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Running a hospital based group as “service” for the hospital, functioning as a sort of clearinghouse for income and expenses, severely limits your group’s future.

You Are Not A Service


You keep your medical skills up. It’s time that you focus on your sales skills as well. Why You’re Actually In Sales


Learn to protect negotiating positions and to use “informal” communication with administration proactively. Negotiation Rules: Hallway Chat = Boardroom Meeting


Medical group leaders are busy focusing on day to day activities: Most are deeply involved in direct patient care. Some, yes, some, also devote some time to working on their business. But there’s a pressing need to engage in strategy. And you have to address the tough issues, like governance, succession planning, compliance, expansion of your business, and many more.It’s Never The Right Time


Many medical group leaders bemoan their group’s circumstances: caught in the hard place between increasing commoditization, what they believe to be the limitations of independent structure, and the pressure of national group competition.   How to Cure Paralysis Over Your Future


“I can’t put it in the agreement, but trust me on this. You have my word.”  Those are famous words from a hospital CEO. And, maybe you can trust him. But can you trust his successor?  Why You Must Understand How Sky-High Hospital CEO Turnover Impacts Your Practice


Opportunity is a funny thing because it’s always there but isn’t usually seen. That’s because it’s hiding in the camouflage of everyday problems. Will the Lightbulb Go On For You?

Will today’s physicians soon be referred to as “human physicians” or “carbon-based docs” as opposed to the silicon-based kind? Paging Dr. Robot? The Rise of the Machines: Dr. Watson, Al and the Future of Your Medical Group

Robert Collier, one of the fathers of direct mail advertising, famously advised copywriters to enter the conversation already going on within the customer’s mind.  What A Long Dead Copywriter Knew About Medical Group Success

A magic show is about misdirection: that which is seen and that which isn’t seen.  Bastiat, A Teenage Magician and Medical Group Decision Making

Compliance – it’s the multi-zillion dollar reason why your medical group’s or healthcare business venture’s efforts must constantly be tested, reviewed, and retuned. Extrapolation: How the Government Turns One Alleged Bad Claim Into Thousands of Violations

Are your contract in line to be held hostage through collective bargaining? How to Avoid a Black Friday for Your Medical Group

RFPs can wear many faces, is it an organic, fictitious or fulcrum RFP? Find out which type you’re facing, and strategize your responseWeaponized RFPs – A Podcast

Are you planning for your ideal future reality, or focusing on slight incremental improvements? Mediocre Advancement or Transformational Improvement?

Strategic planning is the cornerstone of all businesses footed with longevity in mind. Are you skillfully navigating an ever changing world?  You Can Plan On This! 

Contracts exist so all the information can be located in one convenient place. - Contracts Needn’t Always Be Contracted

July 4th, Independence Day in the United States, celebrates the original 13 colonies’ declaration, in 1776, of their independence from Great Britain. -Your Independence Day

Seemingly discreet events in the life of running a medical group, are actually all related. - It’s All Related

It’s Friday night. After leaving the restaurant you turn onto the sidewalk and walk down the street. Ah, an art gallery! You wander inside. - Artists, Patient Satisfaction, And The Creation Of Something Out Of Nothing 

“When you have time to gripe, you have time to wipe. When you have time to lean, you have time to clean.” – When You Have Time To Gripe

I recently read an article about a physician who had sold his practice to a hospital. The physician was quoted as having stated that he had grown disenchanted with running the business end of his own practice, thus his agreement to “have my practice managed by” the hospital. – This Isn’t Medical Practice It’s Employment

Legend has it that it was a bottomless basket. As much tribute to the master as could be piled into it, the basket took more and more and more. – Beware Of The Open End

Letting each partner write his or her terms of partnership is not a long term strategy for success – I’m a Partner in The Group, So Leave Me Alone

Don’t worry, we’ll have your blog back up by 1:00 p.m. Pacific time on the 28th. Yet, as I’m writing this post on the morning of January 30, 2017, our blog is still down. Somehow, someplace within Network Solutions, which provides our webhosting, they disconnected our blog from the rest of our website. Oh, I mean from the entire internet. Listen to Do What You Say You're Going To Do.

I recently heard of a consumer survey done at a hotel in which it was found that the guests’ impressions of every factor tested for, the quality of the service, the attractiveness of the rooms, the cleanliness of the common areas, etc., depended upon their satisfaction with the hotel check-in experience. Listen to Yes, I Agree.

There was a time warp in the box from the garage. Listen to What The Time Warp Reveals About Healthcare Employment.

Let’s listen in to a series of calls from a potential deal partner to the office of the Smith and Jones Medical Group. Listen to The Fast And The Dead. 

Don’t get your medical group or healthcare business lost in big data. Listen to Speak Truth To Numbers. 

If yours is an average group, you’re doing more work for less pay. Listen to The (Not So) Obvious Alternative to Cutbacks. 

Hospitals that use RFPs and others fool’s tools in respect of physician relationships will surely suffer as fools in the end. Listen to RFP For Physician Services: Really Foolish Proposition.

