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| Dear Friend,
Antifragility in healthcare.
In the book Antifragile, author Nassim Taleb points out that there’s no word that describes the opposite of fragile.
“Fragile” describes something that is injured when shaken.
Something that is resilient isn’t the actual opposite of fragile — it isn’t made better when shaken — it’s just able to withstand being shaken.
But antifragile, in Taleb-speak, describes something that is actually improved when subjected to stress.
We’re at a point in time where there is increasing complexity and change in healthcare and its regulation. We're also at a point in time in which a virus, coronavirus or COVID-19, is wreaking havoc not only on society, but on medical groups. Depending on the specialty, the havoc is a flood of demand, more than can be handled, or a dearth of work, a time to batten down the hatches and wait out the storm.
Is it possible to apply the concept of antifragility to a medical group or a healthcare business? I’m not sure. But, certainly, there are things that you can do now to put your group or other healthcare venture into a better position moving forward, even if that position is merely a hardening against injury and not true antifragility.
You can use my concept of the Scenario Survey Process™ (read about it here) to develop potential future scenarios and then to devise a strategy that will help you not only survive, but even potentially thrive, in as many of those futures as possible.
For example, consider a group or a practice that is currently dependent upon a single hospital or a single location or a single referral source. Those relationships are certain to become far more stressed in coming months. They are fragile.
Or for example, consider a group whose work load is cut back drastically, yet which has promised, contractually promised, all of its 43 physicians "an equitable share of the schedule." The group is fragile.
Through the use of the Scenario Survey Process™ the group or practice can examine potential scenarios and then strategize as to them: How could you best hedge against any such scenario? What relationships can you create and to which facilities might you expand and what changes within your group might you make to not only devise a softer landing, but perhaps build a better launching pad no matter what happens?
I don’t have the one, single, simple solution to this. Nobody does. But that doesn’t mean you shouldn’t start thinking about it today. |
| | Tuesday - Success in Motion Video: Why You Need to Let Them Know You're Really There
Watch Tuesday's video here, or just keep reading below for a revised, more polished transcript: |
| | The Wall Street Journal recently featured an article, laid out in Q&A format, about employees working from home. One of the questions was “how does my boss really know I’m here?" or, in other words, how does my boss know that I’m really working?
It occurred to me that the same dynamic is true in any remote relationship, whether remote means a thousand miles, halfway around the world, sixty feet away, or four floors away in some large hospital.
In particular, how would this work for an anesthesiology or radiology group? How does the hospital CEO know that you’re really there?
Now, I don’t mean that you’re not doing cases. What I mean is how does that hospital CEO know that you or your group, as a contracting party, are really there, involved in fulfilling the obligations under your contract that go way beyond treating patients.
Or, how does a referral source know that you’re thinking about him or her and are looking forward to receiving referrals?
It occurred to me that it’s akin to the whole notion of “out of sight, out of mind.” When someone can’t be seen or someone isn’t heard from, are they sort of “lost” in a sense, in terms of priority in comparison to those things which are more pressing and more demanding?
I once knew someone who said, in the context of running a hospital-based group, that he didn’t like setting random appointments with the hospital CEO to fill him in because the only thing that could happen would be something bad.
I don’t see it that way.
I truly believe that you have to keep those who are important to you, to your relationships, to your business, in the loop. Sure, you don’t want to disturb them or bother them just for the heck of disturbing them. You have to have reasons (even if you have to invent them), important reasons, to remind them that you are there, that you are involved and, in connection with referral sources, that you are grateful for their business.
Consider that in business, as well as in personal relationships, out of sight might lead to out of mind. In fact, it might lead to the end of the relationship: Out of mind as out of business.
Go out there and work on those relationships, whether or not you think they need working on. |
| | Wednesday - Walgreens Slims Number of In-Store Clinics
Watch the video here, or just keep reading below for a slightly polished transcript:
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| A few weeks ago, Walgreens, the giant drug store chain, announced that it was planning to close the 157 in-store health clinics that it owns. It will continue to keep those clinics run by third parties.
Why close their own stores? They didn’t make money.
Instead, Walgreens is partnering with weight loss company Jenny Craig, which will place Jenny Craig consultants in approximately 100 Walgreens locations.
What this means for retail healthcare is unclear.
Walgreens profit is driven by sundries and over the counter products as well as by prescription drug sales. If, as it turns out, their foray into retail medical care didn’t make money, and didn’t drive more traffic into, and more sales from, stores, then it had to go.
On the other hand, despite Walgreens’ status as a large chain, it’s small compared with CVS Health and its well over 1,000 in-store retail clinics. With only approximately 150 owned clinic locations, some analysts believe that Walgreens lacked the scale to make retail health profitable, but of course, that’s just a guess.
My analysis is that Walgreens discovered that it’s more difficult to operate clinics than imagined. Retail stores are driven by sales and profit per square foot. Apparently, their third party partners are not clamoring to back out of their in-store clinic space leases.
Retail primary care remains a growth opportunity, especially when it can be leveraged by multi-specialty medical groups as a referral funnel.
Some specialty areas present similar opportunities, such as retail orthopedic clinics.
And, of course, for those medical groups which control ASCs or physician-owned hospitals, retail centers with high traffic and visibility are prime locations to facilitate new patient relationships.
Think health system moves, even if you aren’t a health system.
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| | Thursday - Podcast: Stars Don't Audition. Why Are You Responding to That RFP? |
| Listen to the podcast here, or just keep reading for the transcript.
When I first began practice, I worked for a law firm that represented clients in the entertainment industry.
One thing that struck me from each morning's required reading, Daily Variety, was that although it carried many announcements of auditions for minor roles, stars didn't have to addition at all – in fact, the paper often reported how many scripts some star was reviewing: the buying/selling or supply/demand situation was completely flipped.
It's hard to imagine a more common service commodity than actors in Los Angeles – they are everywhere: waiters, secretaries, office support staff, temps, and substitute teachers; in fact some even work as actors.
But some have differentiated themselves and are no longer in the same, well, solar system, they are "stars."
How different in this regard are most hospital-based physician group members from actors? Most are stuck, at least in their minds, in the commodity world.
But if stars don't have to respond to the acting equivalent of RFPs, casting calls and auditions, why don't you create an experience monopoly practice and do the same?
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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 here.
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Come listen to Mark speak in sunny
Las Vegas on June 5, 2020, at The Advanced Institute for Anesthesia Billing and Practice Management.
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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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