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| Dear Friend,
Self-sabotage.
That's the subject of Monday's blog post, Avoiding a Self-Defeating Negotiation Mistake. Follow that link to the blog, or keep reading for the entire post.
Have you ever allowed the negotiating rug to be pulled out from under you?
Or even worse, have you helped the other side pull the negotiating rug from out under you?
Let's say that you're negotiating a contract with a hospital. You think you’ve come to terms on some of its provisions, but not on all of them.
Then, the hospital begins putting pressure on you.
“We have to have this agreement signed by next Tuesday." Or maybe something like, "if it's not signed by next Tuesday, we might send this thing out to an RFP”.
Alternatively, perhaps you're told things like, “how could you be demanding these points? They're very minor. In fact, it's insulting for you to bring these points up." Or maybe, "the agreement is fine like it is. So why are you just going back and forth on this when we have better things to do? We should be moving forward with the deal.”
But if you bite on one of these, it's like a fish biting on a hook with a nice juicy salmon egg on it. In fact, it's worse than that; it's biting on a shiny lure, there's not even any salmon egg to swallow before you're hooked.
You've basically fallen prey to pressure, to a scare tactic that makes you think, or rather feel, which is worse than thinking, that you might be losing the deal.
The tactic works even better on you if you have no option to the deal, if you've ignored my longstanding advice to have multiple deals in place so that no one deal is required for your group's continued existence.
Don't fall prey to being divided and separated by yourself.
Do you press for provisions that you know you need, or do you cave because the deal is going to be yanked, or so you're being told?
Don't negotiate against yourself. |
| | | 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 transcript:
When I first began representing hospital-based groups back in the 1980s, I used to joke that hospitals would go through a checklist:
Laundry service? Check.
Cafeteria? Check.
Anesthesia group? Check.
Over the years I began to realize that if physicians in office-based specialties didn’t start protecting and speaking up for their hospital-based colleagues, sooner or later, all physicians would become hospital-based in a sense.
This story has come home to haunt a radiology group in St. Louis. The group is over 30 years old. It has over a dozen physicians, has many office staff members, and has brought hundreds of thousands of patients to the SSM Health System. But now, the group's apparently been told that soon it will no longer be providing services for patients at one of the SSM hospitals because the facility has chosen to (wait for it, here it comes!) bring in an exclusive provider of cardiology services.
The sorry part of the story (as told by the group at least), is that the group spent millions to build offices close to the particular SSM facility from which they’re going to be shut out.
The group filed suit to preserve the staff privileges which are about to be mooted by the new exclusive contract. I have no idea what the strength of their claim is; they’re alleging reputational damage.
The hospital’s retort is that there are other hospitals to which those patients can be taken, in fact there are other SSM facilities. The group’s position is that many of their patients live in the area near this particular hospital and that forcing the patients to travel 15 miles away to the next nearest facility is not a good option in terms of patient care.
How that particular lawsuit will pan out is anyone’s guess. I’m not betting on the group, but we’ll see.
The story for you isn't simply that putting all of your chips in with the hospital is a bad bet. The group here didn’t do that; they have multiple offices and privileges at multiple hospitals. The bottom line is you just can’t trust a relationship to last.
And that’s life. It's not a change in healthcare; well not since the 1970s.
It's folly to think that a hospital is going to look out for you. It's folly to think that when a hospital forces someone else out, or plays hardball with somebody after a 30-year relationship, that they won't later do the same to you. The hospital doesn’t have your back. You’re only aligned if you don’t step over the line, or as long as someone won’t push that line more in the hospital’s favor.
Hedge your bets by establishing lots of relationships. A contract has a term and it has a termination provision. The relationship is only as good as long as the termination provision.
And here, in the story of the cardiology group, there was no contract. But what do you know – there can be one, and it can displace you.
Think and look out for yourself.
There is no security other than the security you create for yourself.
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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 Your Group Still Sharp? Strategy, Tactics and the Future of Your Medical Group – Medical Group Minute
Watch the video here, or just keep reading below for a slightly polished transcript:
The Wall Street Journal reported that Japan's 100 year old Sharp Corp. announced that it had doubts that it could remain as a going concern.
Sharp had invested heavily in building liquid crystal display manufacturing plants in order to compete with its South Korean rivals, only to have the market collapse.
Sharp's president was quoted as saying, "We lacked a sense of speed. The situation could have been different if we took steps more quickly."
That sense of speed and action is entirely consistent with the philosophy of Col. John Boyd, considered by many to be the greatest military strategist since Sun Tzu, and his OODA loop, OODA being Observe, Orient, Decide, and Act.
Boyd's concept is that strategic advantage is gained by being able to process information and take action faster than one's opponent. This is referred to as getting inside your opponent's OODA loop.
Whether or not Sharp ever heard of the OODA loop, it's abundantly clear that someone got inside of theirs.
There are two important lessons here for medical groups.
The first: A 100-year-old company, or an office-based practice that has always received referrals from a certain group of internists, or a hospital-based group that has held the exclusive contract for 50 years, are not necessarily guaranteed a satisfactory future.
The second: Strategy and tactics exist. You either use them to your benefit or someone else uses them on you. |
| | | Listen to the podcast here, or just keep reading for the transcript.
According to a February 18, 2021, article in the Wall Street Journal, IBM is considering the sale of its touted-to-be-game-changing big data crunching wizard, Watson Health.
Although the venture has big top line revenue, around $1 billion a year, it’s a consistent money loser.
It appears that the overall feeling inside IBM is not that it is IBM’s fault, it Is just that doctors do not seem that interested in turning over decision making to a machine. Go figure.
And that brings me to the point of this post.
Big data and business decision making, especially in your practice, are two very different things. I am not qualified to tell you about the dangers as relate to the domain of medical practice, but I am certainly qualified to tell you about the dangers as they relate to the domain of healthcare business.
Data is data but it is not decision making. Artificial intelligence is not intelligence, it is just a tool.
Yes, so-called “big data” is a faster tool with more inputs than, say, notes written on index cards spread out across the floor because there is no more room to tape them to the walls.
But no amount of data should ever be confused with making a decision.
Instantly being able to vet the financial performance of an acquisition target against thousands of other similar targets, or being able to assess the combination of education and training across tens of thousands of x-ologists to gauge your new hire, do not supplant, or come even close to supplanting, your own judgment concerning the decision. Decision-making can not be outsourced.
Oh, I can hear someone saying, “But without all of the data there’s more risk.” But big data, simply as a function of being tremendously big, suffers from the problems of noise.
There is far more data, but how much of it is bullshit? And, of course, there is no reward without risk. (With the exception of being a government employee.)
It makes you wonder if those who have opted for big data as a decision making tool as opposed to a decision support tool, are simply afraid to make decisions themselves or are preselecting a scapegoat.
Think of it this way: IBM’s Watson, for all of it big data, could not figure out that it is essential intended audience, physicians, did not want to use it. |
| | | 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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| | | | 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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