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| Dear Friend,
Stabbed in the back.
Do any of these sound familiar?
Your group's been courting facility X across town as an additional service site. Then you learn that one of your partners, through an entity she controls, has been covering it for the last six months.
Or how about the opposite? When Dr. Y was admitted to your group as a full partner, he agreed to turn over his contract at facility X to the group as of the end of the calendar year. New Year’s Day, Mother’s Day, and finally Father’s Day come and go and yet Dr. Y refuses to follow through on his commitment.
Breaches of fiduciary duty and of contractual commitment within medical groups occur every day. The question is, are those duties enforced?
If they’re not enforced, what signal is being sent to the rest of the group?
If they’re not enforced, is it because you think it’s too expensive to do so? If that’s the case, what costs are you considering? Do they include your group’s future?
There are many ways to prohibit purely self interested conduct, that is, self interested conduct that is not tied to the group’s self interest. These range from placing physicians into categories that, by law, result in the creation of fiduciary duties, to specific contractual provisions.
But just as a 500 page contract is no more binding then a few scribbles on the back of a napkin if it is not enforced, periodic attestations and periodic audits of outside interests can be seen as sticks signaling that there will be a price to pay for violation.
What signal is your group sending? |
| | | 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.] |
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Watch Tuesday's video here, or just keep reading below for a revised, more polished transcript:
I read a story in The Wall Street Journal about Tiffany suing the French luxury goods giant LVMH over LVMH’s backing out of the $16.2 billion deal pursuant to which LVMH was to acquire Tiffany.
Purportedly, the French government put some pressure on LVMH not to close the deal until sometime in 2021. Tiffany says that's a pretext and is suing to enforce the acquisition agreement.
Do you need a deal as badly as Tiffany? Have you ever needed a deal so badly that you would sue to get it done?
Maybe not exactly sue, but have you signaled that you need the deal so badly that you'd, in essence, die for it, that you have to have it, that unless you have that deal, the sky will be falling?
In other words, have you signaled that you don't have any alternatives?
Power in a deal comes from the ability to walk away. It doesn't come from signaling, whether it's true or not, that you need a deal so much that you'd die for it. Then, it becomes “deal suicide”.
Be careful what you're signaling. Of course, like Tiffany, once the document is signed, I could understand why, in their case, suing is a valid option.
Or, perhaps, Tiffany, that jewel, is signaling that everything isn't diamonds. . . maybe it's just paste.
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| | 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. |
| | | | In my 2017 post, What You Need To Know About The Flea That (Metaphorically) Killed The Medical Center CEO, I wrote about the fact that, as in a guerrilla war, change within an organization, as well as within a domain in which the organization interacts, can occur as a result of agitation by a vocal minority.
Just as no vote was required for a dictator like Castro to take over Cuba, no medical staff vote, no survey by Press Ganey, no long and drawn out process among “stakeholders,” is required to topple the status quo.
In the original “flea” post, the story centered on the fact that a relative handful of physicians toppled the rule of Ohio State University’s Wexner Medical Center CEO, Sheldon Retchin, M.D.
And now, the Detroit Free Press is reporting that physician leaders at Southfield, Mich.-based Beaumont Health System are circulating a similar no-confidence petition aimed at Beaumont’s President and CEO John Fox and its Executive Vice President and CMO, David Wood, Jr., MD.
The “takeaway” of the original “flea” post, was that the few can make the mighty fall, and fall hard. That if you’re the mighty (the dog in the flea example) watch out for the few, for the flea. And, alternatively, that you can be the flea. That lesson still stands, as valid as ever.
But there’s another takeaway as well, one that I urge you to focus on very carefully.
We’ll all steeped in the notion of the status quo, of how things are done, of the normal order of things.
Many, perhaps most, even, perhaps all, physicians have trouble with this concept. Maybe it’s the result of the lockstep progression through school to school to school to residency to fellowship to the stratified world of medical staffs and hospital-centric healthcare.
As a result, many physicians, and even group leaders, settle for what they’re given. The hospital says “structure it this way” and they accept it. They think that reviewing the contract is the same thing as developing and implementing a strategy for success; it’s not. The first is a form of giving in and giving up. The second is charting your own course, of putting, dare I say(?), your own interests first.
Would you rather die from the flea dip of playing it safe, of “this is how it’s done, so what control do we really have?” Or would you rather stand up and realize that you had power all along?
To do the latter means you can no longer blame and claim subjugation. To do the latter means you have to invest in yourself: time, effort, and money.
The flea can beat the dog. The David can beat the Goliath. And you, what can you do?
If you want to come along on this journey, contact me.
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| | | Listen to the podcast here, or just keep reading for the transcript.
You're probably familiar, if not personally, then at least conceptually, with the notion of "F.U. money" - having enough money that you can simply walk away. That concept, whether you have the money or not, applies directly to your negotiation strategy. Have you ever simply stood up and walked away from the negotiating table, saying to your teammates, "let's go, we're done here"? As I've espoused many times before, for example, see here and here (and, by the way, it's the subject of my upcoming webinar on June 25, 2020, How to Deploy the Secret Sauce of Opportunistic Strategy) negotiation is far, far more than what takes place at a negotiating table. But the overall ability to walk from a deal requires either the actual ability to walk away from the deal because you don't actually need it, or the guts, strategic thinking, and the ability to project your power to do the same, even if it's your only deal, the one that you need to survive as a business. True power in any negotiation is the ability to project that you do not need the deal, even if that "not needing" is not true. That power can be developed multiple ways. It can be developed in the sense of "F.U. money," by the size of your bank account. It can be developed even if you don't have enough money to make the initial deposit into a bank account by having a high enough "deposit" of confidence that you can project the same power to the opposite party. You want a concrete example? OK. I've guided clients through a strategic process whereby start-up physician groups have adopted and implemented a position against large healthcare systems that we would negotiate from our documents, from our position, and have achieved tremendous results. The secret? Besides the proprietary strategy, those clients were coached on having supreme confidence in themselves and on the strategy, and on how to project their power through their demonstrated willingness to walk away. They had the willingness to invest in themselves by controlling the drafting of the documents - they knew that sitting back, pinching pennies, and waiting for the opposite party's documents was a fool's position, one that would have put them at a disadvantage before the first shot was fired. Develop and project power. |
| | | 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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