Office-based specialists, from ENT’s to urologists, often enter into suite sharing arrangements. No problem! That is, until they make it one. Listen to Office Sharing: Turning Share Mates Into Cell Mates.

Properly done, medical group management is neither a collaborative nor a unanimous process. It is a leadership decision. Listen to Medical Group Management.

Most medical groups have a two-level physician engagement/compensation structure: owners and non-owners. Listen to An Alternative Structure For Medical Group Compensation. 

If, as I’ve written before and as we’re now beginning to see, a hospital need not have beds, then what’s the difference between a hospital (which physicians can’t develop as a Medicare facility) and an ASC? Listen to Bedless Hospitals And Physician Opportunities. 

Would you rather have one marshmallow now, or two tomorrow? Listen What A Marshmallow Says About Your Medical Group's Future.

It’s morning in a mall outside of a metro station in Washington, D.C. Josh, dressed in jeans, T-shirt and baseball hat, picks up his violin and begins to play. Classical music, some of the most complex and beautiful ever written for the instrument, floods the air. Listen to Why You Must Control The Context To Influence The Outcome.

Tom Peters popularized the style of business management in which the manager cruises the workplace observing and interacting. He referred to it as “management by wandering around.” Listen to Management By Wandering Around (Someone Else's Business). 

Want to make a deal?Sure you do. Perhaps it’s the renewal of an exclusive contract. Perhaps it’s an extension of your office lease. Perhaps it’s a rate increase in a payor agreement. Listen to Do They Have The Power To Say Yes? 

To paraphrase J.P. Morgan, we always have two reasons for doing anything: a good reason and the real reason. Listen to A Good Reason And The Real Reason To Avoid Physician Owned Hospitals. 

Medical groups,especially first generation medical groups, often suffer from a common management error: Their leaders or board members manage from the perspective of their individual personal success, not from the perspective of the group’s, that is, the business’, success and of its long-term future. Listen to Medical Group Management Error: Managing For Your Personal Gain. 

Compounding pharmaceuticals, specific drugs for specific patients, offers tremendous benefit. The problems arise when the benefit is for the prescribing physician. Then, we’re dealing with analyses under the federal Anti-Kickback Statute (AKS), the Stark Law, and their state law counterparts. Listen to Compounding The Kickback Problem. 

Many medical groups (actually, many of all sorts of businesses) shortchange their future as a result of their past. Listen to Why Your Past Doesn't Count. 

They say that beauty is in the eyes of the beholder. Listen to Why Document The Value Of A Group Member's Interest? 

A friend told me about his old boss, a guy who thought he was sending a message of his own importance by showing up late to meetings with his clients. Listen to Showing Up On Time and Negotiation.

I’m no enemy of fast food. I just don’t want to eat it. I don’t care if you do. I wouldn’t make it illegal. But some mayors would. Listen to Opting Out To Opt In For Yourself. 
Measurement of “care” will soon count for more than care itself. Listen to Bean Counters 1, Patients 0.  

They looked for a 16 cent phone charge.I know someone who runs an efficient business. Or so he tells me. Listen to Do You Measure Up Or Measure Down? Efficiency vs. Efficacy. 

How do you become a millionaire? Make a billion dollars and then buy an airline.” — Warren BuffettAmerican Airlines emerged from bankruptcy and merged with, well, actually into, US Airways. Listen to How To Become A Millionaire. 

You’ve heard that old expression to the effect that it’s better to do and then ask for forgiveness than it is to ask for permission in the first place.I’m not sure if that’s always right in a social setting, but in business it often works out in your favor. Listen to Why Taking Control Is A Smart Contracting Tactic. 

Here’s something you can absolutely plan on: most planning done by medical groups, especially that common variety, the “strategic planning retreat,” is a complete waste of time. Listen to Why You Shouldn't Waste Your Money Planning A "Strategic Planing" Retreat.  

Socialism is alive and well, and I’m not simply talking about the socialistic charade of Hugo Chavez. Listen to Socialism Is Alive And Well Within Medical Groups. 

It was 9:00 p.m. The restaurant was clearing out. I was eating alone after returning to the hotel following a meeting. Listen to Physician Talks Out Of His (not)Mouth - Brags Of Kickbacks.

1. Look before you leap. CHECK.2. Measure twice, cut once.  CHECK.3. Document your deal with your partners before commencing joint practice. WHAT? Listen to Look Before You Leap: Document Your Deal.

Anita Roddick, the late founder of the highly successful natural cosmetics chain, The Body Shop, which she sold to the cosmetic giant L’Oréal for $1.1 billion, was a tremendously driven entrepreneur and an extreme social and political activist. Listen to Department Of The Future. 

It’s hard enough to watch what you say when you’re speaking, but at least you’ve got inflection on your side. Listen to Do You Make This Mistake In English? 

My dog stood body frozen stiff yet ready to lunge. His eyes fixed on the only object in his world, the squirrel eating seeds off the ground 14 feet away. Listen to The Odds Of Medical Group Survival. 

