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| Dear Friend,
Hot dog!
In English, we have a number of dog expressions all of which are interesting idioms but one of which, in particular, is instructive for medical group leaders. No, it’s not to “avoid dogs” (which, by the way, is culturally insensitive to dogs . . . just kidding); it’s to not let the tail wag the dog.
For readers for whom English is not your native language or, for some, not your 2nd or even your 3rd, the expression means to not let things of lesser importance control something of greater importance. As such, what appears to be a silly saying packs a lot of meaning into a few words.
Why then do we see medical group leaders pursuing, sometimes at great expense in time, effort, and money, things which clearly are “tails” wagging the entire group’s success, or even existence, i.e., the dog?
For example, take Pulmonologists of the Upper Peninsula (“PUP”), a group providing services out of three offices, each located near a hospital campus. Duke, PUP’s leader, gives one physician, Dr. Boots, an exception to the group’s hard and fast rule that all employed physicians must devote their entire professional efforts to the group’s business. Why? Because Duke doesn’t want Boots to leave. Yet, Duke hasn’t factored in that once an exception has been granted, it can quickly result in jealousy, anger, and a slew of additional requests, no, demands, to permit others the same “kindness”. The group becomes unstable. Why risk the group to, perhaps, save the relationship with one physician? What other ways were there to save the relationship with one physician if it should be saved at all?
Or consider, Spike, a former sans-medal Olympian turned orthopedic surgeon, an otherwise control freak who’s fixated on creating a joint venture with a not-for-profit hospital. But why, one might ask, when nearly any joint venture with a not-for-profit hospital will result in lack of control? Is it to “have” one? * What is in Spike’s actual long-term interest and is it really advanced via a joint venture? How might it be better advanced?
The takeaway here for you is that it’s essential that you first consider what’s most important for your group’s success. What truly drives that success and is what minor, or at least minor in relationship, to it. What decisions should be subordinate to overall strategy and success? What seemingly small decision might upset the larger strategy or success? What seems to be important, but, actually, isn’t?
The corollary is that significant business decisions can’t be made in a vacuum. No decision of any import can be made piecemeal. Almost every decision must be made in the context of the group’s overall strategy. As I like to say, “it’s all related.”
________
*This issue is by no means particular to medical group leaders; it’s a management disease that runs across professions and industries. Years ago, my firm occupied the 17th floor in a building in Los Angeles. Another firm occupied both the 16th and 18th floors. The managing partner of the other firm asked to meet with me concerning swapping floors with us so that their two floors would be contiguous. When we met, I asked him why that was so important to him and he said that he wanted to put in an open staircase between the floors, something that I knew might cost close to a million dollars. I then asked him why an open staircase was so important to him, and he burst out, almost screaming, “because the office in New York has one and I want one too!” |
| | | 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:
It is a beautiful day here. There were many storms last night, and it's expected to storm again tomorrow.
Sometimes when you look at calm, nice, blue-sky weather like this you say, “everything is fine. It’s a beautiful, sunny day, what do I have to worry about?”
It’s the same thing in business.
Is this truly calm weather, or just the eye of the storm? Part of the storm has passed over, now, it’s calm, but the rest of the rough spot is on its way.
Many medical group leaders assume that when everything’s going fine, they can sit back. After all, there's nothing much to work on, plan, tune-up, re-do, or take care of.
In other words, they’ll just work in the business, as opposed to (as the author Michael Gerber emphasizes), on the business.
But that’s the wrong approach.
When things are going smoothly, when they’re going well, that means you have more time to devote to problem-solving, prevention planning, and strategizing – whatever you want to call it.
What’s in the group’s organizational documents that needs to be revised? How can we better prepare for a potential problem with employed or subcontracted physicians? And so on.
Use the time wisely. It’s more or less a rarity that everything is going smoothly; sometimes even the ocean looks like it’s smooth but there’s a riptide.
It’s almost like a gift to have a calm day like this. I can devote time to preventing a problem that's going to be a storm within the group, within the business, or within our lives, that would otherwise disrupt us. How are you going to use it?
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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 - No More Room for Average - Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript:
There's no more room for average in terms of any medical practice's business approach. This applies regardless of specialty or whether you are hospital-based or office-based. This applies whether you are in solo practice or with a group.
Medical practice is becoming stratified. Some practices are aligning with ACO's. Some practices are taking action to go a completely independent route. Some practices are merging or forming other alignment with other practices as opposed to with hospitals. Some practices are opting out of government financed care completely.
In some instances in life and in business, it pays to wait and see. In other instances, after weighing alternatives, it pays to do nothing. But this is neither of those instances.
Rather, not taking any action puts your practice into a position equivalent to that of a ship dead in the water.
It's obvious that the current system is broken - no matter who you think broke it.
Doing nothing is not the cure.
Wait and see is what got you into this mess.
Set a strategy for your group's future and implement it. Note that unlike a ship, your group can hedge its bets and adopt more than one strategy - that is not the same as doing nothing. |
| | | Listen to the podcast here, or just keep reading for the transcript.
I had a friend, let's call him "Bob," who'd readily make promises and just as readily break them.
All medical groups have a culture, whether or not it's been purposefully created. It exists.
All medical groups have a story, too. A story its leaders or members or both tell about the group.
So, while culture exists, story itself is a representation or image of culture.
Some say that story is how culture is transmitted. But what I'd like you to focus on is the impact of the match or mismatch between story and culture within a medical group and how it affects the group both internally and externally.
The Community Group prides itself on delivering high quality care and on meeting the needs of its patients and referring physicians. That's the story they tell themselves.
If that story matches with the actual culture, that is, the group actually delivers high quality care that meets its customers' needs, then value is being created for the customers and it's likely that the group is highly performing internally.
On the other hand, if the story remains the same but the group's physicians are rude and if reports promised to referring physicians are generally late, then there's trouble in store for the group -- they are just fooling themselves and no one else.
The same mismatch can happen internally as well. For example, when a group's leaders believe (belief being the story) that they have created a culture of mentoring younger group members but the reality is that there is no guidance and that management by yelling around is the rule. That misalignment of story and culture creates a cancer within the group.
My friend Bob thought that he was a man of his word. But that was just a story. |
| | | 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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