Videocasts


Some hospital attorneys and, therefore, some hospital administrators, believe that every contract for professional services should be subjects to a request for proposal (RFP) process. That's ridicules.
Ride along with Mark as he discusses the best way to deal with disruptive employees. 
Hospitals are employing more physicians. So why don't they want them to become really successful? 
Take a seat and ride a long as Mark discusses using the concept of "Future You" when Structuring medical group and physician contracts and business relationships. 
Alchemists struggled without success for centuries attempting to turn lead into gold
Ride along with Mark as he discusses why medical groups shoot themselves in the compliance foot by shooting the messenger - the bearer of "compliance" bad news.
Hospitals purchased physician practices, employed and otherwise aligned physicians, and pushed into outpatient care.
Ride along with Mark as he discusses a little-known reason to have a strongly worded confidentiality provision in any contract between a hospital and a medical group. This is important for hospital-based physician groups with exclusive contracts, as well as for the office-based practices with the hospital contracts.
Creative destruction is taking aim directly at community hospitals. You can fight to save them, But if they've failed, you can, á la Shumpeter (and Weiss), take part in creating, phoenix-like, far more appropriate healthcare solutions for your community and for your profit.
Ride along with Mark as he discuses the parallels between the Industrial Revolution, the bespoke customization of bike farms, and modern medical practice: more patients and a transformational experience.
As more physicians rush to invest in ASCs, unscrupulous facility promoters/managers scheme to separate physician investors from their money.
We're aware of the push for greater efficiency in healthcare. Unfortunately, doing the absolute wrong thing the right way is incredibly efficient.  
Like a dry cleaner, healthcare providers have to screw up to lose a customer's loyalty.
Ride along, if you dare, while Mark waxes political on what a permanent government shut down as to "nonessential" regulation writers might mean for healthcare.
How many times and for how long do you think a Broadway actor prepares for his first performance, or even for subsequent performances?
Ride along with Mark as he discusses two examples of false bilateral choices for physicians and medical groups prevalent in healthcare thinking today.
In a quote qualitatively to "my dog ate my homework," a hospital CEO blamed an "aggressive, direct competitor" for the downturn in his facility's patient volume.
LIFO and FIFO are inventory concepts. But they apply to the quandary of which physicians would be let go if case volume drops precipitously. This is a pressing issue for hospital-based groups as hospitals shrink and close. The time to plan is well ahead of the time, if ever, to implement. 
Someone at a conference once asked me what's the biggest mistake medical group leaders make. That's easy, I told him, it's not engaging me to represent them.

He told me to get serious. I told him that I was. So, he asked me what's the second biggest mistake.
Take a seat as Mark discusses the concept of antifragility as applied to your medical group and then shares a tool to achieve it.
The survey, conducted annually by the data technology firm Geneia, found that 87% of surveyed physicians say that it's increasingly harder to spend time in an honest, engaged patient encounter, and that they're personally at risk of burnout.
Ride along with Mark as he discusses why your medical group needs an underlying purpose. Like life without an underlying philosophy, business without a purpose is simply giving in to the default position. 
How many compliance related crimes have you or your colleagues or employees committed today, whether purposefully or, completely inadvertently?
How To Expand Your Years Of Active Practice And Profit

How To Expand Your Years Of Active Practice And Prof

On the one hand, it's said that many physicians don't want other physicians to "profit" off to their work. Yet, at the same time, the great majority of physicians leaving training see a career in which they will never become practice owners. Ride along with Mark as he discusses how you, as a physician group owner, can add years to your career and significant profit to your bottom line.

What’s your medical license worth? Charles R. Leach, M.D., who practiced for close to four decades, surrendered his. I assume that he’ll soon be surrendering his freedom, too.

Take a seat while Mark discusses a hospital's announcement that it's closing down its physician joint venture ASC. Was it really their decision? Or have the physician partners realized that they no longer need the hospital?
John Holland and William Moore, both former Tenet Healthcare hospital CEOs, are facing trial in a criminal case that alleges that they personally violated the federal Anti-Kickback Statute.

