The tides come in and out, ties get wider then narrower, then wider again, and society cycles round and round from an emphasis on, and worship of, rugged individualism, to an emphasis on, and lauding of, community and cooperation. I call this the "Me - We Cycle^TM."



Currently, society is heavily affected by "we" think, from notions of shared sacrifice, to paying your fair share, to "giving back."

Physicians are told that the future of healthcare is not in rugged individualism but, rather, in the "it takes a village" world.

Of course, not everyone in a society buys into the current stage of the Me - We Cycle and that's why trends eventually moderate and return toward the antipode. However, there are some who, while holding a view closer to the other extreme, understand that they can benefit from co-opting the current zeitgeist.

Thus, the move by hospitals to take advantage of "we" think.

As the current wave of collectivism shapes trends in healthcare, hospitals seek to ride the wave to further their own "me" interests: Witness the completely hospital-centric notions of Accountable Care Organizations, healthcare collaboration, and physician alignment.

Physician groups that want to survive the crush of the Me-We Cycle's current collectivist position need to focus attention both internally and externally.

Internally, you must take steps to ensure that your group is cohesive. Hospitals often use dissension within a group as both an excuse and a pathway to extend their tentacles of control.

Take, for example, an office practice group consisting of three physicians, one owner and two employees, with offices located adjacent to a hospital. The owner physician has held a medical directorship at the hospital for some time. One of the employed physicians becomes unhappy with his subordinate role, notwithstanding his subordinate skills, management style, and personality. Instead of striking out on his own, he approaches the hospital CEO who convinces the physician that it would be too expensive to start his own practice, but that if he could get the other employed doctor to join him, the hospital would "sponsor" their new practice via an existing controlled medical group. For all practical purposes, the hospital gained control of that practice and jettisoned its relationship with the original practice and its physician owner.

Among other essential steps, bringing cohesion to your group involves governance, ownership, and management issues, and it also involves weaving legal protections throughout your group's agreements. These are not individual efforts, they require careful strategy and woven execution.

Externally, you must take steps to stop or hinder the hospital's efforts to gain advantage through "collaboration." Seek alliances with similarly situated groups, explore ways of using the hospital's existing medical staff bylaws and political support within the medical staff to preserve physician control. To the extent that hospital efforts to "align" physicians are underway, use that process to argue for physician control of the resulting entities and arrangements. If your relationship with the hospital involves a contractual arrangement, build in restrictions and protective provisions, such as prohibitions on solicitation and fees for outplacement to the hospital.

Eventually, the Me-We Cycle will shift back the other way, but that may take decades. If you'd like to wait it out then you don't need to take action other than to learn the words "may I have my paycheck, please?"

If that's not the future you have envisioned for yourself, contact me today, and we'll get started.

*COMPLIMENTARY*

Not Much is Fair About Fair Market Value

The fair market valuation process is often unfair, blind to value and generally ignores the true market.   

And, that's not the worst part.

Now learn about its negative impact on physician compensation, group stipends and the ability to do real world deals.