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| Dear Friend,
Think like a buyer to maximize what you'll be paid.
It sounds simple, but in reality, it’s very difficult.
Difficult, that is, to control what appears to be a built-in human nature: The impulse, when dealing with a potential deal partner, to have the mindset of a seller.
Let’s step back for a moment.
Note that I said “mindset” to distinguish the concept of inner talk and expectations from the fact of the matter that you will still engage in activities to, in essence, “sell” the deal, as you desire it, to the potential deal partner, whether we’re talking about a deal with a hospital, a hospital system, a referral source, or with anyone else.
It’s one thing to have the mindset that you need to convince the opposite side to engage your services, or to acquire whatever it is that you’re or providing, or, on point with current times, to provide substantial stipend support to your group. However, and here’s the point, it is an entirely different thing to do so from the mindset that you are somehow less than, or will be lucky to receive it, or that you are some sort of a supplicant to the other side.
The best way to put this is that even when you are, in actuality, selling, your mindset should be that of a buyer. Would you buy what the other side is selling you?
Let’s put this into a very easy to understand context.
Even in the situation in which your entity is doing a deal, for example, with a hospital system, in which the system will be providing substantial stipend support to you, don’t negotiate as if that stipend support is a gift or a handout or a “May we have more please?”. Instead, view the deal and evaluate it as if you are a buyer of that relationship, with something extremely valuable to offer.
Let your deal partner prove itself worthy of you.
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| | | Tuesday - What Law Would You Choose? - Success in Motion
Watch the video here, or just keep reading below for a slightly polished transcript:
A few minutes ago, I passed an armored car which made me think about boilerplate in a contract.
Boilerplate isn’t extra stuff at all. Like the heavy, protective plating around an old boiler, contractual boilerplate keeps the rest of the agreement tight. In other words, it helps assure that the deal points that you negotiated stand a better chance of being enforced.
Let's talk about the boilerplate provision that deals with choice of law.
In a contract, the parties can (with some exception and we’ll touch on that) choose what state’s law applies. So, for example, two parties in a deal in California could adopt Delaware law in connection with the interpretation of their agreement.
Of course, that requires that you do some thinking about what state’s law might be better to enforce the provisions you’re looking to protect. How does a particular state enforce, for example, non-competition provisions, or how does a particular state’s law interpret the effectiveness of notice?
Now in some instances, due to public policy arguments, choice of law provisions might be disregarded. For example, courts in California generally apply public policy reasons to find that a person employed in California by a California employer, a situation in which a covenant not to compete would be void, shouldn’t be governed by another covenant-favorable state's law even if the employment agreement imports that state's law into the deal. (But there may be ways around that ...)
The bottom line is you’re never going to hurt yourself by attempting to choose more favorable law to apply to a contract -- but it’s a complex issue at to what law is actually more favorable. Some other state's law might help you with provision A, but does it help you with provision B, or does it put you in a worse position?
Choice of law is one of the usual boilerplate provisions, but choose wisely.
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| | Wednesday - Using (And Used By) Public Information - Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript:
What do you know, really know, about the people you do business with? For example, about your employees, subcontractors and the CEOs of the hospitals you deal with.
A few years ago a friend, let's call him "C," told me the following story:
C's son, attending college in the East, was looking for a new roommate to share an apartment. C's friend said that his son attended the same university.
Instead of simply passing the kid's name along to his son, C decided to do a bit of research first and, much to his amazement, found a treasure trove of information that, to say the least, disqualified the potential roommate, at least through a parent's eyes.
Recently, the Wall Street Journal reported that some school admissions officers are using Facebook and other social media sites to discover information about applicants, searching for things which don't match with the applicant's statements made in the course of the admissions process.
Of course, this post isn't about vetting roommates or potential students, it's about gathering information in the context of your business dealings, where research of this sort is more than simply prudent, it's required.
For individuals in general, this means you have to be careful about what you post on the Internet about yourself and about what is posted about you. Of course, there's a flip side to this: you also have the ability to create your own "truth," or mythology.
For physician group leaders, this means that you need to clearly vet, and regularly check, available public information about, and posted by, your group's members. You should also be checking the information that others have posted about your group.
And, extremely importantly, you need to develop a thorough knowledge base of your group's business competitors and contracting/negotiating partners. Even the smallest detail can often be used to your advantage.
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| | | Listen to the podcast here, or just keep reading for the transcript.
Hospitals are happily benefitting from the expanding role of paraprofessionals and from the top level professional degrees, the doctorate, those paraprofessionals are now obtaining.
Take, for instance, the push by CRNAs to be recognized as equivalent replacement providers of anesthesia services. Hospitals, seeking to break the financial and medical staff voting block hold of anesthesia groups, are often more than willing to accept CRNAs in place of anesthesiologists. They view them as cheaper, more controllable and disposable.
If you're not an anesthesiologist, don't think this doesn't apply to you -- in a very real sense, anesthesiologists are simply the "canaries in the coal mine." Soon, surgical PAs will be pressing for the ability perform some procedures unsupervised.
At the same time, doctorate degrees are becoming the top professional degree in many paraprofessional categories. Once the nurse specialist performing your function becomes a "doctor," you will become irrelevant – or so goes the thinking of hospital-centric healthcare pundits.
Physicians do have one important branding tool, the "M.D." degree. Of course, as paraprofessionals become branded as doctors also, the value of an M.D. will become diluted. Physicians cannot allow that to happen and your professional societies must begin now in educating the public on the difference between M.D. delivered medicine and care delivered by nurses and other physician extenders holding doctorates.
Additionally, physician specialty boards, which to the public are generally meaningless (after all, what do all those initials after a physician's name mean?) must devote significant resources to promote the public's awareness of the high-level of training and peer-reviewed expertise required in order to earn that designation and, even more importantly, what that means to patients and their families.
It's bizarrely amusing, in a sick sense of the use of that word, to see hospitals demanding that all physicians in a contracted group operating a hospital-based department be board-certified, while, at the same time happily replacing a significant portion of those doctors with far lesser trained nurses. If medical specialty boards don't understand this is an absolute repudiation of the value of board certification, and an attempt to render their members' roles, and perhaps most if not all physicians' roles meaningless, and therefore, fail to act, they, and you, will be in for a significant surprise.
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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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| | | | 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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