Ride along with Mark as he discusses the darkly humorous story of a forgotten patient locked in a physician’s office . . . and what it means for your business planning.

Suppose people who want to sell us driverless cars, or to force us into driverless cars, are right and that we'll all be driving in them. What's the impact on healthcare? What's the impact on your practice?
We hear about people being de-platformed by social media sites. But are you ready for when your medical practice or medical group is de-platformed in a far more destructive way? Ride along with Mark to hear the rest of the story.

Like a bear emerging from its long winter nap, the Federal Trade Commission is hungry to enforce antitrust law in the healthcare sector.
Ride along with Mark as he discusses the branding lessons taught by a $12 million stuffed shark. 

What does partnership mean in a medical group? What does it mean to you? What does it mean for your group? What does it mean if you are setting up a medical group?

Ride along with Mark as he fills you in on how a simple 2-cent card created loyalty that will drive many thousands of dollars in future business. Learn how the same psychology of small, personal touches can drive thousands to millions of dollars in business to you.

Ride along with Mark as he discusses the death of another small hospital system and how it can result in the birth of many physician-led ventures.
Many physicians bemoan the fact that we have retail, corporate run walk in clinics, such as the Minute Clinics run by CVS, staffed with nurse practitioners and PAs.
Ride along with Mark as he discusses how to think differently about healthcare venture formation. Stop thinking first about outside capital. This is healthcare collaboration in its true form.
On Thursday, June 28th, the DOJ and HHS announced the largest ever health care fraud enforcement action. It resulted in charges against 601 defendants across 58 federal districts, including 165 doctors, nurses and other licensed medical professionals, for their alleged participation in health care fraud schemes involving more than $2 billion in false billings.
Take a seat and listen in as Mark discusses Walmart’s latest foray into healthcare via it’s Walmart Town Center concept.

The flashpoint is the defendants’ development of a competing ASC, Riverview Surgical Center. That’s the straightforward news. But, what’s really going on? And why should you, probably not a surgeon in Sioux City, care? Keep listening. It will become clear, really clear.

