Nov 27

This Robot Can Change Your Future

Robby the Robot.

No, not a Da Vinci, but a robot just the same. And, fully functional. Well, at least enough to have co-starred in the 1950’s sci-fi film, Forbidden Planet, a movie about medical groups and their physician leaders.

Well, okay, if you’ve seen the movie, you’ve caught me.

On the surface, the film, set in the 23rd century, is about the crew of a spaceship, commanded by John J. Adams, sent from Earth to the planet Altair IV to investigate what happened to a lost expedition. Robby is one of the co-stars, but the monster in the movie and, specifically, its creation, is what stole the show. It’s what provides the central message for physicians and medical group leaders.

In the movie, the only humans Adams and his crew find alive are a scientist, Dr. Morbius, and his daughter, Altaira. They learn from Dr. Morbius that some mysterious force killed the rest of the original crew. Only he and his wife, who subsequently died of natural causes, survived. Altaira was born on the planet.

Over his 20 years on Altair IV, Dr. Morbius discovered the incredible technology left by the Krell, a dead race, including the “plastic educator” that enhances the intellect.

Adams wants to take the Krell technology back to Earth, but Morbius strenuously objects because humanity is not yet ready to receive such limitless power.

Then, a monster appears, immune to all weapons and defenses. It kills several of Adams’ crew.

Cutting to the chase (and major spoiler alert) we learn that the Krell’s technology would materialize anything that they could imagine. The weakness in the design was that that included materializing their darkest thoughts, their “monsters from the Id.” Just as the Krell’s mental monsters had materialized to wipe out the Krell, the mysterious forces that killed Morbius’ crew and the monster that attacked Adams’ men were creatures of Morbius’ own subconscious mind.

And, that’s the message: We often mentally create roadblocks and boogeymen big and small (e.g., the “competition,” “that’s the way it’s done,” “the hospital controls us”) and throw them up in front of us as if they were real, when the truth is that they’re simply self-created, imagined limitations.

Dr. Morbius died on the planet Altair IV, a victim of his own monster. Don’t let his thinking limit your future.

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

www.advisorylawgroup.com

 

Nov 23

How To Use Red Teams To Strengthen Your Business – Podcast

You can use a red team strategy to discover your medical group’s weaknesses and to correct them before someone else takes advantage of them.

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Mark F. Weiss

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Nov 22

Physician Control of Hospitals From the Virus’s Point of View – Medical Group Minute Series

Think like a virus when considering open possibilities in taking control of your future.

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Mark F. Weiss

Nov 21

You Have a Spy in Your Organization – Success In Motion Series

Join Mark as he discusses the danger of the spy in your medical group or facility.

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Mark F. Weiss

Nov 20

But Does it Work in the Real World? Second Order Thinking and the Perfect Legal Structure

I recently attended a continuing legal education seminar concerning some very complex organizational structures for healthcare venture development.

Slide after slide flashed on the screen, each looking even more like a dish of spaghetti topped with Froot Loops and Cheez-Its than the one before it.

This entity and that. Physicians here. Investors there. Money flowing this way. Control over here and ownership over there.

From a purely legal standpoint, the models made sense.

However, from the practical standpoint, one apparently lost on the presenter, the structures were unfinanceable.

And, even assuming that the owners could finance the deals completely out of pocket, the structures would likely cause payors either to balk at paying you in the first place, or worse, to pay you now but later wake up to what’s really going on. Then, they’d demand their money back and claim that you defrauded them, or worse.

This is an example of the necessity of second order thinking.

The first order in our example is simply to ask whether the structure works from a legal standpoint. (“Yes, it does, so let’s proceed to document it.”)

The second order is consideration of the impact of your decision made at the initial level. (“Can we finance that type of deal?” “Is the legal structure ‘too cute by half?'”)

The dive goes deeper from there, to the third level (e.g., “What’s the impact of an unfinanceable structure on our relationship with . . . “”) and beyond, bounded only by the time and money you’re willing to invest in the process and the question of whether it makes sense to do so.

How deeply are you thinking?

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

www.advisorylawgroup.com

 

Nov 16

Get Sure That You’re Insured – Podcast

What if you’re sued for an event that one of your own members didn’t cause? To your dismay, you find out that you’re not covered for that.

