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| Dear Friend,
Control your story to help control the outcome.
That's the topic of this past Monday's blog post, What's Your Story? You can follow the link to read the post online, or just keep reading for the rest of the story.
I've written previously about the power of framing – of creating context – to support your group's position in negotiations. For example, framing negotiations around quality, not cost. Or, as an example of the same argument coming from close to the polar opposite, consider the government's argument that accountable care organizations are all about quality, not cost. Related to framing is the power of the story, from the fairy tales that your parents read to you when you were a child to the story of your group and its meaning to the hospital, to referring physicians, to patients, and even to the community at large. A few minutes before writing this, on a whim, I googled "who discovered America?" I found the popular stories of Christopher Columbus, claims that it was actually Leif Ericson or other Vikings, and others citing Chinese explorers. Or was it the Basques? Others pooh-pooh all this and say what about the Native Americans? But even they didn't "come" from here – their ancestors came from Asia. My point isn't who discovered America but rather that there are a number of believable stories about who discovered America. People buy in to the story they believe and discredit the others. So the underlying truth really isn't the point – no one can force you to believe; you do all the "believing" yourself in your own head. Now, of course, it's really not that simple because while someone can't force you to believe, they can certainly create conditions that make it conducive for you to believe. That's the whole point of advertising and sales - telling a story that resonates with you so well that you develop a coherent belief. What story are you telling about your practice? If you're not telling one, or if you're not telling it convincingly, someone else is out there telling another story about you or your group that is likely to be believed. These are not amorphous or esoteric concepts. They have real-world application. They are as much a part of negotiating your next contract, for example, an exclusive contract with the hospital, as in the face-to-face stage of negotiation when you're sitting across the table from one another hammering out paragraph 47. Abe Lincoln learned to write using a piece of charcoal from the fireplace. George Washington cut down the cherry tree and admitted it. What's your story? |
| | Wednesday - Love at First Blight: Surgeon and Fiancée Settle Kickback Allegations - Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript: Love might be blind, but whistleblowers aren't.
That’s one of the two takeaways from a kickback allegation settlement announced on March 22, 2023, by the U.S. Department of Justice.
The second takeaway should already be well known to you: The federal Anti‑Kickback Statute (“AKS”) prohibits soliciting or receiving anything of value in return for the referral of items or services covered by federal health care programs.
Pursuant to the announcement, neurosurgeon Dr. Sonjay Fonn and his fiancée, Ms. Deborah Seeger of Cape Girardeau, Missouri, and their professional companies, Midwest Neurosurgeons, LLC and DS Medical, LLC, agreed to pay the U.S. Government $825,000 to resolve a lawsuit alleging that they violated the False Claims Act by soliciting and receiving kickbacks from spinal implant companies.
The underlying False Claims Act case was originally filed by whistleblower physicians, Dr. Terry Cleaver, Dr. Kyle Colle, Dr. Scott Gibbs, Dr. Paul Tolentino, and Dr. Kevin Vaught, together with Paul Cairns and Certified Surgical Assistant Daniel Henson.
Although the original Complaint included a number of other alleged improper acts supporting FCA liability, the settlement was made in reference to the Complaint’s allegations that Dr. Fonn, Ms. Seeger, Midwest Neurosurgeons, and DS Medical solicited and received remuneration from spinal implant companies in return for arranging for the use of those companies’ products in Dr. Fonn’s surgeries, in violation of the Anti-Kickback Statute.
Violation of the AKS is one of the underlying routes to violation of the False Claims Act.
Specifically, it was alleged that Ms. Seeger’s entity DS Medical acted as the exclusive provider of various medical devices to Dr. Fonn’s practices for use in Dr. Fonn’s spinal surgeries. It was alleged that in connection with commercially insured cases, that allowed the defendants to capture profit between the manufactures’ price and the marked-up price obtained from the commercial insurers paying for the cases, and that in connection with Medicare and Medicaid patients, the defendants captured profits from reselling the devices to the hospitals which in turn billed government programs.
Note that as in connection with any such settlement, the claims settled were allegations only and there was no determination, or admission, of liability.
The physician whistleblowers practice together in Cape Girardeau at the Brain and NeuroSpine Clinic of Missouri, LLC and saw prior patients of Dr. Fonn. Mr. Henson, the Certified Surgical Assistant, was employed by Dr. Fonn for approximately 3 years.
As of the date of the Department of Justice’s announcement, the share to be paid to the whistleblowers had not yet been determined.
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| | | Listen to the podcast here, or just keep reading for the transcript.
A few years ago I met a "plumber; " he had taken over his father's small company with a few trucks. Over the course of less than a decade, he built it into a statewide service with hundreds of technicians and was expanding into the two neighboring states.
I asked him, we'll call him Chris, how he found enough qualified plumbers to expand so rapidly?
He told me that he didn't especially look for trained personnel – he hired employees for attitude and taught them to be plumbers. He knew that his business was largely commoditized and found that the way out for his business was to provide a complete experience to his customers. His edge – tidy, polite, clean plumbers.
Hiring for skill is not even half the battle for your group – the price of admission. To set your group up to break free of the commodity trap, and to prevent your group from crumbling from within, hire for more than medical expertise.
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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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