Right Sized Group

Some see the future for hospital based groups in the context of large versus small, often stating that groups need to merge to achieve significant size or simply sell out to so-called national groups.  It not clear whether “sell out” means to be acquired or is simply a colloquial expression.

But large groups are like walruses in that when they get bigger they may more easily attract a mate, but what they gain in that respect is offset by the fact that growing too big makes them too slow to avoid predators.

The issue really is not large group vs. small — large does not equal better and small does not equal better; only better equals better.  The issue is what any group must do to increase the odds of its business success and relationship longevity, and that’s to create a unique experience, what I refer to as an “experience monopoly” tailored to each hospital that the group serves.

The “franchise operation” approach of large groups gives them an advantage in managing far flung outposts.  But that blessing is a curse in that they become too unwieldy and bureaucratic to ever truly deliver an experience monopoly.

At the same time, most small groups are too unstructured to provide it.

Groups of both sizes may be doomed.  Groups of both sizes may be successful.  Size in this instance doesn’t matter.  Better does.

Mark F. Weiss






Why Hospitals Don’t Want Employed Physicians to (Really) Succeed – Podcast

Hospitals are employing more physicians.  So why don’t they want them to become really successful?

Using (and Used By) Public Information

What do you know, really know, about the people you do business with?  For example, about your employees, subcontractors and the CEOs of the hospitals you deal with.

A few years ago a friend, let’s call him “C,” told me the following story:

C’s son, attending college in the East, was looking for a new roommate to share an apartment.  C’s friend said that his son attended the same university.

Instead of simply passing the kid’s name along to his son, C decided to do a bit of research first and, much to his amazement, found a treasure trove of information that, to say the least, disqualified the potential roommate, at least through a parent’s eyes.

Recently, the Wall Street Journal reported that some school admissions officers are using Facebook and other social media sites to discover information about applicants, searching for things which don’t match with the applicant’s statements made in the course of the admissions process.

Of course, this post isn’t about vetting roommates or potential students, it’s about gathering information in the context of your business dealings, where research of this sort is more than simply prudent, it’s required.

For individuals in general, this means you have to be careful about what you post on the Internet about yourself and about what is posted about you.  Of course, there’s a flip side to this:  you also have the ability to create your own “truth,” or mythology.

For physician group leaders, this means that you need to clearly vet, and regularly check, available public information about, and posted by, your group’s members.  You should also be checking the information that others have posted about your group.

And, extremely importantly, you need to develop a thorough knowledge base of your group’s business competitors and contracting/negotiating partners.  Even the smallest detail can often be used to your advantage.

Mark F. Weiss




Can You Flip The Switch – From Physician to Group Business Leader?

Top students quickly figure out that getting A’s requires delivering what the teacher is looking for, whether answers on tests or responses to questions asked aloud in class — they focus on the “correct” answer.

Setting aside the question of regurgitation versus critical thinking, top students focus on getting the answer right, on not making mistakes.

For physicians, as well as other professionals, that error-avoidance drive becomes hard coded into their careers.

But although risk avoidance and the focus on excellence serves you extremely well as a physician in terms of patient care, it hampers you in terms of group business success.

That’s because succeeding in business requires the exact opposite trait: the willingness to take risks and the understanding that risks unavoidably lead to mistakes. Those mistakes serve as the rocket fuel for learning what works and what doesn’t.

If you want to be a successful group business leader, you have to you learn to flip the switch: To compartmentalize your life into elements of both risk adverse clinician and as a failing forward faster entrepreneur.

Mark F. Weiss


Opportunities Knocking in Market Flux – Podcast

Let other physicians worry about surviving the down economy:  Take these steps now in order to thrive.

The Traitorous Healthcare Collaborator

We hear a lot about “healthcare collaboration” these days.  “Align with the hospital and make healthcare better and more affordable and better and more available and better, too!”

If you’re a frequent reader (see, for example, If Technology (and HIPAA) Drive Independent Healthcare Practice Why The Need For Physician Alignment, or The Problem of Perception – Healthcare Collaboration), you know that I see healthcare collaboration for what it really is:  a grab by hospitals for power and control.

“Healthcare collaboration,” as the term is used by its hospital-centric healthcare proponents, is a trope: a  figurative or metaphorical expression meant to transmit a condensed message.  The message they hope to get across is one of healthcare kumbaya in which doctors and nurses and pharmacists and respiratory technicians and all these other people who are giving wonderful caring help to so many sick people, work very closely with the hospital to deliver that care and never fight over the money.  Gee!

That’s a load of crap.

What the term really means is let the hospital hold all the money, let the hospital decide who gets to render the care, and let the hospital decide what those providers should be paid.

The choice of the term “healthcare collaboration” is ironic, in that the word “collaborator” has two meanings.  The scheme’s perpetrators see “collaborator” in the context of someone who works jointly on a project.

But recall that “collaborator” also means a traitor, someone who conspires with the enemy, as in “the healthcare collaborator was shot at dawn.”

Now before someone dashes off a nasty comment, I’m not suggesting that anyone actually be shot; I’m simply demonstrating the power of the trope as I urge you to use it:  “Don’t listen to Joe, he’s just a healthcare collaborator.”

Mark F. Weiss




The Tipping Point – Captive Medical Staffs and Loss of Accreditation

As a result of the prevailing trend of hospital-centric healthcare, in which more and more physicians are contracted with or employed by hospitals, the medical staff is quickly reaching a tipping point.

Soon, if it is not already taken place at your facility, a preponderance of medical staff members, or at least those who are active enough to vote and to serve in department and medical staff wide leadership roles, will be either employed by or otherwise dependent upon the good graces of hospital administration for their likelihood.

At that point, the medical staff will truly become what it has often been de facto, and that is a simple rubber stamp for hospital administration.

Consider the fact that the Joint Commission requires an independent medical staff.

Once the tipping point is reached is accreditation lost?

Mark F. Weiss



How a Hospital Based Group Can Profit From Problems – Podcast

Problems happen.  But when they do, turn them into profit.

If Technology (and HIPAA) Drive Independent Healthcare Practice, Why The Need For Physician “Alignment?”

30 years ago, in order to practice law on a sophisticated level, you needed to be part of a firm with its relatively large support staff. You dictated and your secretary either took shorthand or transcribed the tape, typing away at a typewriter.

Flash forward to today — I’m dictating this post into Evernote on my iPhone from home, will polish it on my notebook computer in an hour or two and then upload it to the web.  Gone is the need for a large support staff.  Gone is the need to be in the same location.

In even more striking technological fashion, the microchip revolution that took place in medicine over that same time period enables physicians in independent practices and far-flung locations to share healthcare information and deliver technologically advanced treatment.  This technological revolution enables the coordination of care across locations, providers, and facilities.

This, in fact, was the entire underpinning of the need for HIPAA:  Information was going to be shared electronically among various providers and entities; therefore, standards for sharing the data were required and data security and privacy protections were adopted to make sure that sharing would be secure.

Yet over the past several years the pressure’s been to amalgamate physicians, under the control of hospitals, purportedly to coordinate care.  That flies in the face of the technological advancement that has rendered superfluous the need for common ownership and close financial relationship.

So then why “physician alignment,” and “healthcare collaboration” in the form of hospital-centric healthcare?

The answer is clear:  money and control.

Mark F. Weiss





Is Your Group a Vendor or a Partner? – Podcast

If you want your group to have a future, stop being a vendor.