 50,000 ft. level, such as via geographic expansion, or down close to the ground, such as having the ability to easily jettison a disruptive physician.
The consequence, especially for hospital-based groups such as anesthesiology or radiology groups, is that they set themselves up to be leveraged by hospitals, by payors, and by other physicians.
There’s always something we can do, even close to the last minute. But infinitely more can be accomplished through a long-term approach to creating freedom and optionality, to become both the lever and the one pushing down on it.
Why do so many groups fail at this? It’s likely because their focus remains short-term: “What’s the ROI?” What’s the ROI on your mother?
