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| Dear Friend,
Bureaucracy. The rule of the desk.
That's the subject of this Monday's blog post, Avoid Bureaucratic Bloat. You can follow the link to read the post online, or just keep reading for the rest of the story.
In just one week of driving, I passed a Dallas police car, a Dallas school police car, a Dallas transit police car, a Dallas sheriff’s car, and a Dallas constable’s car.
Why so many police departments? I would assume each one has a police chief/equivalent, a bunch of assistants, and dozens-to-hundreds of bureaucrats sitting behind desks. Why?
Instead of waxing political, let’s just take that tripling or quadrupling of bureaucracy and look at a normal healthcare facility, a hospital, for instance.
How many levels of bureaucrats (called administrators) are there? Are they all needed?
Now I know that my audience doesn’t, for the most part, consist of people who work for hospitals, as opposed to at hospitals. But it consists of many who own large medical practices, healthcare facilities, surgery centers, imaging facilities, and other sorts of healthcare business entities.
Do you need that same level of bureaucracy?
Unfortunately, many large medical practices and other healthcare businesses have transplanted hospital-level bureaucracy into their operations.
Maybe they think that level of bureaucracy is necessary based on the owners’ hospital experience.
Or maybe their business’s administrator, call him or her a CEO, COO, or whatever, duplicated hospital-style bureaucratic bloat because, well, that’s the way it’s done.
Or, maybe it’s because you have a hospital partner that manages your practice or facility. Perhaps it’s applying the same “best practices” that result in managing most hospitals into unprofitability.
Do you want to operate your practice or other healthcare business like a county with least 5 separate independent departments all doing the same job, or, sometimes, no job at all?
Who do you have doing what, and why? How could bureaucrats be terminated with no impact upon your business’s function? What could be outsourced for less?
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| | | Tuesday - Pacing Deal Lifespan - Success in Motion
Watch the video here, or just keep reading below for a slightly polished transcript:
We often speak of lifespan in terms of our own lives, i.e., the human lifespan, or even in terms of the lifespan of our pets.
Inanimate objects, buildings, for example, and even objects that don’t have any physical substance, such as a deal between parties, also have a lifespan.
In connection with an agreement, say the acquisition of a facility, its lifespan begins with a pre-negotiation phase, moves on to actual negotiation of large and small deal points, progresses to the drafting of documents, and then culminates in a closing, at which point the deal is complete.
But what many people often miss is the fact they have to keep pace in terms of shepherding the deal along. If they get out of whack with the deal's natural pace, its lifespan, they risk screwing it up.
Imagine, for example, a deal to contract with a hospital to provide a certain type of product or service. Perhaps you’ve agreed on price and you’ve agreed on most of the smaller deal points, but you’re delaying in documenting the deal. As a result, at some point the other side is going to lose interest. They’re going to think you’re not serious, or that you’re backing out, or that you’re unreliable, and that they should be obtaining the product or service from another source.
Pay attention to the pace of the particular deal. If you rush a deal too much, you may scare the other side away. If you delay a deal too much, it might pose a bit of intrigue and attractiveness, but on the other hand, it might come across as sloth or disinterest.
Be careful. Pay attention to the lifespan of a deal and pay attention to pacing your participation within its lifespan.
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| | Wednesday - Management by Wandering Around (Someone Else’s Business) - Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript: Tom Peters popularized the style of business management in which the manager cruises the workplace observing and interacting. He referred to it as "management by wandering around."
The same observational style applied to instances within and, equally or even more so, outside of your specific practice specialty, or business, or industry, provides a tremendous amount of information that can be applied to your benefit.
Henry Ford developed the automobile production line after observing the way that hogs were "processed" in a slaughterhouse.
Walk-in clinics owe as much, actually more, to fast food operations as they do to operating room operations.
The key is to always be observing and learning. A trip to the dry cleaner or to the pharmacy becomes fun: what can you learn, what can you see, what do you never want to allow to happen in your business operation?
For example, on a recent visit to a chain store pharmacy, I saw bottle caps strewn on the floor behind the counter, wadded up paper on the floor next to the trash can, overheard an employee complaining that the line of customers was unending, and overheard customers complaining that they were going to find a new pharmacy. A virtual treasure trove of business lessons.
Or for example, while touring an emergency room, I noticed this bizarre business goal (see the sign pictured below) touted by the hospital:
Very good care? Why not excellent care? What message does this send to the scared and nervous patient or to his or her family? That the E.R. staff is going to be doing good enough work?
The idea of course is not to simply notice and chuckle (or cry if you are waiting in that pharmacy line or your little Johnny is the E.R. patient). It's to take what you observe on your wanderings and apply the lessons learned in your own business or practice.
It's easy. That's why no one does it.
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| | | Listen to the podcast here, or just keep reading for the transcript.
Medical group mergers are a lot like marriages.
Some are actual mergers. The formerly separate groups really do become one. For richer, for poorer, in sickness and in health. So if one of the merged practice sites closes, the partners based there are reassigned. There's still love, or as much as there can be in a merger as opposed to an actual marriage.
But too common these days are mergers that are simply temporal, for market share, for beefing up for a private equity deal, or to share contract rates. These are a bit like marriages for the purpose of obtaining a green card. So if merged-in group "A" loses its exclusive contract or if providing services at that site no longer makes economic sense to the group as a whole, then everyone in "A," from partners to part-timers are shown the door.
The ties that bind versus the lies that say goodbye.
Sure, unlike immigration love, less than heartfelt medical group merger isn't a federal crime. If you're in control of the merger, "do it until it no longer feels good" may be exactly what you're looking for.
But if your group is the merger target, make sure you know what kind of marriage your intended has in mind.
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| | | 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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