Midday on the Serengeti, the cheetah softly approaches the herd of gazelle. She stops and waits. She watches the gazelles' movements, sighting an older straggler here, a younger one there.
Sensing her approach, the herd begins to run. Quickly springing forward, the cheetah aims for the older, slower gazelle closest to her -- within 15 to 20 seconds, the gazelle will be brought down or the cheetah will abruptly end the chase and search for other prey.
Midday at St. John's Community Hospital, the CEO, Jonathan Crump, leans back in his chair and ponders the roster of your group's shareholders. Slowly his eyes move down the page to the name "Dr. Smith," who's been with the group for 30 years, never in a position of leadership. He circles it with a red pencil.
Moving further down on the list, he does the same for "Dr. Jones," who's been with the group for four years, a shareholder for the past two.
Picking up his phone, Crump tells his assistant, "Please set up two appointments. I'd like to meet with Dr. Smith sometime Tuesday afternoon and with Dr. Jones on Thursday or Friday."
Three weeks later, you're chairing the meeting of your group's shareholders, discussing strategy in connection with the upcoming exclusive contract negotiations.
Dr. Smith, who rarely speaks up at group meetings, cautions that the group shouldn't push so hard on the amount of stipend support because he's heard that the hospital's been receiving lots of inquiries from other groups. Smith's quiet for the rest of the meeting, but he is taking a lot of notes.
Dr. Jones mentions that he's heard that the hospital has serious questions about the group's leadership and that it might affect the group's ability to get the contract.
Jonathan Crump may be a hospital CEO, but at heart, he's a hardball negotiator with a cheetah's ability to stalk his prey.
And now he's created two double agents. One is afraid that he'll lose his position in the department and be considered too old by other potential employers regardless of the
niceties of age discrimination laws. The other is being stroked with smiles and pats on the back and visions of his future as tomorrow's leader.
The road to hospital-based group hell is truly paved with your own group members' emotions.
Hospital based groups rarely, if ever, lose their exclusive contracts due to poor medical performance. Instead, it's usually a political move or a financial one.
Importantly, the political issues which infect a group's contractual relationship with the hospital are often internal group issues as opposed to political attacks from physicians within other medical staff departments. But of those internal group issues, they could be true intergroup issues or seeded ones.
The first category would include a disgruntled group member who runs to the hospital CEO to complain about the group's compensation plan, thinking he can get the CEO to force better terms from the group -- the disgruntled member usually finds that he, just like everyone else in the group, soon ends up looking for a new job.
The second category includes a "seeded" issue, like those of Drs. Smith and Jones, whose neediness (one to remain employed and the other to become a leader) is a weapon in the hands of a CEO seeking to cause dissension within your group in order to obtain an advantage in negotiations, or even worse, to get rid of the group completely.
Many groups focus their exclusive contracting negotiations outward. Of course, that's required. But don't forget to focus inward as well.
Just as negotiation with the hospital takes place over an extended period of time - the entire course of your current contract term - so does the strategy in respect of your group's structure and members, including that in respect of guarding the herd against predators, like your Mr. Crump.
