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| Dear Friend,
A bottle of Anacin, a pack of toilet paper, and oh, your annual physical exam.
Welcome to the pharmacy.
Physicians, think that your competitor is Dr. Smith across the street or the hospital and its 185 captive docs? Think longer term.
In 2014 CVS/pharmacy rebranded as CVS Health.
As of 2014, they operated 850 MinuteClinics staffed with nurse practitioners and physician assistants spread across 29 states.
In 2023, CVS acquired primary care provider Oak Street for $10.6 billion. As of the closing of that deal, Oak Street operated more than 170 clinic locations across 21 states.
CVS's current plan is to open an additional 50 to 60 Oak Street locations in 2024, some standalone, including in space once occupied by now-closed CVS pharmacy locations, and others co-located within existing CVS stores.
CVS, Walgreens, Walmart, and other large retailers aren't just "stores", they are your competitors, perhaps even vicious ones, because they are not your “colleagues.” They are happy to care for whom you imagined were your patients. In addition to their current disruption of what used to be patient visits to primary care physicians, they will eventually expand to other medical specialties and direct what used to be your referrals to them.
Think that sucks? Or do you smell the opportunity?
Depending on what your definition of a “chain” store is, there are almost as many independent pharmacies, around 23,000, as there are stores owned by the national players.
Each of those stores, or affiliated groups of them, can make the same foray into far more of the healthcare market than selling pharmaceuticals.
For the independent pharmacists reading this, there is tremendous opportunity.
For the physicians reading this, at least those who have enough entrepreneurial guts to take action, there’s an opportunity, too. An opportunity to align with (from ownership to joint ventures to other affiliation) non-chain pharmacies.
It’s your choice: Run and hide or run and profit.
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| | Breaking News: FTC Issues Final Rule Banning (Most) Covenants Not To Compete
On April 23, 2024, the U.S. Federal Trade Commission issued a final rule prohibiting most covenants not to compete.
As expected, the rule is drawing both cheers and criticism and will more than likely draw courtroom challenges.
We’ll cover the new rule in the April issue of our monthly newsletter, to be released on April 31st.
In the meantime, the FTC’s press release, with a link to the final rule, can be found here.
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| | Wednesday - Showing Up On Time and Negotiation - Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript:
A friend told me about his old boss, a guy who thought he was sending a message of his own importance by showing up late to meetings with his clients.
With one caveat, which I'll discuss below, showing up on time in business is vital.
For physician group leaders, that means showing up on time to meet, in person or remotely, with hospital administrators, to meet with potential deal partners, to meet with your bankers, and so on. Especially if what you're showing up to is a negotiation.
And, by the way, every exchange, verbal and non-verbal with someone with whom you do, or will, deal, is a negotiation whether you acknowledge it or not: your "opposite" is receiving a message even if you didn't intend on conveying it.
Don't make the mistake of thinking that being late signals your importance or your power.
Everyone else thinks that they're more important than you. So instead of playing to your ego, play to theirs. Let them feel that they are the most important person in the room, the most important person in the negotiation.
I'm not saying that you want to cave to their position in the negotiation. To the contrary, I'm saying that showing up on time is a courtesy that you demonstrate. It removes the negative that's created by what the other party will see as rudeness. Then you can continue to implement your plan of world domination.
The only caveat is when you are using lateness to signal that you might not want the deal at all. Use that tactic carefully, as the risk is that you will need to deal with the other side in the future, when they may not want you at all.
Oh, my friend and his old boss? That's how my friend got started in business. He launched his own firm simply by showing up on time to meet with the clients of his old boss.
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| | | Listen to the podcast here, or just keep reading for the transcript.
Working from home doesn’t work for most, well, nearly all, physicians, but taking work home does, or even taking a work call in a car.
The issue is, who’s within earshot?
From BP and a Couple of Texans to Potential Trouble For You
On February 22, 2024, the U.S. Securities Exchange Commission announced civil charges against Tyler Loudon of Houston, Texas, the husband of a BP p.l.c. mergers and acquisitions manager. The same day, the U.S. Attorney’s Office for the Southern District of Texas announced that Louden pleaded guilty to securities fraud.
As background, during the relevant time in 2023, both Loudon and his wife were working from home. His wife was an executive in mergers and acquisitions at BP p.l.c. (often commonly referred to under its former name, The British Petroleum Company).
The criminal and civil cases center around the allegations that Loudon overheard several of his wife’s work-related conversations in the course of which she discussed BP’s then pending acquisition of TravelCenters of America Inc., a large chain of truck stop and travel centers.
According to the allegations, Loudon then, without his wife’s knowledge, purchased 46,450 shares of TravelCenters stock before the acquisition deal was publicly announced. Upon the subsequent announcement of the deal, the value of TravelCenters stock shot up 71% and, as alleged, he immediately sold all of his shares for a profit of $1.76 million.
As a part of his criminal case plea agreement, Loudon agreed to forfeit the $1.7 million in illegal proceeds. Additionally, he faces up to five years in federal prison as well as up to $250,000 in fines.
From Insider Trading to Inside Voices
As interesting as the Loudon case is, insider trading isn’t the point of this post. Rather, it’s the fact that an almost identical situation applies to HIPAA violations in the context of disclosures of PHI made by physicians, both orally and in the form of unsecured records, while working from home or even while taking a phone call in the car with, as in the Loudon case, a family member present.
What policies does your group have? How are they enforced . . . or even, how can they be enforced? What does difficulty in enforcing them mean? (Answer: nothing.)
As the WWII era poster says, loose lips sink ships.
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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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