ADVISORY e-ALERT     April 28, 2009
Advisory Law Group, a Professional Corporation
Who's your real competitor?


When I ask potential clients this question, the answer is often the name of one or two competing groups or of a few individual physicians.  Sometimes it just draws a blank -- he or she just doesn't know who the competitors are.


In truth, the question is a bit of a ruse, because no matter what the response, it's highly unlikely, until now that is, that anyone would give me an answer of the type I've been looking for.


I'm not looking for a radiology group to give me a list of other radiologists or for an orthopedic surgeon to let me know the names of the other surgeons in his community


Rather, from my perspective, a well run medical group doesn't consider other groups within their specialty to be their competitors:  A superior level of medical skills, what many consider to be the determining factor in their practice's competitive advantage, is, in my world view, simply the price of admission.  Without superior medical skills you aren't even going to be invited to the table; but even if you have them, they are nothing that is going to lead to breakthrough success. 


Instead, groups seeking a transformationally better future need to focus beyond the medical service they provide to the entire experience offered to their patients, to their referral sources and to the facilities at which they practice, because experience, especially in a world in which individuals are more frequently distanced from one another by way of technology, is what people crave. 


The response that I'm looking for when I ask prospective clients to tell me whom their competitors are is "Ritz Carlton" or "Four Seasons" or something similar.  There are thousands of hotels and dozens of hotel chains.  Many provide clean rooms and perfectly acceptable, even well above average, amenities, but few are in a class by themselves.  The Ritz doesn't provide a room - it provides an experience, in competition with other superlative experiences outside of the "hotel" business. 


You're an anesthesiologist.  You're a radiologist.  You're an E.R. doc.  But your competitor is the Ritz. 


What is your practice doing to provide this same level of experience?  What standards have you enacted?  How do you measure your performance?  How does your governance structure allow for this to be accomplished?  How do you incentivize, and disincentivize, your employed or subcontracted physicians in this regard?

Contact Mark F. Weiss for more information.

How much money is your practice leaving on the table every day?
What percentage of your practice's business consists of managed care, PPO and other negotiated rate services?
How long have those contracts been in place?
When was the last time you visited the issue of reimbursement?
Physician practices and third party payor agreements are an interesting combination:  Sometimes agreements are hardly read but readily signed.  In other cases, payor agreements are hotly negotiated.  Nonetheless, almost all fall victim to the "moving target syndrome" imposed by agreement provisions that permit the payor to effectively amend the deal by way of unilateral changes in "policy," which, once made, are largely forgotten even if the impact of the "policy" change is a dramatic reduction in reimbursement. 
When you add the impact of these deemed amendments to the fact that market driven rates may have dramatically increased over the years since the contract was signed, there's a high probability that significant money has been left on the table -- it's a certainty that the loss will continue unless and until you resolve to stop it. 
The first step in this process is to embark upon a review of every managed care, PPO and other negotiated rate agreement to which you are a party.  This involves much more that a rate review -- it's essential that the terms of the agreement also be reviewed to discover the entire impact of the contract on your practice.
Someone is making money on the deal.  Increase the chances that it's you.
Contact Mark F. Weiss for more information. 


Mark's writing has recently been featured in:
Anesthesiology News, March 2009:  More Monkey Business - Response to Letter to the Editor in connection with my article, Establish Surgeon Support Without the Monkey Business.  [To view the response on the Anesthesiology News site, click here, free registration required]., April 24, 2009:  The Profit Center: Part 2 -- Crafting effective employment contracts. [To view the article on the site, click here, free registration required.], March 31, 2009:  The Profit Center: Part 2 -- Steering clear of Stark and false claims allegations. [To view the article on the site, click here, free registration required.]
These articles will be available soon on our website.  Until then, if you would like a copy sent via email, please contact us at:


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The materials presented in this Advisory e-Alert are educational only and are neither legal advice nor a substitute for it. Advisory e-Alert presents a general discussion which may or may not apply to your particular legal or factual circumstances. The distribution of Advisory e-Alert is not intended to create, nor does it create, an attorney-client relationship. Please do not send us confidential information without receiving explicit authorization from Advisory Law Group to do so. Do not take or avoid taking any action as a result of the materials presented in this e-Alert without first obtaining legal counsel.   
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In This Issue
Who Is YOUR Competition?
(Almost) Free Money
Videocast: Attention - Paging Dr. Wouldacouldashoulda
Recently Published Articles
The e-Alert Archive
Repeat of Popular Free Seminar
How 20 Minutes Can Change Your Life
Mentor Program
The Wisdom. Applied. Blog


MAY 20, 2009
3:00 p.m. PDT/6:00 p.m. EDT
Approximately 30 Minutes in Length 

In order to allow those who had trouble calling in to the crowded conference line last month, we're repeating the presentation of Positioning Your Group. 

Obtaining a highly favorable exclusive contract or other long term agreement with a hospital requires far more than engaging in the face-to-face phase of negotiation:  You must carefully position your group and the story of the benefit it provides to the facility.

Film stars groom their image as much as, or even more, than their skills -- after all, far more talented actors are waiting tables. 
Hear Mark explain why your group's image is vital to its relationship with facilities and learn about telling the better story.
May 20, 2009 at 3:00 p.m. PDT/6:00 p.m. EDT.
Enroll in this free teleseminar by May 15, 2009 by sending an email to
Prepare to re-wire the entire way that you think of, and execute, the contracting process -- what negotiation is and how it's conducted. 
Listen in by way of conference call as Mark explains, though a powerful story and examples, this new insight.
Due to the nature of this information, participation in this teleconference is open only to clients of the firm and, upon application, to limited others only.
Cost:  $497 per location
Date:  June 3, 2009
Time:  3:00 PDT/5:00 CDT/6:00 EDT - Approximately 20 minutes in length.
The deadline for registration is May 29, 2009.  Applications from non-clients must be received by May 26, 2009 for consideration.
Contact for information and for an application.
Mark's mentor program, the Advisor Program, is designed to provide an extremely high level of personal guidance for solo physicians, including those just completing their residencies, as well as for physician group leaders. Its focus is on personal career guidance and on leadership skills, not projects.
Admission to the program is upon application only - space is highly limited.  If there is no space available, you will be placed on the waiting list.
For more information on the program, click on the following link:  The Advisor Program
The Wisdom. Applied. Blog
Can't get enough free advice? 
Read Mark's new blog, containing frequently updated mini-articles on issues relating to the business of healthcare.
The Wisdom. Applied. Blog appears on ALG's website. 
Read it ... often!
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