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| Dear Friend,
I don't know.
How much uncertainty can you handle?
In your professional life you certainly want certainty, well, actually, as much of it as can be had. You want to be certain you’ve made the right diagnosis; you want to be certain a procedure you’re going to perform will be successful. You may not be able to get complete certainty but certainly you’re looking for a very high level of it.
But life in general isn’t like that at all.
As I dictate this, I can’t be certain that I’m going to make it the few remaining blocks to work. I may have a heart attack at this corner, a bus could come flying down the street and kill me, but I can handle that level of uncertainty – you probably drive to work and can handle it as well.
But in terms of business deals, contracting, and negotiating, physicians often ask me, “are you certain it’s going to work? Can we know for sure? Has somebody already done this?”
From a business perspective, those are signs of an amateur, of someone who doesn’t comprehend that in order to succeed in business we have to be more and more comfortable with more and more uncertainty. Look, if it doesn’t work, you stop and try something else.
But if you need to have a guarantee that it’s going to work before you start, you’re never going to start.
Think about how much uncertainty you can handle. If the answer is none, then don’t get in the game. Get a job someplace and, well, hope you’re certain they’ll stay in business.
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| | | Business Life in the Time of Coronavirus Mini-Series
The coronavirus crisis caused a short term economic crisis for many medical groups. Our mini-series shows you the way out. Plus, many of the concepts discussed are applicable during both good times and bad.
[If you haven't already seen them, follow this link to watch our entire series.] |
| | Watch Tuesday's video here, or just keep reading below for a revised, more polished transcript:
I recently saw a news story about a group of California legislators, state-level legislators, who’ve written a letter to HCA concerning the “dangerous staffing practices” at a south San Francisco Bay area hospital.
The legislators are complaining that staffing levels are low and present a danger to patients.
But on what are they basing their claims? Well, it turns out that they're based on three-year-old data! What’s that all about?
As I read more of the article, I learned that (maybe coincidentally, maybe not) the hospital in question is the target of an ongoing nursing protest, not quite a strike, but work slowdowns and the like by the nurses' union.
I’m not dumping on union politics, at least not right now, but you can see how the union is using outside leverage, governmental leverage, the legislators, to put pressure on the hospital. The issue gets immediate press and, in a state where legislators are very friendly to unions, gets a pretty darn quick and vocal response.
I’ve been doing a number of these Success in Motion videos hitting on the leverage gained in The War of the Flea context. Chiefly, that's been in the context of votes of no confidence. In the war of the flea, rather small players can obtain outsized leverage by coordinating their activities (and by being very quick in doing so) to present outsized amounts of pressure when measured with what one might think is normally assigned to someone in their position – the disproportionate political pressure they “shouldn’t” have.
The union and the legislators presents another instructive lesson:
Don’t simply think about what pressure you can put to bear, or what leverage you have.
Think of drafting (for your own benefit) the leverage that could be provided by an outside source, whether state legislators, other physicians, and so on. Creatively consider what you can use in your negotiations to pressure the other side for your benefit.
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| | How to Deploy the Secret Sauce of Opportunistic Strategy
Webinar On Demand
They say that COVID-19 has changed the world, creating the "new normal." Many of your colleagues and many hospital administrators are running scared.
Others, leaders like you, know that crisis means opportunity.
Let me provide you with the strategic tools and insights that you need in order to seize opportunities, whether they’re in the context of your current business relationships, the expansion of your business activities, or the creation of new ventures.
You will learn:
•Defense as a defective default: It’s necessary, but not sufficient.
•Exploiting weakness: Drop the guilt and identify opportunity.
•Flat line negotiation is fatal: Understand its myths and limitations.
•Negotiation reality: Learn to identify and deploy on multiple planes to affect the outcome.
•Maneuver: Harness the power of maneuver, both in overall strategy and in specific negotiation strategy.
Others see a crisis and freeze in fear. Learn how to see the opportunities and obtain the tools to increase your odds of obtaining them.
The price to attend is $479. The cost of not attending is astronomical. |
| | | | Wednesday - Avoiding a Self-Defeating Negotiation Mistake - Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript:
Have you ever allowed the negotiating rug to be pulled out from under you?
Or even worse, have you helped the other side pull the negotiating rug from out under you?
Let's say that you're negotiating a contract with a hospital. You think you’ve come to terms on some of its provisions, but not on all of them.
Then, the hospital begins putting pressure on you.
“We have to have this agreement signed by next Tuesday." Or maybe something like, "if it's not signed by next Tuesday, we might send this thing out to an RFP”.
Alternatively, perhaps you're told things like, “how could you be demanding these points? They're very minor. In fact, it's insulting for you to bring these points up." Or maybe, "the agreement is fine like it is. So why are you just going back and forth on this when we have better things to do? We should be moving forward with the deal.”
But if you bite on one of these, it's like a fish biting on a hook with a nice juicy salmon egg on it. In fact, it's worse than that; it's biting on a shiny lure, there's not even any salmon egg to swallow before you're hooked.
You've basically fallen prey to pressure, to a scare tactic that makes you think, or rather feel, which is worse than thinking, that you might be losing the deal.
The tactic works even better on you if you have no option to the deal, if you've ignored my longstanding advice to have multiple deals in place so that no one deal is required for your group's continued existence.
Don't fall prey to being divided and separated by yourself.
Do you press for provisions that you know you need, or do you cave because the deal is going to be yanked, or so you're being told?
Don't negotiate against yourself. |
| | | Listen to the podcast here, or just keep reading for the transcript.
Chalk up a victory for less care at higher prices. Hey, aren't those two of the Anti-Triple Aim?
Maine is a Certificate of Need (“CON”) state. Want to build a new ambulatory surgery center to provide better care than a hospital at lower prices to patients and payors? Well, in Maine and other CON states, it is not so easy. You need permission from the state and from your competitors, a so-called Certificate of Need.
Earlier this month, the state’s CON board recommended against approving an application submitted by Central Maine Healthcare to build a $14 million, 20,000 square foot ASC in Topsham, a town outside of Portland. In opposition was a competitor, Mid Coast Parkview Health, a health system that includes a hospital and an affiliated physician group.
Why the “no” vote, you might ask? Because, in the world of CONS, competition is bad. Somehow, in the rarified air of regulatory ridiculousness, reminiscent of the former USSR, top down is the way to keep prices low. Or, is it to keep prices up?
Let's say that instead of being in the health care business, Central Maine and Mid Coast ran competing chains of supermarkets. Central Maine decides to build a new store across the street and down one block from Mid Coast’s Topsham market location. Once they open the new market, do you think that prices for potatoes and pickles are going to go up in Topsham or down?
Please don't interpret this the wrong way if you are a public “servant”: I know that food is a bit more essential than healthcare, and I am not trying to plant the idea that you need to regulate whether someone can open a new supermarket.
CONs are simply a variant of “I’ve got mine, you can’t have yours.” They never served a useful purpose and they certainly don't serve one now. In essence, they are a con on consumers.
Or, as an activist might put it: “How many people have to die before the CON system is put in the grave?” OK, it is a bit over the top . . . but you are free to use it. |
| | | Calibrate Your Compass
Read our exclusive RedPaper to guide you through this evolving situation.
The coronavirus crisis caused a short-term economic crisis for many medical groups. Our RedPaper shows you the way out. Plus, many of the concepts discussed are applicable during both good times and bad.
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| | Help Us Help You With Helpful Content
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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| | | | 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.
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| 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 Free.
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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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