It’s about 1 pm on Sunday and I’m thinking of getting a cheeseburger for lunch. But if I don’t, it won’t make any difference to me. Listen to Why Not Wanting The Deal Is The Way To Get It (Or, If Not, Who Cares!)
Why Not Wanting The Deal Is The Way To Get It (Or, If Not, Who Cares!)
July 4th, Independence Day in the United States, celebrates the original 13 colonies’ declaration, in 1776, of their independence from Great Britain. Listen to Your Independence Day. 

In 1919, New York hotelier Raymond Orteig announced the Orteig Prize: $25,000 to the first aviation team to fly nonstop between New York and Paris. Listen to It's Human Nature: Incentivizing Performance.

The first time that I saw a computer there were two in the room. One of them took up most of the south side of a floor of the Computer Science Building and the other took up most of the north side. Listen to Beware The Government-Hospital Complex.

Earlier this year, a Santa Clara County, California jury awarded the insurer Aetna a $37,452,199.00 judgment in a lawsuit against Bay Area Surgical Management, LLC, a surgery center management company, a number of its managed ASCs, and three of Bay Area’s executives. Listen to Aetna Obtains $37-plus Million Judgement Against ASC Manager.
Some leaders of hospital-based groups, and I use the term “leader” broadly, believe that their groups are a function of the hospital. If the hospital no longer wants to contract with them, then that would be it, they’d simply pull the plug on the group. Listen to Who Is Really In Charge Of Your Medical Group. 

You probably already know that it is my firm belief that hospitals, at least as we know them, are basically dead. They just don’t know it yet. What I mean is that the majority of surgery cases are going to be shifting out of hospitals. Listen to Thoughts On Surgery Center Development And Operations. 

Major League Baseball has an antitrust exemption. It also has a level playing field. The players, as employees, can collectively bargain. Listen to An Antitrust Exemption For Physicians.

When my kids were small, they used to talk about their super powers. They were convinced that they were real. Listen to How Not To Destroy Your Medical Group's Ability To Compete. 

Yes. Sure. Of course. How many times each day do you say one of those words? Listen to No, But Thank You.

I see too many deals that are hatched from the evil twins of self-inflicted human nature: fear and hope. Listen to Why Hope And Fear Drive (Stupid) Deals. 
It’s not just the delivery of medical care that determines the value that your medical practice or group delivers. It’s all of the “soft” stuff as well — in fact, the so-called soft stuff is a larger factor than groups generally acknowledge. Very few groups reward their physicians for it.
It’s not just the delivery of medical care that determines the value that your medical practice or group delivers. It’s all of the “soft” stuff as well — in fact, the so-called soft stuff is a larger factor than groups generally acknowledge. Very few groups reward their physicians for it.
It’s not just the delivery of medical care that determines the value that your medical practice or group delivers. It’s all of the “soft” stuff as well — in fact, the so-called soft stuff is a larger factor than groups generally acknowledge. Very few groups reward their physicians for it.

Trust is a rare commodity. Listen to More On Compensation Plans - Align Rewards With Required Efforts. 


Efficiency. Hospital administrators and other bureaucrats say that they want it. Medical group leaders parrot it. Listen to Do You Believe In The Myth Of Efficiency? We Aimed For The Wrong Thing, But We Scored A Bullseye!


Did you think the goal of negotiation is to be liked? Try galvanizing respect. Listen to Being Liked Is Not The Goal Of Negotiation


Have you heard the one about the man who doesn’t walk into the bar? Listen to You’re Dead. Now What? Succession and Medical Group Governance


Preparation. It doesn’t matter whether you’re grooming your practice or business for sale or grooming it to hold and grow. Listen to

You Need To Know Whether Your'e Grooming For Sale Or Grooming to Grow.

Obamacare provides health insurance coverage, but coverage is not access to care. For care, you need physicians and you need to be able to see a physician, the right one, when you require care. Listen to The Physician Assistant, No, I Mean Assistant Physician, Will See You Now

We usually think of nosocomial infection, one contracted from the environment or staff of a healthcare facility, in terms of the impact on patients. Listen to Nosocomial Infection Consumes Hospital! Stop The Spread To Your Practice.

It's not just the delivery of medical care that determines the value that your medical practice or group delivers. It's all of the "soft" stuff as well - in fact, the so-called soft stuff is a larger factor than groups generally acknowledge. Very few groups reward their physicians for it. Listen to How Are Your Services Valued?

I read an article in the Wall Street Journal reporting that more states are regulating Medi-Spa ownership and placing scope of practice restrictions on the procedures performed at those facilities. Listen to Mixed Message: Restricting Scope Of Practice At Medi-Spas, Increasing It Elsewhere

Growth. There's lots of talk about it. Listen to Growth for What's Sake?

We’ll begin boarding in a few minutes. Although airlines have a lot to learn about customer service, they do serve as a model for pricing strategy in healthcare. Listen to Flying First Class Medical Care.

I just read an article on Modern Healthcare’s website about balance billing in the out-of-network context. Listen to Bamboozled Over The “Cure” For Balance Billing.

