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| Dear Friend,
"No thanks."
Hospital-based medical groups are often faced with a choice upon exclusive contract renewal: The expectation or demand on the part of the hospital that the group must provide its services, perhaps even at a higher level of intensity, for lower or no stipend support.
A group enters into an exclusive contract in order to protect its turf. In return, it takes on the obligation to provide coverage. But if, without stipend support from the hospital at an acceptable level, the group cannot recruit and retain its providers, then, if we assume that its billing and collections have already been maximized, the group has only a few choices if it wishes to remain committed to the obligation to provide coverage:
It can negotiate a more efficient coverage schedule.
It can reduce compensation to its existing providers at the risk of losing them to other opportunities.
It can attempt to find new providers willing to work for less, a near impossibility in today's market.
If applicable in the medical specialty, it can shift work to lower level healthcare professionals.
Alternatively, and usually not considered, the group can choose not to renew the contract. If the group had adopted a business-like attitude, it will have already expanded its business to other facilities. If it hadn't expanded, the choices are closing up shop -- there'd be no reason to exist -- or to attempt to continue to provide services at the facility on a request-only basis, perhaps with a pared-down staff.
Most group leaders will probably consider that last option unworkable. But query whether, with more hospitals themselves being in financial trouble, and with regional groups having the power to walk away from unprofitable deals let alone pursue yours, whether more hospitals won't be left begging for any assistance at all from hospital-based specialists? |
| | Wednesday - Are You Lying About the Present and Shortchanging Your Future? - Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript: The limo driver said that he’d made some bad choices in life. Some things hadn’t worked out as planned. He said he’d call her.
There are still some doubters out there. They discount my advice on creating an Experience Monopoly™ for all of their customers: patients, referral sources, hospital staff, administrators, and so on.
Like some physicians, especially hospital based physicians, who think that being the best at what they do is enough in today’s market. That it’s somehow demeaning to them professionally to cater to their customers. That they are protected within academic practice. That advice on this from a “lawyer” is somehow tainted.
Maybe it is, because often I’m the guy your employer or group leader consults with before letting you go. Or, I’m the guy working to save your group’s contract with the hospital before it’s too late. Or, I’m the guy working with another group to take your contract away, in which case I implore you to keep your head in the sand, or up your, well, wherever it is.
One way or another the hospital controls who’s practicing there. Think the medical staff is totally independent? Despite what is supposed to be, let’s get real.
And that hospital runs on tight margins, very, very tight margins. If you or your group are causing disruption (rudeness, lateness, unwillingness for personal as opposed to medical reasons, etc.), or even if there’s the perception that that’s the case, and if it can’t be remedied quickly, then the writing is already on the wall: Your service might be put out to bid via RFP. Or maybe you'll be replaced without an RFP. Or all of a sudden someone else gets all of the referrals. Or, you're branded "disruptive" and subject to medical staff intervention. I've seen them all. And more.
We've all made mistakes. The key is whether we can learn the lesson and make the necessary correction before it’s too late.
The limo driver? I watched as he drove off, heading out of the airport. I wonder what he’ll really do?
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| | | Listen to the podcast here, or just keep reading for the transcript.
Johnson & Johnson may have pulled the plug on its anesthesia robot, Sedasys, as a result of pushback from human doctors, but the fear of increasing automation and robotization of healthcare is leaving many physicians and other providers questioning what will remain for them to do within their specialties.
Maybe nothing. Maybe a lot.
But it doesn’t matter, because it’s really the wrong question to ask about your future.
That’s because that first question, “what will be left for me to do?” is based on the assumption that your specific set of job duties/responsibilities would continue to into the future. As a result, the envisioned real-world deviation from the assumption triggers a sense of loss, a sense of fear.
So, for example, the coming of the Sedasys machine, aimed squarely at the market for anesthesia in connection with colonoscopies, caused anesthesiologists and CRNAs to fear that they would be cut out of the picture in connection with those procedures and then maybe more.
For those providers, the picture’s changed due to the demise of that machine. (That is, until the next one is “born.”)
But it’s likely that, for providers of all sorts, physicians, advanced practice nurses, and so on, automation, robotization and other technological advances will displace your current “scope of practice” from the practical standpoint. In other words, at some point in the not-too-distant future, “X-ologists” will no longer be performing such-and-such procedure or such-and-such task. A machine or a pill will.
The right question to ask is what underlies your profession, your specialty, or its role. What’s the motivating desire or overriding function?
For example, for an orthopedic surgeon, the answer might be “aiding patients in connection with orthopedic injuries.” How then can you arrange your practice now and in the future to best survive and even thrive in light of both anticipated and unanticipated changes?
Continuing with the example of an orthopedic surgeon, from the higher vantage point I suggest, many are looking at their role as much broader than simply as surgeons: How can they create practice entities, educational entities, facilities (including ASCs) all wrapped around the hub notion of preventing/diagnosing/treating orthopedic injuries? In that context, even if a machine comes along that can do, say, hand surgery, they’ll have an active role including, very likely, owning the facility in which the procedure is performed.
What underlies your profession or specialty? What underlies your desires? What’s your overriding professional function? Answer that and we'll build your future around it.
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What tailored content would you most like to see during this
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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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