Mar 05 2018

Take A Minute (Clinic) to Consider The Future of Your Medical Practice

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.

But, like it or not, the Minute Clinic and other variants of a consumer-friendly model are going to become an increasing part of the way healthcare is delivered in the U.S. And, they’re going to become an increasing force as the gateway to physicians (especially to specialists), to facilities, and to ancillary service providers.

The reality is that that’s the future. The question is whether you’re going to attempt to stop it or whether you’re going to do something to align your practice and the way it operates with that type of future.

Note that I don’t mean that you have to align with CVS (or any other drug store chain) in particular. I’m simply using CVS as an example, but with its coming combination with Aetna, expect that they’ll be pushing hard to assemble their own, integrated provider network in an attempt to crush competition from hospital-centric healthcare.

Instead, I’m urging that you pause to consider how the increasingly consumer friendly model will impact your practice. And, better yet, that you consider how you can participate, whether as a direct operator, a co-venturer, or simply as a referral-receiving provider, in the future of the retail healthcare market.

When you’re doing this thinking, consider that there’s no one, single model. The concept isn’t limited to the in-retail-store model. It’s as varied as app-based portals, to walk-in clinics, to “surgery center centers of excellence,” to wellness centers, and on and on.

I’m sure that carriage manufacturers took one look at the Model T and thought “we should pass laws to keep these things off the road.” But saying that, or even screaming that, didn’t stop cars from running over their business.

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

Mark F. Weiss


Mar 01 2018

Why You Must Know How Framing Changes Value – Podcast

I’m going to share a secret with you today. There’s no such thing as value. At least not in the fixed sense. In fact, value is as malleable as clay.

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Mark F. Weiss


Feb 28 2018

Rebroadcast: How Are Your Services Valued? – Medical Group Minute

It’s not just the delivery of medical care that determines the value that your medical practice or group delivers. It’s all of the “soft” stuff as well — in fact, the so-called soft stuff is a larger factor than groups generally acknowledge. Very few groups reward their physicians for it.

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Mark F. Weiss

Feb 27 2018

Are You Playing The Long Game? – Success In Motion Series

Ride along with Mark as he discusses why physicians and medical groups must play the long game in terms of strategy.

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Mark F. Weiss

Feb 26 2018

CVS, Aetna and Your Practice

The Wall Street Journal portrays it as causing panic in the streets.

I’m taking about the pending acquisition of Aetna by CVS Healthcare. It’s stoking fear of the combination of a ubiquitous retail delivery platform, CVS, with the health insurance, managed care, and huge patient database of Aetna. More traditional health insurers and large scale pharmacies are afraid that their days are numbered.

But there’s another lesson here for physician practices, and it’s not directly related to either CVS or Aetna. Instead, it’s something that I touched on before on the blog in the post The Pharmacy Will See Your Patients Now, which discussed the fact that pharmacies are beginning to encroach on physician practice.

Healthcare is increasingly becoming less “silo-ized.” The pretty and neat silos of the pharmacy, insurance company, hospital, medical practice, and so on – the walls between types of entities, organizations, silos have been breaking down over time. And, the walls between healthcare entities and other retail business, too, have become permeable.

Over many decades, retail pharmacies morphed into convenience stores and more recently into platforms for employment of, or collaboration with, physicians, PAs, and nurse practitioners. So, too, have physicians morphed into pharmacies, either via direct ownership or direct dispensing. And, of course, physician practices and medical groups have morphed into retail care – the walk in clinic, the urgent care facility, and, in some states, the freestanding E.R.

The opportunity for physicians and other players smaller than the CVSs of the world is to understand that the membranes between types of organizations and types of professions which were completely impermeable are not only now becoming semi-permeable, they’re becoming almost completely permeable.

The question to ask is how can you take advantage of that in your own business structure.

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Mark F. Weiss


Feb 22 2018

Disruptive Physician or Nonconformist Medical Group Asset? – Podcast

Disruptive physicians. But what if the physician isn’t actually disruptive, but simply nonconformist or challenging?