Kodak was once the country’s leader in photography. Then along came both Fujifilm and digital photography. And bankruptcy. And a lesson for medical group leaders. Listen to A Clear Picture Of The Future of Medical Practice.


In my November 28, 2011, post, All Hospitals Should Be Physician Controlled, I discussed the fact that, as a result of society's current communal tide, the trend toward a "we" society, healthcare is becoming increasingly hospital-centric with looming negative impact.
Keeping that in mind, consider now that people, not institutions, are capable of morality. At best, institutions are amoral. At worst, they are immoral.
In my November 28, 2011, post, All Hospitals Should Be Physician Controlled, I discussed the fact that, as a result of society's current communal tide, the trend toward a "we" society, healthcare is becoming increasingly hospital-centric with looming negative impact.
Keeping that in mind, consider now that people, not institutions, are capable of morality. At best, institutions are amoral. At worst, they are immoral.It was June when I saw it. The boarded-up stores of Main Street, paved red with bricks and lost hope.
It was June when I saw it. The boarded-up stores of Main Street, paved red with bricks and lost hope.
When we think of risky behavior, we usually think of personal acts. Listen to Risky Behavior And Healthcare Businesses.

It was June when I saw it. The boarded-up stores of Main Street, paved red with bricks and lost hope. Listen to Audit Medical Group and Physician-Owned Facility Deals In Light of Tomorrow (and Today).

Are you a Chevy dealer or a doctor? Listen to Are You Selling Chevys? 

In my November 28, 2011 post, All Hospitals Should Be Physician Controlled, I discussed the fact that, as a result of society's current communal tide, the trend toward a "we" society, healthcare is becoming increasingly hospital-centric with looming negative impact.


Keeping that in mind, consider now that people, not institutions, are capable of morality. At best, institutions are amoral. At worst, they are immoral. Listen to 

Amorality Of Institutions – An Additional Argument For Physician Control Of Hospitals.


Where are the flying cars and the metal and glass houses, and the robots walking dogs? I was promised that future and it's not here and I'm mad as hell. Listen to 


Most of us seek comfort. We want the usual. Listen to Comfort Zone Or Continued Existence, Your Choice.

Speed and size are often an advantage, but in some situations, and in some markets, they're not. For medical groups, the current healthcare market is one of them. Listen to The Advantage Is To . . .

The hospital approaches you and says that they are building an ACO – won't you join with them and become an employee of their sponsored foundation or medical group? Listen to Picking Off The Fruits Of Your Success.

When I was 17 I worked at a McDonald's. The store was a franchise location. Franchise models exist in medicine as well as in hamburgers. For example, in the urgent care center market. Listen to Franchising As A Healthcare Business Model.

What good is an exclusive contract if the facility demands that it become non-exclusive? Listen to Your Exclusive Contract Is About To Be Non-Exclusive.

His comment still sticks in my craw. The so-called expert said something like, "In the new economy, physicians need to lower their income expectations." Why? Listen to

I know. In light of tons of illegal profits, complying with the federal anti-kickback law (“AKS”) is a hard sell. But, it’s easier than a prison cell. And better than paying a $125 million fine. Listen to Pills, Capsules, and Kickbacks: Drug Manufacturer Pays $125 Million. Execs and Docs Headed to Jail.

Years ago, one of my former partners had a case in which a stock broker built up a huge book of business, only to have his clients “reassigned” to a famous heavy-hitter at the firm that took over the brokerage. Listen to Why They Stole Your Business.


Speed kills. I read it on the message board that stretched across the lanes of the highway. (I suppose that reading message boards kills, too, but they aren’t advertising that.) Listen to Why Speed Saves.


You’re under competitive pressure, so why cut your own group off at its knees? Listen to How Not To Make This Governance Mistake.


Hospital based medical groups are often faced with a choice upon exclusive contract renewal: The expectation or demand on the part of the hospital that the group must provide its services, perhaps even at a higher level of intensity, for lower or no stipend support. Listen to An Exclusive Contract Renewal Choice: No Thank You.


A diamond and a rock, sitting side by side. Both discovered near the bottom of the Udachny diamond mine in the Sakha Republic region of Russia, one of the world’s ten deepest open-pit diamond mines. But are they of the same value? Listen to Do You Know This About Value?


Words matter. They are the bullets in the fight for public perception, in the battle for change. Listen to Isn’t It Time To Re-Brand Non-Profit Hospitals?


Earlier this year, a federal trial court in Idaho struck down, and ordered unwound, a hospital’s acquisition of a medical group on grounds that it violated antitrust law. Listen to The Antitrust Undoing Of A Medical Group Acquisition.


What does your ideal future look like? Listen to Your Ideal Future — What Does It Look Like?


I recently read an article about a woman bemoaning the fact that she had been “cheated,” as her investment in General Motors bonds was about to become worthless. The system had failed her, she cried. Listen to Bondholders, Docents and Hospital-Based Groups.


On a January day in 1493 off the coast of the island of Dominica, Christopher Columbus reported seeing three “mermaids” — in reality manatees. Columbus commented that in real life, mermaids were “not half as beautiful as they are painted.” Listen to Mermaids And Medical Groups.


