It was a little after 4:00 a.m. as I left my driveway. Pitch black and raining. But from the moment I merged onto U.S. 101 heading south into Los Angeles to give a grand rounds presentation, there were other cars on the road. By 5:30 a.m., as I approached the major arteries of the L.A….
Group Therapy Needed to Protect Hospital-Based Physician Income?
Whether you are an anesthesiologist, radiologist, pathologist or emergency medicine physician, picture a meeting of your national specialty association. Chances are great that you’d hear voluminous hallway chatter bemoaning more work and lower collections, what I call an increasing Workload-Reimbursement Gap™. Chances are also great that you would hear next to nothing in the symposium presentations…
Exclusive Anesthesia Contracts Under Attack
Fear of rising healthcare costs is being used to attack exclusive anesthesia agreements. Similar arguments can be used to attack other service department agreements: exclusive radiology agreements, exclusive pathology agreements and exclusive emergency medicine agreements. The argument goes as follows: Hospital exclusive contracts are anticompetitive and therefore allow one group to control pricing. Hospital coverage stipends…
Tearing Up Your Exclusive Contract for Profit
If a hospital’s demands on your group have markedly changed but the compensation for your services has not kept pace with the market, it’s not only unfair, it’s immoral, that you continue to eat the burden. Proper planning at the time of exclusive contracting includes developing a strategy to terminate and addresses the issue of what…
Human Pack Behavior
Taken individually, a few dogs with mildly aggressive personalities is one thing; let them form a pack and the level of aggressiveness rises astronomically. We’re all familiar with pack behavior among animals, but are largely unaware of pack behavior among humans even though we encounter it regularly. The social psychology concept of “group polarization” describes…
The First Step
“Hi, my name is Dr. X and I’m a workaholic.” Actually, it’s usually much worse: Dr. X spends devotes his or her life to working in the production side of the practice (that is, on aspects related to patient care), which means that there’s no time left to devote to working on it. As a result, the Dr….
Ignoring the Perceived Bounds of Weakness
Wildebeest, travelling in a herd of 1.5 million animals, migrate annually across the Serengeti. Predators lurk. Their targets are not the strong or even the multitudes of animals pulling together with the pack. Rather, it’s the stragglers, the unfocused and the tired who become the easy pickings. We’re animals, too, and this same relationship of predator and…
In the Bureaucratic World
Just because your hospital based group operates within the bureaucratic world of the hospital does not mean that it must be bureaucratic itself. The trick is to operate an entrepreneurial entity partly within those bureaucratic bounds. I say “partly within” because the most successful groups move outward from there. It’s sometimes difficult for group leaders to…
“When Negotiations Begin”
Saying that you’ll consider the issues (or do the planning, or consider the options, or… “when negotiation with the hospital begins” misses the point entirely. The negotiation has already begun, you just don’t know it. It’s exactly on point with the observation about being at a poker table: “If you don’t know who the patsy is,…
Dogs and the Power of Observation
“From a dog’s point of view his master is an elongated and abnormally cunning dog.” – Mabel L. Robinson Why is it that dogs seem to immediately know someone’s intentions but that it takes us so much longer to figure them out? Perhaps we’re just as good as interpreting the situation but we’ve covered it…