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Mark F. Weiss


Feb 21 2018

This Robot Can Change Your Future – Medical Group Minute

Robby the Robot. No, not a Da Vinci, but a robot just the same. And, fully functional.

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Mark F. Weiss

Feb 20 2018

Hospital Closures Drive Change and Physician Led ASC Opportunity – Success In Motion Series

Over the past few years, 83 rural hospitals have closed. Mark discusses why, although each disrupted employees and the physicians on staff, hospital closures present opportunity for entrepreneurial physicians.

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Mark F. Weiss

Feb 19 2018

More Bites From The Flea That (Metaphorically) Killed The Medical Center CEO

Last May, in my post, What You Need To Know About The Flea That (Metaphorically) Killed The Medical Center CEO, I wrote about 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. Just as no vote was required for a dictator like Casto to take over Cuba, no medical staff vote, no survey by Press Ganey, no long and drawn out process among “stakeholders,” is required to topple the status quo.

The example used in the original post was the dramatic end of the rather short tenure of Sheldon Retchin, M.D. as CEO of Ohio State University’s Wexner Medical Center. Dr. Retchin’s downfall was triggered by two letters of “no confidence” signed by no more than 37 out of the 1,200 physicians employed at OSU Wexner. Yes, 3% of the medical staff was able to unseat the king.

And, now, not quite a year later, at least 10 highly placed physicians leaders and executives have chosen to leave OSU Wexner due to what has been said is its inability to address necessary cultural changes.

The lesson gleaned in the original post was that what you think is permanent is only temporary. How temporary is the question.

What you do, and how you do it, within your organization, and how you project it to essential third parties (e.g., hospital-based medical group to hospital) is all-important in maintaining relationships, contracts, and even existence.

And, just the same, from the perspective of the individual, the small, the “out group,” the “flea,” a steadfast, vocal, and somewhat intransigent minority, can kill the dog. The large group can be made irrelevant. The hospital CEO can be forced out. The small organization can ingest the larger. Yes, the dog bites back. No win is guaranteed.

But, there’s another way, too, of looking at the entire string of events at, just as an avatar, OSU Wexner.

We tend to think that history played out in some determinative way. That some war was won, or a corporate valuation achieved, or a medical system empire created due to the greatness of the leader, the supreme skills involved, and the predestiny of the outcome. But that’s a lie we tell ourselves. History observed is simply the remnant of alternative historical paths that are not capable of observation (at least by us) and a great deal of randomness. Small events, small changes, can, and do, knock what is, and therefore, what might be, off course, or on course, depending on your scoring system.

The mistake we make is to assume that what is will always be and then either place all of our bets on it, or believe that it’s futile to bet against it.

Yes, overall, things including organizations that have existed for a long time are more likely to continue to exist when compared with things that have just come into existence. That may be the way to bet. But the bet has to be hedged. Roman Empire, anyone?

In the original “flea” post, the “takeaway” was that the few can make the mighty fall, and fall hard. That if you’re the mighty (the dog in the flea example) watch out for the few, for the flea. And, alternatively, that you can be the flea. That lesson still stands, as valid as ever.

In this post, I’m suggesting another, complementary point: That even if you’re neither the dog nor the flea, the situation that you think exists may simply and immediately stop, or simply and slowly morph into something unacceptable. The question is, how are you going to hedge your bet that the situation will continue in a fashion acceptable to you?

The physician leaders and executives who left OSU Wexner had a hedge: The ability to jump to other positions, in some cases reported to be on much improved financial terms.

What’s your medical group’s hedge? What’s your personal hedge?

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Mark F. Weiss


Feb 15 2018

Payor Agreements and Hidden False Claims Act and Criminal Traps – Podcast

Criminal and, at least, serious civil, liability lurks in many neat neighborhoods. Create your own neighborhood watch to make sure that it’s not lurking behind your medical group’s otherwise metaphorical neat lawn.

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Mark F. Weiss