Ride along with Mark has he discusses the factory-like history of public education and its overlay with the factory-like hospital system model.
In your negotiations, are you letting the other side think that they won?
Ride along with Mark as he talks the true cause of physician dissatisfaction: Hospital-centric healthcare.
Yes, 4.89 billion reasons for you, if you are a physician who owns or is thinking about owning a surgery center (“ASC”). And, yes, each of them is green. Green as in a dollar bill.
Ride along with Mark as he talks about re-purposing closed hospitals into other healthcare facilities.
Cyber criminals pay far more for health data than for credit card or banking information. Don't inadvertently help them out while exposing yourself to, potentially, tens of thousands of HIPAA violations.
For years, hospitals have pushed to “align” physicians. Take a ride with Mark as he talks about a reversal in the trend: As what were hospital cases now flow out to independent ASCs, hospitals are begging to be aligned with physicians. But why allow a hospital to be a partner in your ASC deal?
Ride along with Mark as he discusses the recent indictment of a slew of doctors and pharmacists for pushing millions of oxycodone pills. But what’s great law enforcement has a chilling impact on the legitimate practice of pain medicine.
If you say that you're going to do something, do it! We can all apply this lesson in our businesses.
What are you incentivizing your employees or independent contractors to do? And what if those incentives are driving them to not do other things that are far more essential for your business? What if those incentives are driving them to do things that are clearly detrimental to your business? 
Ride along with Mark while he shares his thoughts on why huge hospital mergers, like the one just announced by Baylor Scott & White and the Memorial Hermann Health System, aren't good for anyone other than the executives who run them.
Lead, follow or get out of the way. I'm a strong proponent of the "strong leader" form of governance. True democracy doesn't work in business any more than it works in running a city, state or nation.
Ride along with Mark as he discusses the seeming acceleration of the speed at which hospitals and other healthcare facilities terminate physician and physician group contracts.
"Direct" is more of a mindset - it's the dematerialization of the payment intermediaries in connection with your design of a payment/delivery structure. Direct contracting can be used as a strategy to deflect the negotiating pressure of payors, especially down-stream middlemen such as IPAs and risk bearing medical groups.
Ride along while Mark discusses bloated hospital administrative bureaucracy and warns against adopting similar structures at physician-owned surgery centers, imaging facilities and other outpatient ventures.
When physicians think about allegations of kickbacks in the context of large insurers, it's generally related to how a carrier's internal "claims cops" have alleged that some physician or other provider engaged in a kickback scheme, obviating the payor's need to pay claims, or, even worse, supporting their demand for repayment. 
Ride along with Mark as he counsels you on telling yourself the truth about your current practice situation and finances, and suggests ways to break out of being a sacrificial animal for someone else's benefit.
You can see why it's so tempting for unscrupulous hospital CEOs to offer kickbacks to physicians.
Ride along with Mark as he counsels you on telling yourself the truth about your current practice situation and finances, and suggest ways to break out of being a sacrificial animal for someone else's benefit.
If a procedure can be performed outside of the hospital, it will be performed outside of the hospital. And, as technology and payor acceptance accelerate, more, even most, procedures will be performed outside of a hospital.
Ride along with Mark as he talks about how the Michael Cohen/Donald Trump recording story applies to preserving your attorney-client privilege.
When most medical group leaders think about incentive, it's usually in the context of structuring performance incentives for the group's physicians, or in the context of incentives that flow to the group; itself pursuant to contracts with payors or facilities.
Take a seat and listen as Mark warns that all money from hospitals to medical groups isn't actually "free." You may have to pay it back or go bankrupt.
You might skip over indemnification provisions when negotiating a contract. You understand what they are. They're just boilerplate, right? Wrong.
Ride along while Mark talks about the error of confusing the plan with the actual way a deal plays out.
Mark discusses the fact that trends, even those that seem modern, such as home delivery or fully prepared meals, are simply history repeating itself or, at least, rhyming. Understanding this facilitates your exploitation of trends in healthcare.
The NYC Taxi Comission is looking to force Uber, Lyft and other ridesharing businesses out of business through the imposition of a higher wage structure. Ride along s Mark discusses the fact that when businesses can't compete, they become big believers in regulation, just as in the ban on new physician-owned Medicare participating hospitals.
Mark discusses the importance of grooming your medical practice or healthcare business for sale, even if you don't intend to sell.
Meeting to meet is a bureaucrat's game, one that you don't play. Ride along as Mark discussed why you need to have a strategy, and more, in place before any meeting.
Many requests for proposal (RFPs) for physician services completely miss the point by laying out what is expected and setting out strict performance standards, such as "the contractor will cover 'X' sites from 7am to 7pm."

By doing so, they assume that they know the best way to provide the service. But by doing so, they force, or perhaps foolishly fool, potential medical groups to respond as if the requirements set forth in the RFP are actually optimal for the facility.
Ride along with Mark as he talks about the need to question numbers presented as facts in connection with healthcare investment opportunities.
Ride along with Mark as he comments on Google's revelation that they permitted app developers to access Gmail accounts. How safe is your email?
You know that I strongly believe that the future of hospitals isn't hospital, it's outpatient facilities. I'm not sure whether the folks at Banner Health read my book and (1) didn't believe it, or (2) decided to prove me wrong, but either way it just cost them $18.3 million.
Ride along with Mark as he tells you about free consulting services. No, not from him, but the kind that you may be giving away, especially via an RFP response.
Ride along with Mark as he tell you about free consulting services. No, not from him, but the kind that you may be giving away, especially vi an RFT response.
Ebay and Craigslist have disintermediated the classified section in the newspaper, which used to be the largest moneymaker in that business.  The newspaper as middleman has been put to bed for the last time. 

But in healthcare, middlemen abound. Hospital systems are middlemen for their controlled/employed physicians. Insurance companies, and even more so on steroids, IPAs and risk bearing medical groups are the middlemen between, largely, employers and their employees’ medical care.
Ebay and Craigslist have disintermediated the classified section in the newspaper, which used to be the largest moneymaker in that business. The newspaper as middleman has been put to bed for the last time.

