ADVISORY e-ALERT     March 29, 2011 
Advisory Law Group, a Professional Corporation




It certainly appears as if hospital administrators across the country are suffering from a collective bout of dissociative personality disorder.
On the one hand, they are collectively spending countless millions of dollars attempting to sell physicians on closer collaboration through participation in their hospital-sponsored accountable care organizations.
On the other hand, they are increasingly using requests for proposals ("RFPs") to beat down the expectations and demands of physician groups in order to obtain more services for less, narrowly skirting or perhaps even violating the federal anti-kickback statute and its state law counterparts.
The combination of these trends creates a whipsaw effect on hospital campuses.
For office based physicians who think that the RFP phenomenon is limited to hospital based groups, they could not be more wrong.  Yes, it's true that the major focus of the weaponized RFP has naturally been anesthesia, radiology, pathology and emergency medicine groups because those groups commonly have a contract relationship with the facility.  However, the tactic is increasingly being applied to office practice physicians who hold medical directorships and similar service contracts, including contracts with surgeons and surgical groups in respect of specialty coverage arrangements such as trauma coverage.
With this in mind, surgeons and other office practice physicians should not be so keen to salivate to the bell of the hospital's RFP for whatever service department - the next ring of the bell may be tolling for you.
Even more important, office practice physicians miss the greater lesson of the RFP/physician collaboration polarity:  If a twenty year relationship between an anesthesia group and a hospital is no stronger than the paper it is written on, which is weaker than the paper on which an RFP is printed, then how strong can any physician's agreement with an ACO ever be, whether constructed as an employment agreement, a services contract or otherwise?
In synch with my Situation Transformer™ methodology, physicians, both office based and hospital based can find opportunity gold in the "mind-shaft" that hospital administrators have in store for you.
With enough time and effort, and I cannot emphasize strongly enough that significant time and effort are required in order to make a transformational difference, you can greatly increase the odds of averting an RFP or, if one is issued, of greater success in the RFP process.
This requires more than a day long "strategy session;" it requires the development of strategy on multiple levels and the strict deployment of tactics over an extended period of time.  It also requires steps to tighten the cooperation of the members of your group, without which your efforts are likely doomed to failure.
Contact Mark F. Weiss to begin the process.
The Situation Transformer™ Strategy and RFPs:  The RFP For Administrative Services.




All Things Personal


Driving home, I stop at a traffic signal.  A taxi pulls up in the lane to my left and then stops one car length down the street.


The taxi is an older Lincoln Town Car, driven by a disheveled looking guy, a former (still?) 60's hippie type.  The taxi has clearly seen better days, a dent here, a scratch there.


As it pulls to a stop, I can see its back bumper.  What really strikes me is the large black bumper sticker with block yellow letters that reads "Get in - Sit Down - Shut Up - HOLD ON."


I can't imagine a worse advertisement for the experience that a passenger can expect to receive from that cabbie.  And, how is he going to explain away that bumper sticker if he gets into an accident?  Why it's almost an admission of guilt.


Many medical groups present similar adverse signals every day, just not with bumper stickers.


They present disheveled images, in some cases physically but in most cases in the quality of their interactions with hospital administrators, referring physicians, other members of the medical staff, and support personnel.


A scowl here, a rude comment there, a bit-too-loud exchange in the hall, or even the failure to address an issue that you know is important to the hospital CEO; each is an event that carries a negative multiplier effect that comes home like a rocket powered boomerang when, for instance, there's an adverse patient care event or your exclusive contract is up for renewal.


There's an old saying that a happy customer may never recommend you, but an unhappy one will complain about you to ten people.  I suppose that same sort of thinking has me writing about this taxi and not the dozen or so other cabs that I see each workday.


It's time to peel off your bumper sticker.  Start peeling now. 





How to Shield Against "Weaponized" RFPs, published on on March 17, 2011. 
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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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All Things Personal
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Whether you're an anesthesiologist or another hospital based or office based physician, there's tremendous value waiting for you in your complimentary copy of Advisory Law Group's 2011 Anesthesia Business Update.

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You're a physician who wants to form a medical group and, among other things, subcontract with or employ other physicians, enter into exclusive contacts, obtain significant stipend support money, create related entities to increase protection and the like. And you want to come up to speed on all of this immediately.

Or, you're the new leader of an existing group with complex practice and business operations -- you need to understand how to master the group's organizational, operational and leadership issues -- and you need to be brought up to speed immediately.
After having regularly dealt for many years with physicians in both of these contexts, we've designed a process to deliver immediate results: The Immediate Leader Experience™.
The Immediate Leader Experience™ takes place over a weekend in Santa Barbara, California and includes two nights accommodation at the Four Seasons Santa Barbara Biltmore Hotel. 
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Due to the nature of this program, admission is upon interview only -- there is extremely limited availability.
For further information on The Immediate Leader Experience™ follow this link.  
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