| View this email online if it doesn't display correctly |
| |
|
|
| |
| Dear Friend,
Layoffs.
LIFO and FIFO are concepts from the world of wholesale and retail inventory. LIFO stands for last in, first out. FIFO stands for first in, first out.
They’re a perfect analogy for a core staffing issue within medical groups.
The concepts have to do with how a company accounts for the profit on the sales. Let’s say they have 100 widgets in stock, some of which were purchased by the company for $1 each, and others of which for $1.50 each. When a widget is sold, how do you know whether the gain (i.e., the profit) is measured against the wholesale price of $1 or $1.50? If the system is based on FIFO, then the first (or earliest) widget purchased (at whatever its purchase price was) is treated as the first one that was sold, and so on.
The same notion of looking at the first one in, or at the last one in, applies to medical groups in the context of the changes that are going on in healthcare, especially as regards hospital-based medical groups and the number of hospitals that are shrinking or closing.
How does a group of, say, 100 physicians account for whose work is going to be cut back, or who will have to be let go, when and if a facility the group serves closes or drastically scales back?
Is it by seniority, in which case it would be that the last one in is the first one to go?
Or is it by some other method, say based on specialty?
What if your group's business has shifted focus to outpatient centers such as to work at ASCs? Would a last in, first out policy suit the group's business goals if the recently hired folks are better suited to outpatient practice?
There are several issues here and there’s no easy answer. But, you don’t want to have the discussion or make decisions with your back against the wall.
You need to consider these issues now, because it takes time to come to tough decisions, to gain acceptance from the group's owners, and to incorporate corresponding provisions into your group’s employment and organizational documents.
If not, you’re simply asking for a lawsuit that will be far more expensive and difficult to resolve than dealing with this up front. |
| | | 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 version:
I was recently at an anesthesia conference at which several speakers addressed the issue of RFPs – requests for proposals.
Most hospital-based medical group leaders assume that RFPs are a bad thing, as in, "an RFP means someone is going to take my contract away!"
But that need not be the case. In fact, that’s only one way of looking at RFPs; there’s the entire flip side.
The flip side is for medical group leaders, hospital-based group leaders especially, to actively seek out RFPs to expand the footprint of their group.
In doing so, it's essential that you position yourself as a buyer, not as a seller of services. You don’t have to "buy" an RFP deal that’s bad.
But you could use the fact that there's an opening at a facility, created by the hospital (or maybe by the group itself which led to the hospital issuing the RFP), to grab the contract and to make the current contract holder's RFP fear come true.
Go out and flip the RFP process on someone else to expand your own group.
|
| | 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 - The Knife In Your Back Has Your Partner's Fingerprints On It - Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript:
Do any of these sound familiar?
Your group's been courting facility X across town as an additional service site. Then you learn that one of your partners, through an entity she controls, has been covering it for the last six months.
Or how about the opposite? When Dr. Y was admitted to your group as a full partner, he agreed to turn over his contract at facility X to the group as of the end of the calendar year. New Year’s Day, Mother’s Day, and finally Father’s Day come and go and yet Dr. Y refuses to follow through on his commitment.
Breaches of fiduciary duty and of contractual commitment within medical groups occur every day. The question is, are those duties enforced?
If they’re not enforced, what signal is being sent to the rest of the group?
If they’re not enforced, is it because you think it’s too expensive to do so? If that’s the case, what costs are you considering? Do they include your group’s future?
There are many ways to prohibit purely self interested conduct, that is, self interested conduct that is not tied to the group’s self interest. These range from placing physicians into categories that, by law, result in the creation of fiduciary duties, to specific contractual provisions.
But just as a 500 page contract is no more binding then a few scribbles on the back of a napkin if it is not enforced, periodic attestations and periodic audits of outside interests can be seen as sticks signaling that there will be a price to pay for violation.
What signal is your group sending?
|
| | | Listen to the podcast here, or just keep reading for the transcript.
Just as no vote was required for a dictator like Castro to take over Cuba, no medical staff vote, no survey by Press Ganey, no long and drawn out process among “stakeholders,” is required to topple the status quo. In the original “flea” post, the story centered on the fact that a relative handful of physicians toppled the rule of Ohio State University's Wexner Medical Center CEO, Sheldon Retchin, M.D.
And now, the Detroit Free Press is reporting that physician leaders at Southfield, Mich.-based Beaumont Health System are circulating a similar no-confidence petition aimed at Beaumont's President and CEO John Fox and its Executive Vice President and CMO, David Wood, Jr., MD.
The “takeaway” of the original “flea” post, was that the few can make the mighty fall, and fall hard. That if you’re the mighty (the dog in the flea example) watch out for the few, for the flea. And, alternatively, that you can be the flea. That lesson still stands, as valid as ever. But there's another takeaway as well, one that I urge you to focus on very carefully.
We'll all steeped in the notion of the status quo, of how things are done, of the normal order of things.
Many, perhaps most, even, perhaps all, physicians have trouble with this concept. Maybe it's the result of the lockstep progression through school to school to school to residency to fellowship to the stratified world of medical staffs and hospital-centric healthcare.
As a result, many physicians, and even group leaders, settle for what they're given. The hospital says "structure it this way" and they accept it. They think that reviewing the contract is the same thing as developing and implementing a strategy for success; it's not. The first is a form of giving in and giving up. The second is charting your own course, of putting, dare I say(?), your own interests first.
Would you rather die from the flea dip of playing it safe, of "this is how it's done, so what control do we really have?" Or would you rather stand up and realize that you had power all along?
To do the latter means you can no longer blame and claim subjugation. To do the latter means you have to invest in yourself: time, effort, and money.
The flea can beat the dog. The David can beat the Goliath. And you, what can you do?
If you want to come along on this journey, contact me. |
| | | 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.
|
| | 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?
|
| | | | 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 Free.
|
| | | | 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. |
|
|