But in healthcare, middlemen abound. 
The road for hospitals continues to head toward the cliff. Listen as Mark discusses a recent demonstration project/study revealing the patient tremendous benefits and cost savings of hospital care at home.
When I was 17 I worked at a McDonald's. The store was a franchise location. Franchise models exist in medicine as well as in hamburgers. For example, in the urgent care center market.
Ride along with Mark as he discusses how you must uncover and protect your medical practice’s or healthcare business’s hidden intellectual property.
Should non-taxpaying hospitals, the facilities that prefer to be known by the misnomer "not for profit," be able to gamble their tax free funds on venture capital investments?
Ride along with Mark as he discusses HIPPA, naïveté, and why your digitized data probably isn't as safe as you think it is.
Modern office machines, from copiers to printers to maybe even label makers have memory devices, and those devices may be chock full of protected health information.
Take a seat and listen in as Mark discusses the beauty of making a decision.

The large red machine lumbered forward from behind, lights flashing. A fire engine heading off to a fire.
As horrible as a fire is — the danger involved, the risk of loss to the home or business owner — there’s also an inherent opportunity: an opportunity to rebuild, to renovate, and to renew. The stories of the phoenix or of Noah and the flood.

Ride along with Mark as he discusses a way to focus your mind on building your practice

Physicians (and others) considering forming a Medicare certified ASC have to be very careful about not confusing the ASC entity’s purpose. 

If they do, they may not only blow the federal Anti-Kickback Statute (“AKS”) safe harbor on which they likely rely, they may destroy all of their Medicare claims by turning them into false claims.

Ride along as Mark discusses the flip side of the cosmetologist who opens a “medi-spa:” The expansion of medical practice beyond the traditional bounds of treatment into lifestyle.
In my previous video, What You Need To Know About The Flea That (Metaphorically) Killed The Medical Center CEO, I discussed 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.
Ride along with Mark as he discusses converting a closed or failing hospital into a surgery center or other outpatient facility.
Many say that the world is a tough place. Maybe it is, because it’s not just dog-eat-dog. It’s flea-kills-dog as well.
Join Mark in a discussion of the lesson learned from Starbuck’s “solution” to its customer service problems, a solution that created bigger problems. Learn how can you avoid the same fate.
A physician raises honest criticism or files a heartfelt complaint concerning another member of the medical staff or another member of her group. She’s fired.
Ride along well Mark discusses the expanding case involving Insys Therapeutics and kickbacks paid to induce prescription of its drug, Subsys.
Every business (yes, your medical group is a business) needs a streamlined way to make day to day management decisions. And, it cannot allow one or two or a few dissenters to hold the group back in the event of major action such as a sale or merger.
Ride along with Mark as he discusses the need to avoid the trap of viewing the reality of the business of medicine through a tightly focused lens, as if watching a live concert through the screen of your iPhone
Even Warren Buffet can’t get you this return: 420% over three years.
And, it’s 100% leveraged. OPM.
Well, not OPM as in “other people’s money,” but OPM as in “our public money.”
Take a seat while Mark discusses the payment crisis adding to hospitals’ woes. Patients, payors and physician owners are pulling and pushing cases out of hospitals to independent ASCs and other outpatient facilities. And now, payors are becoming increasing parsimonious with payments for hospital inpatient care.
Disruptive physicians. But what if the physician isn’t actually disruptive, but simply nonconformist or challenging?
Ride along with Mark as he discusses the more than 420% financial return to the government that’s fueling healthcare compliance investigations . . . and convictions.

Will today’s physicians soon be referred to as “human physicians” or “carbon-based docs” as opposed to the silicon-based kind? Paging Dr. Robot?

Ride along with Mark as he discusses how competing via providing free services, such as uncompensated medical directorships, or giving into a facility’s demand for free services, is a violation of the federal anti-kickback statute.

In the real world, your practice is worth only what a buyer, if one exists, will pay for your practice at the time you want to sell it.
Take a seat while Mark discusses the cure to the “tax” of inflation, cost of living (COLA) adjustments.
Patient satisfaction surveys are becoming a real part of reimbursement, driving a significant percentage of money.