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| Dear Friend,
Screwed over by one of your partners.
Evolutionary psychologists say that the reason we see a stick on the trail ahead of us as a snake is that it's far better for our survival to see sticks as snakes than snakes as sticks.
This and other biases cause us to more readily focus on the relatively immediate threat as opposed to the long-term one.
So, when earlier this month CMS released its various proposed 2021 payment schedules, physicians quickly focused on what's in it (or, rather, out of it) for them, that is, for their specialty.
But at the same time, a focus outside one’s own immediate specialty reveals other trends, ones that may have a longer term but more significant impact on your career.
As anyone who's been reading my posts and articles (and my book, The Impending Death of Hospitals, available here for download) over the past six or so years knows that the trend of shifting procedures from the hospital setting, including from the hospital outpatient department setting, to the ASC setting is of tsunamic proportions.
In accordance with that trend, CMS’s August proposed payment pronouncements have hundreds of procedures moving to the ASC setting. For example, they propose moving more than 266 orthopedic procedures from the inpatient-only list, which means soon to be done in an ASC.
Even more revealing is that CMS is proposing to eliminate the inpatient-only list in its entirety over the next 3 years.
Shh . . . hang on for second. Can you hear that? Yes, it's the American Hospital Association screaming.
In the long run, for those physicians performing facility-based services, such as anesthesiologists, these very strong continuing signals, in fact, stronger signals than in the past, are clear signs that unless your business model takes into account the fact that hospitals as we know them will soon no longer exist, your business might soon no longer exist.
And, on the flip side, those physicians who understand that competing with hospitals on the facility-side is becoming easier and easier, it's time to consider ASC development.
Comment or contact me if you’d like to discuss this post. |
| | | Business Life in the Time of Coronavirus Mini-Series
The coronavirus crisis caused a short term economic crisis for many medical groups. Our mini-series shows you the way out. Plus, many of the concepts discussed are applicable during both good times and bad.
[If you haven't already seen them, follow this link to watch our entire series.] |
| | Tuesday - Cement Feet or Fear of What Others Will Think?
Watch Tuesday's video here, or just keep reading below for a revised, more polished transcript: |
| | | How to Deploy the Secret Sauce of Opportunistic Strategy
Webinar On Demand
They say that COVID-19 has changed the world, creating the "new normal." Many of your colleagues and many hospital administrators are running scared.
Others, leaders like you, know that crisis means opportunity.
Let me provide you with the strategic tools and insights that you need in order to seize opportunities, whether they’re in the context of your current business relationships, the expansion of your business activities, or the creation of new ventures.
You will learn:
•Defense as a defective default: It’s necessary, but not sufficient.
•Exploiting weakness: Drop the guilt and identify opportunity.
•Flat line negotiation is fatal: Understand its myths and limitations.
•Negotiation reality: Learn to identify and deploy on multiple planes to affect the outcome.
•Maneuver: Harness the power of maneuver, both in overall strategy and in specific negotiation strategy.
Others see a crisis and freeze in fear. Learn how to see the opportunities and obtain the tools to increase your odds of obtaining them.
The price to attend is $479. The cost of not attending is astronomical. |
| | | Wednesday - Why the Lack of Power Corrupts Absolutely: Dealing With Petty Bureaucrats – Redux
Watch the video here, or just keep reading below for a slightly polished transcript:
A few months ago, while waiting at the gate for a flight, I couldn’t help but notice a gate agent making some woman unpack and repack and unpack and repack her expandable carry-on suitcase because it was too wide to fit into the measuring “box” for carry-on luggage.
It was obvious from the gate agent’s face that she took sublime pleasure in the exercise of her “power.”
When I commented to her a few minutes later that I next expected her to make the woman remove her underwear, she responded, “no one gets on my flight unless I say so.”
The reality is that such mini-dictators, the peons of bureaucracy, are nearly replete of any actual authority. Frustrated by their inability to control their destiny, they act out their near total lack of authority by overcompensating within the one slice of power they have – in this case, the power to drive a woman close to tears because her suitcase had to be pushed into the measuring device instead of sliding right in.
You’ve run into these people. They’re at the DMV and the post office and the TSA.
And, they’re at hospitals: The petty mid-level “executives” who occupy places on an org chart that looks like IBM’s in the 1960’s or a plate of spaghetti. They are the bureaucrats who can say “no,” but who lack any authority to actually say “yes.”
Lord Acton commented that power tends to corrupt, and absolute power corrupts absolutely. It appears that the lack of actual power does the same.
The quiver required to effectively deal with these people includes multiple arrows. Some are polite, others are political, and more than a few are pointed. An effective strategy involves knowing when and how to get the petty bureaucrat to open the gate, when and how to get around him, and when and how to get him pushed out.
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| | Thursday - Walmart Understands Action. Most Physician Leaders Just Understand Reaction. |
| Listen to the podcast here, or just keep reading for the transcript.
Your local newspaper and even that national one that claims to print everything that's fit to be printed is telling you that the world as you know it is over. It probably is. But have they told you that the world as you can create it might be better? No. That's not good for selling ad space, especially to drug companies. As a result, most physician leaders are running scared. They're too busy correcting the missteps of poor group structure, poor governance, and poor management to think about strategizing for the future. Heck, if you don't think you're going to have a future, why strategize for it. Just react to what's happening, react to what you read, react to what you hear on TV. Problem -> Reaction. Fear -> Reaction. Crisis -> Reaction. But of course, not everyone thinks that way. Instead, they see opportunity: Problem -> Opportunity. Fear -> Opportunity. Crisis -> Opportunity. Let's take Walmart for instance. They are moving ahead with their third "Walmart Health" center, a facility designed to take food off of your plate if you're a primary care physician, the operator of a clinical lab or of an imaging facility, a radiologist, a psychologist, a dentist, an ophthalmologist, an otolaryngologist, or dietitian. Walmart doesn't think like you. They have a strategy to seize opportunity. They make decisions quickly. They act on those decisions quickly. They are inside of your OODA loop [read about it here]. They will open their third Walmart Health while the primary care doctors they're about to displace can't even figure out how to reopen after the "shut down". But the interesting thing is that the concept of maneuverability, taking fast action that iterates and iterates so quickly that your competitor cannot predict what will happen next, thereby creating confusion and the inability of your competitor to cope, has nothing at all to do with size. It lies at the core of the key to victory in the Civil War Battle of Missionary Ridge [read about it here] and at the core of the story of the flea that (metaphorically) killed the medical center CEO [read about it here]. And, it also lies at the core of developing and deploying the strategy for your group's overall existence and for each and every "negotiation" that takes place. I know it's a foreign concept for most readers, those who sit back to wait to see what "the hospital will come back with." But how's that worked out for you so far? We're designing a program for medical group leaders like you who want to understand the secret sauce underlying opportunistic action. If you'd like to be on the invitation list, send a message to one of my assistants, here. And, if you learned anything by reading the above, act fast. |
| | | 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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| | 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 here.
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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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