If you attended my recent webinar, The Impending Death of Hospitals, you know that I firmly believe that healthcare delivery is shifting away from hospitals and their aligned physicians. In fact, the prognosis for hospitals, at least as we know them today, is guarded. Listen to Tenet Announces Major Joint Venture Expansion Outside of Acute Care Hospitals.


Bob, not his real name, was talking about one of his early post college jobs. Listen to Don’t Incentivize For What You Shouldn’t Get.


Many professionals, from architects to anesthesiologists, from structural engineers to surgeons, make the mistake of focusing solely on developing their skill sets and in delivering those skills to their customers, patients or clients. Listen to How Professional Expertise Can Become An Anchor, Not An Advantage.


Ever watch those old black and white B-movie Westerns? The bad guys would ride into town and rob the bank. “Hands up! Give us all the money!” And then off they’d ride carrying bags of cash. Listen to How To Prevent Your Medical Group From Getting Robbed Of Its Staff.


I’m simply reminding medical group leaders that you need to use the resources of your medical group’s members to advance the group’s strategy through everyday interactions with referral sources, hospital employees and patients. Listen to Keep On Message.


Your group has held the exclusive contract for your specialty services, for example anesthesiology or radiology, for decades, but now the hospital is holding an RFP. Listen to Every Day Is An Opportunity For An RFP Response.


Where’s your next meal coming from? Listen to Why A 59 Year Old Deli Is a Case Study For Your Medical Practice.


I recently read that taken together, the value of all airline shares from the beginning of the industry to date would be a net loss.  Is anyone surprised? Listen to Same Company. Two Different Experiences. One Big Failure.


Shh! We’re eavesdropping right now on a discussion between two healthcare executives who’ve just identified an issue that needs to be resolved. Listen to Have You Made This Mistake About Meetings?


As healthcare entities become larger they appear as formidable competitors in the marketplace. So what’s an independent group to do? Listen to Three Strategic Lessons For Independent Medical Groups.


Remember attending that auction in which people overbid for that obvious-to-most mass produced ceramic vase? The attractiveness of a deal multiplies by the number of “buyers.” Listen to Dear Healthcare Deal, You Are So Attractive! I Need You!


When customer service becomes inconvenient. Listen to Customer Service.


Do you like riddles? When isn’t a hospital’s physician alignment in line? Listen to Here’s What Happens When Physician Alignment Is Out Of Line.


That summer at Magic Mountain was a petri dish of customer service and other business education. Here are 4.5 of the lessons that I learned. Listen to Things Magic Mountain Taught Me.


Market consolidation – that’s what’s impacting medical groups of all stripes and sizes. Listen to Life Is Easy When You’ve Given Someone Else The Power To Determine Your Future.


I recently read an article about hospitals training physicians for “leadership” roles. What those hospitals are really doing is training more physicians to become hospital-employed or hospital-controlled managers. Listen to Why The Hospital’s Idea of Physician Leader Means Follower.


If you think the rate of marriage failure is high, consider the fate of business marriages. Depending on whom you ask and whose data is available for analysis, 70 to 90 percent of all business combinations fail to increase owner value. Listen to Why Culture Counts In Healthcare Mergers and Acquisitions.


What story are you telling about your practice? Listen to What’s Your Story?


Price is what you pay. Value is what you get. Listen to Understanding Price, Value And How To Use Them.


There’s a significant amount of timing involved in respect of the negotiation of agreements between physician groups and hospitals, especially in connection with exclusive contracts. Listen to Pass the Bread and Get the Contract.


Why become a hospital-employed physician? Listen to The "Why" In Hospital Employment.


As much actual tension as there is between physician groups and ACOs, they share a common weakness. Listen to Medical Group Value Walks Out The Door.


Like a dry cleaner, healthcare providers have to screw up to lose a customer’s loyalty. Listen to Do You Know What Costco Pharmacy Doesn’t About The Lifetime Value Of A Customer?


Marcus Lemonis of the TV show, The Profit, says that there are three “P’s” to business success. Listen to The 4 “P’s” of Medical Group Success.


If the hospital can, both through practice acquisition and the expansion of its system, acquire sufficient market power, it can also pressure insurers, individual consumers, and others paying for healthcare to pay more for the same services. It was just such a possibility of higher prices that led the federal courts to order the dismantling of a major medical group acquisition. Listen to Medical Monopoly Not A Game: Court Shoots Down Hospital-Medical Group Merger.


The Mississippi River flows thousands of miles before reaching the Gulf of Mexico. A huge river. What about your practice? Is it a single channel, even a very large single channel, or is it supported by multiple streams, streams of income, that is?. Listen to Into the Stream.

If you’re selling medical services but collecting only peanuts (or even hot dogs) let me know. You need a better agent. Listen to Hospital-Based Services, Not Hot Dogs.

Extending a brand means to branch it out from one product or service line to another. Like Barbie dolls to Barbie bikes. Or, like Community Hospital to Community Hospital Medical Group. Listen to About Brand Extension.

I was finally on the plane. The flight was already 3 hours late to take off. Listen to Are You Just Taping Up Problems?

