Bureaucracy: From French, meaning the rule of the desk or office.
Physicians practice in a bureaucratic world - a few examples: The bureaucracy of the hospital. The bureaucracy of Medicare and Medicaid and of commercial payors. The bureaucracy of Stark, the federal antikickback law and of their state counterparts. The bureaucracy of licensing and enforcement authorities and of specialty boards.
Bureaucrats are like critics in that they may be able to tell you what's wrong but they can't create or perform themselves. They're largely useless, their main directive being to preserve their power.
In prior issues of the E-Alert
as well as in other publications
, I've written extensively on the need for medical groups to break out from being viewed as commodity providers . . . to develop experience monopolies
in which you are viewed by patients, referral sources and facilities as the sole provider of a unique experience, one that cannot be duplicated.
One of the keys to accomplishing this is to understand that just because your group operates within a bureaucratic world does not mean that it must be bureaucratic itself.
The trick is to operate as an entrepreneurial entity partly within those bureaucratic bounds.
I say "partly within" because there is, unfortunately, no way to completely escape from the bureaucratic world of medicine. Even those groups practicing concierge medicine need to toe the line in regard to compliance and licensing bureaucracies.
But "partly within" indicates that there's a "partly without" -- the entrepreneurial world in which your group views itself as flexible, as existing outside the bounds of what has gone on in the past, as being focused on ways to distinguish itself, and as being able to profit from it.
Without this entrepreneurial mindset your group might survive for years but it will never reach its maximum potential, no matter how measured. But with the entrepreneurial mindset, relationships within the group, between the group and other physicians, between the group and its patients, and between the group and facilities and other third parties, are no longer simply subject to the old limits of bureaucratic rule. Those rules can, in many cases, be broken to your great benefit.
The key is in understanding how the various elements of your group's business interrelate and how they, and their legal and structural underpinnings, can be profitably exploited.
In working with clients on this break from bureaucracy, especially in the course of The Strategic Group Process
™, it's obvious that they often need new goggles, so to speak, in order to perceive that that hospital's or the medical staff's or another of these bureaucracy's "bureaucratic web" is not a safety net; rather, it's a spider's web.
If you're not the spider, that's a dangerous place to be.
Let us know if we can help you break free.