Group Culture Manage Your Practice Strategy The Business of Healthcare

How Not to Destroy Your Medical Group’s Ability to Compete

September 21, 2015

When my kids were small, they used to talk about their superpowers. They were convinced that they were real.

Your medical group may have a superpower, too. In fact, if it’s small to medium in size, say from 2 to 100 or so providers, you’ve certainly got one. It’s agility, the ability to make quick decisions and to quickly take action. In business, that is an actual superpower because it tremendously enhances your ability to compete.

Yet so many groups make their own Kryptonite: they shackle their agility with their consensus style decision making or other gummed up governance. Superpower (agility) plus Kryptonite (screwed up governance) equals a big fat zero. No more superpower.

Today, many small to medium size medical groups are in an existential battle. They may not realize it, but that doesn’t change the facts.

Other medical groups, from those across town to large regional and national groups want your hospital and referral relationships. Even hospitals have become competitors: they want to hire your providers and dash your existence as a separate entity.

In his book, The War of The Flea, the seminal work on guerrilla warfare, Robert Taber wrote about how a small band of guerrilla fighters could emerge victorious in a conflict with a larger, well organized enemy.

“Analogically, the guerrilla fights the war of the flea, and his military enemy suffers the dog’s disadvantages: too much to defend; too small, ubiquitous, and agile an enemy to come to grips with.”

But a small, sloth-like force doesn’t have a chance.

Don’t destroy your superpower. Work on your governance structure so that the group can come to quick decisions about what action must be taken and then quickly implement those decisions. Elect or choose and then empower either a single leader or a very small board or management committee. Allow them the chance to succeed or fail. Don’t rush to replace them if at first they fail but then course correct. Of course, if the group’s owners don’t like the overall direction the leaders have them headed in, then replace the leader or board.

And no, there’s no guaranty except one: Continuing with a consensus style or fully participatory (non)governance structure will never allow you to succeed in this market.

A superpower is a terrible thing to waste.

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

Mark F. Weiss


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