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| Dear Friend,
A real-life Breaking Bad, just without the porkpie hat and no one named Walter White.
It is a beautiful day. That is unless you are looking at it through the bars of federal prison, like the guy who compounded his life by compounding pain creams.
George Tompkins is his name, a pharmacist who fancied himself the “compound king.” He, together with his wife, ran a pharmacy in Houston, Texas.
Somehow, the Tompkins got involved in a compound pain medication scam in which the government alleged that $21 million of illegal (i.e., fraudulent) billing was submitted to and paid by the federal government. They were indicted.
George was found guilty at trial and was sentenced to what is effectively a life sentence for a 75-year-old, ten years in prison.
Ms. Tompkins, George's wife, either had a better lawyer or was slightly less culpable -- she received a minor sentence when she plead out long before her husband went to trial.
A third individual, Anoop Chaturvedi, a U.S. resident from India, was also indicted. He is now a fugitive and the FBI is on his trail.
Although there is a big dose of Schadenfreude involved in the story, that is not what I am trying to get across to you.
Instead, if you are a physician, and there is almost always a physician involved in these scams. You have to be extremely wary because these deals almost always end poorly for the physicians, as well as for the pharmacists, and for those who are usually at the center of this, the marketers.
Turning the usual physician-patient relationship on its head, compound medication schemes center around marketers who make phone calls and run scammy websites to lure in federal healthcare program patients. Once in the queue, patients are then transferred by phone bank operators to "on-call" physicians who write prescriptions (generally never seen by the patients) for patients with whom they have had no prior contact.
Thus, the patients were never "real" in the sense that the drugs were "sold" to them via a patina of physician involvement.
Additionally, pain cream or other compounded medication scams rarely involve what are legally "compounded" medications. Instead, they usually involve illegally manufactured drugs: drug combinations that are manufactured in bulk, not actually compounded on a patient-by-patient basis.
And, for the physicians involved, the schemes are replete with unlicensed practice of medicine issues (just where do those patients live and where are you licensed?). Of course, other elements of the scheme, such as prescribing for "patients" who might not actually be patients in the view of your state's medical board, add other licensing violations into the mix. How do physicians get lured into these schemes? In my experience (and I have seen this multiple times) it is because they are going to make a boatload of money for little work, the greed factor.
Don’t fall for it.
Invariably these schemes are crimes. Ten years in jail is nothing to sniff at. Invariably they lead to professional discipline, too.
Don’t believe what the perpetrators will tell you, which is that they’ve checked it out with their lawyers (even a large firm) who’ve told them that it’s fine.
Get your own representation because you are going to need it sooner or later. That is, either now, before you get involved, or later, when you are indicted.
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| | | 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.] |
| | Watch Tuesday's video here, or just keep reading below for a revised, more polished transcript:
Let's talk about malls. Closed malls in particular, and the opportunity for you.
I read today in the Wall Street Journal that Disney has announced they are closing an additional sixty of those cute Disney stores, the ones shoved full of nice little plush animals and other overpriced things that your kids want, and you don't want to buy, but darn it, you buy them anyway. But maybe you didn't buy enough of them, because Disney is shifting to an online model.
At the same time, a recent article in the Financial Times, talked about the many billions (it might even have been trillions) of dollars of real estate that U.S. banks are sitting on, real estate that's in default. The banks haven't pulled the foreclosure trigger because they don't want the foreclosed loans on their books.
Malls are likely a thing of the past. But they can be a thing of your future, if they can be
repurposed by you for medical use.
I am talking about medical malls in which there are medical office spaces, ambulatory surgery centers, lab spaces, and imaging facilities. The buildings are already there, and in many cases, they're hollow shells, shells that can easily be reconfigured to meet requirements.
I'm not talking about giant multi-million square foot malls with roller coasters, Hot Dog on a Stick, and Auntie Annie's Pretzels. What I am talking about are more manageable-sized malls, such as the three or four that I passed on the drive into the office today.
Think about how someone else's misfortune, the store owners, the mall owners, can be your fortune.
Think about how you could repurpose already existing space for your own profit.
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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. |
| | | Wednesday - Is It Really Easier to Schedule Coverage of a Closed Hospital? – Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript:
We used to joke about the name of Midway Hospital, an acute care hospital in L.A., saying that it was midway between life and death.
An anesthesiologist, commenting on my theme that inpatient care is becoming outpatient care and that the center of outpatient care is not the hospital but the freestanding facility, in his case the ASC, told me that I was missing an element in the analysis.
Specifically, he argued that it is far more efficient and profitable to schedule coverage for a hospital, with its large number of operating rooms running for long hours each day, than it is to schedule for outlying surgery centers running a few rooms for part of a day.
He's right. But only until the hospital loses so many cases that it does not pay to cover it. Or, until the hospital closes.
Let's get back to Midway. “Born” in 1040s . By the 1980s it was a part of Summit Health. In the early 1990s, Summit sold the hospital to OrNda Healthcorp which, in turn, became part of Tenet Healthcare™. By the mid-2000s, Tenet sold the facility to a physician-led venture, Physicians of Midway. Perhaps seeing the irony in the Midway name, Midway became Olympia Medical Center. On December 31, 2013, Alecto Healthcare purchased the hospital.
And then, 7 years later to the day, December 31, 2020, Alecto announced the hospital’s shutdown, to be effective March 31, 2021. Midway was no longer midway between life and death.
UCLA Health has announced that it purchased the property, which is still scheduled for closure at the end of March. If and and when it will reopen, and as what, is unknown.
I suppose that it is easier to schedule for zero rooms at what was once a hospital than it is for 5 or 10 ASCs located all over the place. But it is not very effective, at least if you are running a business.
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| | | Listen to the podcast here, or just keep reading for the transcript.
Improving your group's performance might be the worst thing you can do.
There is nothing wrong with the notion of getting a little bit better each day, month or year.
That is, if you discount the fact that improving the current structure of your group might keep you from getting where you really could be.
We are all familiar with the situation in which we spend considerable money repairing an old car, not a collectible, when all we end up with is an old car that leaks less oil. And, we are all too familiar with a potential client who says his group does not need to improve because they increased their income three percent last year to an average per partner of $400,000.
Perhaps income could be up 20 percent and perhaps average per partner income could be at $750,000.
There are several major defects in a plan based on incremental growth.
Incremental growth, or "planning" as it is commonly known, is present-state focused. By definition, it is not based on where you want your group to be but on where it is now. The improvement trajectory is low.
It is also an extremely limiting mindset. Seen an ice delivery man lately? In 1900, the future looked bright to the employees of ice delivery companies. The population of the United States was booming and food had to be kept cold. They had a lock on the market for the only solution. That is, until the invention of Freon in 1928 and the resulting birth of the home refrigerator which froze thousands of ice delivery men out of their careers.
The better approach is to not rely on a plan of incremental growth, but to develop a strategic outlook – an outlook that is not present-state focused but which is based on your transformationally improved future. In essence, this is the difference between past-based "planning" and future based "strategy."
The required process, Focusing on the Future™, does not ask how to get from here (now) to there (a future). Instead, it first requires you to establish a "there," an ideal future reality. What is that future like? Then, it requires that you question how you got to that future; in other words, you pull your group into the future from the imagined future, not from your present "past." What obstacles did you encounter and what were the solutions?
Your group's future exists. Use it before it uses you. Focus on the Future™.
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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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| | 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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