Sep 20 2018

Dr. Robot Will Cut You Now – Podcast

Back in the dark ages of medicine, I mean, in 2014, I wrote about competition from Dr. Nurses and Assistant Physicians. Now I’m writing about Dr. Robot. Same issue. Just on steroids.

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Mark F. Weiss

www.advisorylawgroup.com

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Sep 19 2018

Can Hospital Affiliated ASCs Survive? – Medical Group Minute Series

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.

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

Mark F. Weiss

www.advisorylawgroup.com

Sep 18 2018

Should You Really Be Recording Conversations With Your Attorney? – Success In Motion Series

Ride along with Mark as he talks about how the Michael Cohen/Donald Trump recording story applies to preserving your attorney-client privilege.

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Mark F. Weiss

www.advisorylawgroup.com

Sep 17 2018

Driverless Cars Might Not Crash But They Will Impact The Business Of Healthcare

I’m writing this on a Saturday, a couple of days before publication. I’m about to head off to meet with a futurist to brainstorm some ideas.

Speaking of the future, lots of people are talking about driverless cars.

Suppose those 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?

Assuming, and yes, it is a very big assumption, that driverless (that is, people programmed) cars might actually be safer than people driven cars, will there be fewer accidents? According to Centers for Disease Control data, in 2006, 3.2 million people received non-fatal injuries from auto accidents. And, according to a 2013 report from the Agency for Healthcare Research and Quality, auto accidents resulted in approximately 2.8 million emergency department visits in 2010, which was around 15% of total emergency department visits for injury that year.

What happens if that business (no, I’m not coldhearted, but I’m writing this for healthcare providers) goes away? What’s the impact on the number of emergency department physicians needed? What’s the impact on the amount of nurses needed? What’s the impact on the number of hospital beds needed? What’s the impact on the number of specialist consults and surgeries and physical therapy and on and on? What’s the loss to the bottom line?

Yes, I’m warming up for the discussion with the futurist. This part of the warm up fits well with my own “futuristic” work, my book, The Impending Death of Hospitals.

But this self-driving car trend and many others and the way they intersect help lubricate the mind and lubricate the discussions among medical group and other healthcare leaders in exploring alternative futures, futures into which you must project your practice or business. That is, unless you want a driverless car to drive you to the poorhouse.

What are you doing to envision your future?

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

Mark F. Weiss

www.advisorylawgroup.com

Sep 13 2018

A Naive Anti-Kickback Question Answered – Podcast

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

www.advisorylawgroup.com

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Sep 12 2018

Why You Must Understand the Intersection Of Incentives And Negotiation Strategy – Medical Group Minute Series

When most medical group leaders think about incentives, 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.

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

Mark F. Weiss

www.advisorylawgroup.com

Sep 11 2018

Not All Money Is Green: Don’t Confuse Hospital Loans With Stipends – Success In Motion Series

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.

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Mark F. Weiss

www.advisorylawgroup.com

Sep 10 2018

Hospital Divorces Anesthesia Group After 24 Years of Marriage

We still love you but, hey, we’re in love with someone else who spends less on clothes stipends.

When I was a kid growing up in Los Angeles, there was a television show that I loved to watch: the original Divorce Court. You see, at the time, California required grounds for divorce, and the show proffered up titillating tales of deceit. But just across the border in Nevada, one could quickly obtain “residency” and snip marital ties on a whim.

Just like a 1960’s Reno divorce,  last month, Olean (N.Y.) General Hospital announced that it was terminating its 24 year marriage to Southern Tier Anesthesiologists. Apparently, it was the “for richer or for poorer” part of the marital vows that pushed the hospital over the edge.

Yes, after 24 years of marriage, it was time for a change. Will the successor group be a “trophy wife” or bring staffing strife? Only time will tell.

Money talks.

According to a letter obtained by the Olean Times Herald, the hospital stated that Southern Tier’s bid for the renewal contract would have cost it too much: “. . . It is simply not feasible for [Olean General Hospital] to pay millions of dollars more than necessary over the life of the . . . contract.”

Of course, none of us are privy to the inside terms. Southern Tier claims to have done its best to meet any offer. But the hospital says there was a great gap. And, it’s reported that the hospital lost $3 million the previous year. How and why they lost it is anyone’s guess, but it’s unlikely that it was significantly due to Southern Tier’s contract.

The lesson for you: If you hold any hospital contract that pays you anything, you must constantly assess how to increase the value proposition. This is easily seen in the context of a hospital-based medical group stipend. But hospital-employed physicians generally are blind to the fact that the exact same concept applies to them.

We love you, but what have you done for us lately?

Again, we don’t have any specific facts, but query whether it was only an issue of money that led the hospital to take “bids” for Souther Tier’s anesthesia contract after a 24 year relationship.

The lesson for you: Despite all of the rainbows and unicorns talk about “alignment” and “valued partners,” hospitals view physicians, especially (anti-kickback statute alert!!) those who do not refer patients to them, as vendors: Cafeteria – check! Laundry service – check! Hospital-based medical group – check! Or, in the case of Southern Tier, uncheck!

Don’t take for granted that you won’t be unchecked as well.

You’re running a business, not supporting a hospital.

As much as you may love the idea that you’re “supporting the hospital,” take a bit of advice from polygamists: Spread the love around.

You never know when you’re going to be dumped even if you’ve done everything you possibly can to keep the love alive.

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

Mark F. Weiss

www.advisorylawgroup.com

Sep 06 2018

Direct Contracting – Part 2: Clear Your Mind of The Lies That Bind (Your Thinking) – Podcast

This podcast is the second in a series on direct contracting by physicians and medical groups. See Direct Contracting By Physicians and Medical Groups for the first post in the series.

Before we get too deep into the subject, let’s ask an epistemological question: If you saw one dead raccoon, does that mean that all raccoons are dead?

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Mark F. Weiss

www.advisorylawgroup.com

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Sep 05 2018

Putting A Limit On Your Obligation To Indemnify – Medical Group Minute Series

You might skip over indemnification provisions when negotiating a contract. You understand what they are. They’re just boilerplate, right? Wrong.

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

Mark F. Weiss

www.advisorylawgroup.com