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Mark F. Weiss

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Nov 15

A Naive Anti-Kickback Question Answered – Medical Group Minute Series

There’s an expression in carpentry, “measure twice, cut once.” We should have the same expression in terms of healthcare deals…

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Mark F. Weiss

Nov 14

History Rhymes in Healthcare Just as it Does in Home Delivery Services: Ride the Trend – Success In Motion Series

Ride along with Mark as he discusses the fact that trends, even those that seem modern, such as home delivery of fully prepared meals, are simply history repeating itself or, at least, rhyming. Understanding this facilitates your exploitation of trends in healthcare.

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Mark F. Weiss

Nov 13

Healthcare Freedom of Choice: Doughnuts and Doing Time


In a Wall Street Journal piece published in last weekend’s Saturday/Sunday Nov. 11-12, 2017, edition, Ezekial Emanuel, M.D. of the University of Pennsylvania and other pursuits, wrote of the “hype of virtual medicine.”

In particular, he cited studies that show that virtual medicine and high-tech health gadgets such as Fitbits accomplish nothing in regard to increasing patient compliance with doctors’ orders or to actually live healthier lifestyles. The same compliance problems that exist with regard to traditional medical encounters exist with regard to technological encounters.

The bigger issue is why he’s surprised at all.

People are free to do with their health what they want to do, and the simple fact of the matter is that many people don’t feel like complying with physicians’ “orders” any more than many physicians feel like complying with “compliance” laws.

It’s simply a fact of free choice.

Just as I wasn’t surprised when, several years ago, a corpulent physician suggested that I eat a second lunch in the physician’s dining room at the hospital “because the food is free,” I’m not that surprised when a group of hospital administrators thinks that an obviously defective and illegal kickback scheme is a perfectly valid business model.

Free choice in structuring healthcare deals, just as free choice in having that fifth doughnut, falls on a risk-reward-punishment continuum.

What’s Sally’s (the wife and mother) health risk when faced with the question of second glazed or fourth jelly? What’s Sally’s (now at her desk as hospital CEO) risk when faced with the question of entering into an undocumented financial arrangement with a referring physician, thus implicating Stark and the Anti-Kickback Statute? What’s Sally’s sister Sarah’s risk when faced with the question of entering her medical group into a deal with pharmacy owners and investors to telephonically prescribe pain creams to patients on a one-off, transactional basis?

Pleasure/money now, with some risk of diabetes/debarrment/detainment far off in the future. Or, maybe not so far off.

The issue of risk isn’t just the cold calculation of the chance of getting caught. It’s that chance times the intensity of the punishment. A 5% chance of 10 years in prison is riskier than a 60% chance of a $50,000 civil monetary penalty and being forced into a Corporate Integrity Agreement.

Of course, the scale that we use to measure risk isn’t fixed either, and some put an extra finger or even two on the side of the scale marked “it won’t happen to me.” But, then again, we’re also free to fool ourselves.

How else can you explain deals gone awry such as these:

Sweet Dreams Nurse Anesthesia agreed to pay $1,034,416 to the U.S. government and $12,078.79 to the the State of Georgia to resolve allegations that it violated (due to underling AKS violations) the False Claims Act and the Georgia False Medicaid Claims Act.

Specifically, they were alleged to have entered into arrangements with ASCs to provide the facilities with free anesthesia drugs in exchange for exclusive anesthesia agreements. They were also alleged to have agreed, through an affiliate, to fund the construction of an ASC in exchange for contracts as the exclusive anesthesia provider at that and a number of other ASCs.

MediSys Health Network Inc., the owner of Jamaica Hospital Medical Center and Flushing Hospital and Medical Center, both in Queens, New York, agreed to pay $4 million to the U.S. government to settle allegations that it violated (due to underlying Stark Law violations) the False Claims Act by engaging in improper financial relationships with referring physicians.

Specifically they were alleged to have have submitted false claims to the Medicare program for services rendered to patients referred by physicians with whom the defendants had improper compensation and office lease arrangements.

So, strap on that Fitbit and have the glazed, or give free drugs to the ASC, or provide free office space to the cardiac surgery group.

Hey, it’s a free country. Just remember that you’re free to suffer the consequences, too.

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

www.advisorylawgroup.com

 

Nov 09

You Are Not A Service – Podcast

Running a hospital based group as “service” for the hospital, functioning as a sort of clearinghouse for income and expenses, severely limits your group’s future.

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Mark F. Weiss

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