The Four Circles

 

After having represented medical groups with a particular emphasis on hospital-based groups for 30 years, it has become strikingly clear that what distinguishes the most successful groups, the Strategic Groups, from the great majority of the mediocre.

In fact, I have come to realize that there is a way of ranking groups from the most reactive to the most strategic. I call this ranking The Four Circles™:

4circles

The Reactive Group

A group at the reactive level exhibits many of the following characteristics:

  • It exists only as a matter of convenience to further each of its individual physician’s goals.
  • It has little, if any, organizational structure beyond the rudiments required by law, and even those formalities are rarely followed.
  • The relationship among its members may or may not be civil but the mindset is definitely “what’s in it for me?” not “what’s in it for us?.”
  • The group is entirely reactive to its circumstances in respect of the hospital, competition, referral sources, and the medical staff.
  • Its sole purpose for existence is to provide services at a hospital — if that hospital no longer wanted to obtain those services from it, it would have no reason to exist.
  • Their services are completely commoditized.  There is virtually nothing that distinguishes their services from any other group of providers within their specialty.

The Group in Equilibrium

A group at the equilibrium level exhibits many of the following characteristics:

  • It exists primarily to further each of its individual physician’s goals although there is some understanding that they must band together as a group in order to compete – in essence, it is a “club” with members sharing at least one common goal:  keeping others out.
  • The group follows the minimum required formalities to protect its structure from legal attack.
  • The group members have more or less civil relationships among themselves.  They understanding, to a certain degree, that fulfilling their individual objectives requires that they align themselves with others.
  • The group engages in a low level of planning as to its very short term future, chiefly in respect of scheduling matters.  For the most part, it is reactive to all circumstances outside of its easily accomplishable, immediate concerns.
  • Its sole purpose for existence is to provide services at a hospital — if that hospital no longer wanted to obtain those services from it, it would have no reason to exist.
  • Their services are commoditized.  There is little that distinguishes their services from any other group of providers within their specialty.

The Focused Group

A group at the focused level exhibits many of the following characteristics:

  • It exists to further the group’s immediate and midterm goals although group members are also free to pursue their independent goals outside of the group.
  • The group follows the required formalities to protect its structure from legal attack.
  • The group members have good relationships among themselves, understanding that fulfilling their individual objectives requires that they align themselves with others.
  • The group engages in a high level of planning as to its short and medium term future, chiefly in respect of scheduling matters.  However, it remains chiefly reactive to all circumstances outside of its easily accomplishable, immediate concerns.
  • Its chief purpose for existence is to provide services at a hospital — if that hospital no longer wanted to obtain those services from it, it would have little reason to exist as its outside work is not sufficient to enable it to remain in business.
  • Their services are commoditized.  There is little that distinguishes their services from any other group of providers within their specialty.

The Strategic Group

A group at the strategic level exhibits many of the following characteristics:

  • It exists to further the group’s long term goals.
  • The group follows the required formalities to protect its structure from legal attack.
  • The group members have well developed, positive relationships among themselves, understanding that they will maximize their long term interests by maximizing the group’s long term interests.
  • The group engages in a high level of planning as to its short, medium and long term future.  Although it remains flexible in order to deal with the inevitable surprises, it actively strategizes and deploys tactics to influence its future.
  • Its chief purpose for existence is to develop its business for the profit of its owner physicians and, as such, does not see its existence as necessarily tied to the existence of its relationship at any particular hospital.
  • The way that their services are delivered is unique.  Although it may well be that there are many other providers of their specialty services within the area, the overall combination of the way that the group delivers those services and the experience that they provide to the facilities, to the other members of the medical staff, to their patients and to the community at large, has created an experience monopoly that competitors, even if they understood what was being provided, would not be able to duplicate it.

Where does your group fall on the continuum?

Mark F. Weiss

www.advisorylawgroup.com

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© 2009 Mark F. Weiss

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