Like it or not, the practice of medicine is also a business. Listen to Adopt The Company Mindset.

Time travel. A joke? Or can you do the equivalent right now? Listen to Time Travel.

We used to get bomb threats all the time. Far too often, medical groups – in fact, closely held businesses of all kinds – have bombs, of sorts, within them, too. Listen to The Coming Explosion In Your Business.


The reason why countries revolt simply to turn to another dictator, why the spouse of some politician is feted as savior, and why hospitals turn to national organizations to provide items and services as varied as toilet paper to neonatology, is the same: People — all of us, from Joe and Josie on the street to hospital administrators on the third floor — have an innate desire to be led. Listen to Lead Because They Want To Be Led.

Value is what’s important to your customer. Not to you. Listen to McDonald’s and Delivering Medical Group Value.

A few years ago, I wrote two articles on physician group governance, both available on the ALG website, one for AuntMinnie.com, a radiology publication,
http://www.advisorylawgroup.com/radiologygroupungov.html, and the other for Anesthesiology News, http://www.advisorylawgroup.com/anesgroupungov.html. Listen to Why Discarding Democracy Improves Your Group’s Chances of Success

As the old bumper sticker says, shit happens. Despite all you do to prevent it, all the systems and all the rules, when humans are involved, things can and will go wrong. Listen to How Not To Deal With Performance Problems

During junior high school summers, my friend Steve Cunningham and I would ride our bikes across the San Fernando Valley to buy a root beer (and sometimes a chili cheese burger) at The Munch Box. The root beer was ice cold. The burger hot, it’s cheese melty. It was a special blend of distant, delicious, almost forbidden fruit. Listen to What A 57 Year Old Burger Joint Can Teach You About Delivering Value

When my kids were younger, we used to play a game when we left a store.  We’d critique the way that the store employees greeted and treated us, whether or not we made a purchase. Listen to "Thank You"

There’s little question that most, if not all, medical groups should be led by practicing physicians. Listen to Don’t Hinder the Ability of Group Leaders to Lead

Your medical group’s most important assets, its physicians and other providers, walk out the door each night. Listen to Stop Trade Secrets From Walking Out The Door.

It’s not uncommon for some physicians to be engaged in multiple ventures. For example, an ophthalmologist may be a partner in a group with a practice location in City X as well as a shareholder in a group providing weekend ophthalmology coverage in Suburb Y. Listen to Outside Work Leads To Claims Of Inside Collections.

Some hospital attorneys and, therefore, some hospital administrators, believe that every contract for professional services should be subject to a request for proposal (RFP) process. That’s ridiculous. Listen to Idiocy Of The RFP Process For Professional Services

I hate taking out the trash. Listen to Disruptive Physician – You Know Who! (He/She Works For You)

An $800 sneaker? How can its lessons be applied in your practice or business? Listen to An $800 Sneaker And Its Lessons For Your Business

The physicist Niels Bohr is reputed to have quipped that prediction is very difficult, especially if it’s about the future. Listen to Why You Need A Different View Of Business Strategy

A congressional study compared the performance of San Francisco International (SFO) Airport’s privately contracted screeners with those of LAX’s TSA staffed screeners. SFO’s staff screened 65% more passengers per screener than the government employed TSA personnel at LAX. Listen to TSA Screeners and The Myth of Medical Group Institutionalization of Business Relationships.

“Bob, we’ve got to give you your two weeks notice. Here’s a check for the next two weeks’ compensation. Just pack your personal belongings and Jerry, here, will see you to the door.” Listen to Termination Notice

Grace, not her real name, was very pretty. Long blonde hair. Tall. Fun. Listen to Merger: Fallen From Grace

As hospitals gather more power courtesy of Obamacare, some are becoming more daring in terms of extracting cash from non-aligned physicians who don’t control referrals.
Listen to Healthcare Executives In Prison

Models. No, not the skinny kind in a magazine. But conceptual frameworks. Like global warming “models” or even Obamacare. Listen to Venezuela, Rice Farmers and Doctors in Dallas

As a recent Wall Street Journal article recounts, Japanese manufacturers, once the world’s leaders in electronic goods and especially in cell phone technology, lost big in the switch to smartphones. Listen to Not A Smart Call

You’ve seen it before. Some customer in a store is bitching and moaning about something. I’m not saying that he might not have a point. But the way he goes on and on and on, the way that he’s rude to the store staff, it’s just too much. Listen to Because All Business Isn’t Good Business

What parent hasn’t heard the words "are we there yet?" Listen  to Are We There Yet?

People often cite Newton’s First Law as something akin to “an object in motion tends to stay in motion with the same speed and in the same direction.” Listen to A Medical Group In Motion

I’ve been thinking today about Pareto-type distribution, you know the “80/20 rule,” and physician employment. Listen to Physician Employment, the Pareto Principle, and the 99%

I’m not really one for documentaries, but I recently watched, for the second time, Jiro Dreams of Sushi. Listen to Mastery And Your Medical Group.

