Impending Death of Hospitals

Honey, I Shrunk the Hospital!

Have you heard the jokes about the incredible shrinking hospital in Decatur, Alabama?

Sure, they’re funny. But the reality isn’t a joke to hospitals. Instead, it’s just another interesting detour along the way to what that I’ve described as The Impending Death of Hospitals. If you haven’t yet read my book by that title, follow the link to download your complimentary copy, or visit Amazon to buy yours in print.

The future of healthcare doesn’t include hospitals as we know them today. Cases, care, and observation that can be performed or provided outside of the hospital will be provided “hospital free.” As technology advances the pace of the shift from hospitals to ASCs and other outpatient facilities, and to care at home, will advance, too. And, as it does, we’ll be saying “See ya later” to more and more hospitals.

I’ve written about hospitals closing. I’ve written about a 865-bed hospital being torn down to be replaced with a 70-bed facility.

And now, we have the incredible shrinking hospital.

According to a January 8, 2017, article by Evan Belanger of The Decatur Daily, Decatur Morgan Hospital is chopping off the top three floors of its five story south tower.

The hospital’s CEO is quoted as saying that the hospital’s haircut is part of their “right sizing” efforts. The soon to be missing three floors housed 100 patient beds, to be replaced with 35 beds in another area of the facility.

Perhaps their next facility will be bedless?

But then it will just be an ASC, which is my whole point: As hospitals become more like ASCs and other outpatient facilities, physician owned non-hospital ventures can become more like hospitals.

Brick and mortar doesn’t change thinking. Thinking changes brick and mortar. And, creates opportunities.

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Mark F. Weiss

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Focus on the Future

The Future of Hospital Care Isn’t in Hospitals. It’s Outside of Them.

New York City’s Mount Sinai Health System gets it. Will you?

As I’ve written over the past year (see my most recent book, The Impending Death of Hospitals — get your complimentary copy, here) the future of healthcare doesn’t include hospitals as we know them. Surgical cases will move to outpatient facilities and, if you’re a surgeon or an anesthesiologist/CRNA, you’d better prepare for that future now.

Witness Mount Sinai’s decision, announced late in May 2016, to plow under its 865-bed Mount Sinai Beth Israel hospital and replace it with a 70-bed facility.

And, just last week, it was reported that Mount Sinai’s Mobile Acute Care Team program, which delivers hospital-quality home care to patients at risk for readmission, has reduced readmissions, increased patient satisfaction, and cut costs by almost 20%.

Technology and innovative care are beginning to replace in-office physician care, in-hospital surgery, and in-hospital patient care. Sooner or later, hospitals will be small institutions for the most ill and, perhaps, the most indigent. Or, they will be parking lots.

As with any instance of creative destruction, the bad news for hospitals is good news for physicians and entrepreneurs willing to take the risk to play an oversized role in the future of healthcare.

Patients aren’t going away. It’s the locus of care that is changing. Be there or be square.

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

Mark F. Weiss

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Philosophy | Situation Transformer

Lewis and Clark on Medical Group – Hospital Deals

Lewis and Clark, yes, that Lewis and Clark, the explorers, can teach medical group leaders an important lesson in respect of negotiating with hospitials.

Journal Entry September 2, 1803

“Suppose it best to send out two or three men to engage some oxen or horses to assist us [in crossing the sandbar] obtain one horse and an ox, which enabled us very readily to get over . . . . paid the man his charge which was one dollar [that’s about $350 in today’s money]; the inhabitants who live near these [sand bars] live much by the distressed situation of the traveler, are generally lazy, charge extravagantly when they are called on for assistance and have no philanthropy or conscience.”

What’s the lesson?  You’ve got no room to bargain when the seller knows you need a horse.

Likewise, there’s no room to bargain when the hospital knows that your group’s continued existence depends on getting the deal.

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Mark F. Weiss

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Cohesive Group | The Business of Healthcare

The High Cost of So-Called National Anesthesia and Radiology Groups

A few days ago I heard another of what is becoming a familiar story.

A hospital had dumped its longstanding hospital-based contractor (this time an anesthesia group) in favor of a “national practice.”  The national practice presented well – lots of guys in nice suits and far better graphics on their presentation materials than the old group.  And the old group “cost” too much.

Of so the hospital thought.

But the suits were empty.  The national group wasn’t a group at all.  It was a staffing, or rather, a billing, service.  And it couldn’t or wouldn’t recruit to full strength.  The hospital’s business faltered, resulting in the loss of millions.

Flash forward to a few days ago.  Less than a year after it arrived, the national group has been given notice of termination.  The hospital’s CFO, who championed the cost savings, has been fired.

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

Mark F. Weiss

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