Strategy The Business of Healthcare

The Promise-Delivery Gap

February 20, 2012

You’ve probably heard the admonition to under promise and over deliver.

But what happens if you habitually over promise and under deliver? And what if it’s a central part of your business plan?

It’s become painfully obvious to subsequently disgruntled medical staff members and to subsequently terminated senior hospital administrators that the so-called national anesthesia and national radiology groups are incredibly adept at promising the world, but they often deliver less than a few square yards. I call this The Promise-Delivery GapTM.

Take this recent example:

An all Board Certified, all M.D. anesthesiology group is locked in an RFP battle. The competition: a so-called anesthesia management company, with no existing physician or CRNA personnel available, but full of promises – world class this, best-practices that, and outstanding providers, too! All that they were missing, in their viewpoint, was the demand for any stipend support, which of course clinched the deal for them.

So far so good.

A few months into the new contract the hospital was in disarray. Their Medicare certification was lost, but then regained. A rotating crop of locums providers passed through the facility — few of them stuck around or were even asked to. The hospital’s new cardiac program, on which it spent millions recruiting a new surgical team and building out its facility, wasn’t able to function due to the lack of cardiac anesthesia coverage – it took almost 6 months to do their first cardiac case.

And, the senior administrator who championed bringing in the new group due to the supposed cost savings that would result suddenly departed — the spin: that she had left to pursue other opportunities; the reality appears to be far different.

This is the central weakness of the so-called national groups. All image, but little substance. All hat, but no cattle. All promise, but little delivery.

Take advantage of it.

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