Covenants not to compete. Cultivating new business opportunities. Listen to What’s Your Business Horizon?

The physician subsidiary entity is a physician alignment model sold as a kinder, gentler, freer alternative to direct hospital employment. Listen to Physician Subsidiary Entity – Aligned or A’lying?

“I want to become a partner.” Lawyers hear this all the time from newer members of their firm. Doctors, too, hear it from junior members of their medical group. Listen to I Want To Become A Partner

Are you creating physical touch points for your patients, customers, referral sources and other potential deal partners? Listen to Paper Business Cards And Patient Interaction.

Where fairness is judged by outcome, not opportunity, it soon takes on a surreal twist. Listen to How Soon Will Hijacked Fairness Be Coming To Healthcare?

“We’ve got to stop ordering roller ball pens. Just order those cheap Bics.” Listen to Why Saving Won’t Save

“Sign this please. Right there. Yeah, there, on the last line. Next to the date.” Listen to Would You Sign This?

Why simply play by the rules? Listen to Why Play By The Rules?

Bigger or larger or more providers or more locations do not, in and of themselves, make a stronger business. Listen to Why Any Port Isn’t Good In A Storm

You have been coming into work every day for years. Now there’s no need to come in tomorrow because your group no longer exists. Listen to The Walking Dead: Is Your Group Actually In Business?

False positives. A significant problem in medicine. Listen to False Positives And Medical Group Leadership

How easy, or hard, do you make it for potential deal partners to find you? Listen to I Went To A Food Fair. Can Referral Sources Find You?

As the business of healthcare becomes more complex, many physicians are seeking certainty. It’s not there. Listen to Is It Certain To Work?

Decisions and paths are flexible, fluid, customizable. They are infinitely adjustable, like Gumby. Listen to Paging Dr. Gumby . . . Paging Dr. Gumby . . .

“From a dog’s point of view his master is an elongated and abnormally cunning dog.”  – Mabel L. Robinson. Listen to Dogs And The Power of Observation

Letting each partner write his or her terms of partnership is not a long term strategy for success. Listen to I’m a Partner in The Group, So Leave Me Alone

The is no real security in depending upon a pseudo-parent employer. Listen to In Loco Parentis Or Just Plain Loco?

Money. Future. Status. Popularity. The four human interest motivators. Listen to The Ghost Of Physicians’ Christmas Future

Is there a disconnect between the physician and the hospital? Listen to You’re Not Being Managed, You’re Being Employed

Eighteen wheelers speed down the highway, the second or third or fourth following way too closely for my comfort as they are sucked along, “drafting” off the the truck in front of them. Listen to Eighteen Wheelers And The Medical Group Acquisition Meme

For the most part, physicians are stuck in a Marxian world of reimbursement. Listen to  Karl Marx, M.D.

Mark Weiss interviews Mike Hicks, the CEO of EmCare Anesthesia Services. Listen to The One With Mike Hicks

I see zombies every day. More physicians don’t question the promises of employment. Listen to I See Zombies Every Day

A study found little correlation between nonprofit hospitals’ CEO pay, which averaged almost $600,000 per year, and performance. Listen to Hospital CEO Gets A Raise. You? We’re Not So Sure.

Coups and business cloning often decimate medical groups. Listen to  The Cat’s Away. The Mice Did Play. Medical Group R.I.P.

Your group’s practice metrics indicate all is OK. But you’re about to crash. Listen to Is Your Group Running On Autopilot?

As the chill of Obamacare becomes felt, more and more physicians are looking for alternatives to commoditized medical practice. Listen to Alternative To Commoditized Practice.

Lowering your goals just to tell yourself that you’ve hit them is a crime against your potential. Listen to Don’t Lower Your Goals Just So You Can Say You Hit Them

It’s often how the mistake maker, not the “victim,” reacts that makes the difference in the outcome. Listen to Mistakes Happen.

Many physician groups are fighting the last war, imagining that the threat to their existence is from, say, the hospital. Listen to How Medical Groups Get Mired Fighting The Last War

Physician compensation surveys assume that you’re average. It’s up to you to break out of the paradigm. The Problem With Compensation Surveys – Why Assume That You’re Average?

Adopting a purely defensive position can never advance your or your medical group’s future. Listen to  Why Trying To Protect Your Group’s Position Is Destroying Your Future

Does your group have a contractual right to enforce standards of behavior? Listen to Does Your Employment Contract Have Teeth?


Survey reveals sixty-seven percent of physician who participated in an ACO in 2012 realized no personal financial benefit. Listen to Shocking! No Physician Financial Benefit From ACO Participation.

Sorry. None of your patients, referral sources, or the hospitals at which you practice cares about your success. Listen to

Girl Scout Cookies And Medical Group Success

Your group is actually, and actively, branding itself every day, whether or not you’re aware of it. Listen to Branded


ACOs: Clinical alignment is a great thing. Complete economic alignment is stupid. Listen to A Tip About Physician Alignment


Physicians focus on the correct answer. But succeeding as a business leader requires acceptance of failure. Listen to Can You Flip The Switch – From Physician To Group Business Leader?


Actors scramble to audition for a part, but stars choose from offered scripts. So why are you responding to that RFP? Listen to Stars Don’t Audition. Why Are You Responding To That RFP?


Earning $X, net, self-employed and earning $X, net, as an employee are two very different things. Listen to Physician “Alignment” – When $X does Not Equal $X


What’s the right way of looking at ACOs, physician alignment, hospital-physician collaboration and other initiatives to bind physicians to hospitals? Listen to The Problem of Perception – Healthcare Collaboration


Hospitals are becoming more coercive in thinning the medical staff ranks of independent physicians. Listen to St. Bully Medical Center

Just because you don’t see risk to your future on the horizon doesn’t mean it doesn’t exist. Listen to Are You Blinded By Success?


Many “experts” tell physicians that the key to financial security is employment by hospitals. Do they really think you’re that blind? Listen to Psst, Wanna Buy A Watch? The Myth Of Security In Hospital Employment


Great food isn’t enough to keep a customer. Neither is great medical care. Listen to Carlitos And The Crisis Of Customer Service


Is your medical group’s compensation plan rewarding the right thing? Listen to Does Your Group’s Compensation Plan Suffer From This Defect?


If your group can’t develop a strategy because of internal dissension, then you’re allowing someone else to choose a future for you. Listen to Is There This Disconnect Within Your Medical Group?


Not devoting the proper resources to your future is the most expensive alternative. Listen to Does Your Group Believe In Itself?


In my work with physician groups across the country, I often encounter this defeatist attitude. Listen to Do You Really Want This Smaller Future?


Physician groups are targets–hedge by taking risks outside of your current base. Listen to Preserving The Past


If you don’t like the direction of change in health care, start instituting some change on your own. Listen to Spare Change


Not enough physicians? State plans to expand role of paraprofessionals. Listen to Burgers Must Be Burgers, But Doctors Might Just Not Be Physicians


How medical groups can use surveys as tools in negotiations with hospitals. Listen to Survey Yourself


Medical groups must understand the direction of the societal wind. You might like it. You might hate it. Either way, it’s still windy. Listen to L’air du Temps.


Mark Weiss interviews ERISA expert attorney Christine Roberts about implementing Obamacare’s coverage requirements. Listen to The One With Christine Roberts, ERISA Expert


Efforts treating patients don’t create value between a medical group and a facility. Listen to Efforts Don’t Necessarily Equal Value


Why you should always ask “why” when negotiating. Listen to Negotiation: Why Times 5


The indiscriminate use technology, is akin to the adoption and enforcement of rules. Listen to Technology, Rules and Compliance


Why hospitals are destroying themselves, and setting their CEOs up for termination, when they bring in national groups and “contract management companies.” Listen to The End of Healthcare Symbiosis Might Just Kill The Host (And End The Career Of The Hospital CEO)


Hospital employment? Sure, it’s security… in some alternative universe. Listen to Employment Insecurity


There are few legitimate reasons for groups to have leadership meetings. Listen to No Meeting of the Minds.


All provisions in a contract are intended to be enforced. Listen to Contracts Don’t Contain Extra Baggage


Kodak chose to ignore the threat of digital photography. What threat is your medical group ignoring? Listen to A Kodak Moment


“Conformity medicine” will result in the death of innovation. Listen to Top Down Healthcare Is Killing Your Business And (Literally) Killing You And Me

Hospital employment provides physicians no more safety than any other type of employment. Listen to Layoff Doctors


The importance of group owners sharing the same mindset. Listen to A Tear In The Fabric Of Medical Groups

Demonstrate, don’t just talk about, high touch, high caring service. Listen to Competing On The Basis Of Common Courtesy


Train your medical group’s members for actions consistent with the group’s strategy. Listen to You Can’t Un-Ring That Bell


“No” is only the beginning point for further negotiation. Listen to Lessons On Negotiation From Artie The Briard


Does the death of Hostess offers a glimpse into the future of hospital-centric healthcare. Listen to Hostess Twinkies And Hospital-Centric Healthcare


Why should hospitals be run by nonphysicians? Listen to All Hospitals Should Be Physician Controlled


What if that one hospital your group has tied its future to pulls you to the bottom? Listen to Act On Company Model Threats As Soon As They Surface.


Medical groups must demonstrate communal involvement as a part of the negotiating process. Listen to Demonstrating Involvement – A Required Part of Hospital Negotiation In A Communal

Society


The future’s not guaranteed. Listen to How Sharp Is Your Group? Strategy, Tactics and The Future of Your Medical Group


Someone, or some faceless trend, is always impacting your future. Listen to In Terms Of Thinking About The Future, Are Practicing Physicians Really Different From Residents?


But your group needs to portray a unified image. Listen to Unifying Your Group


Your group’s only as strong as the foundation upon which it rests. Listen to How Strong Is Your Medical Group’s Foundation?


Physician groups can profit from their compliance efforts. Listen to Wringing Profit From Physician Group Compliance: Operational Compliance


Having all group members buy in to the same cause is a winning strategy. Listen to Sun Tzu And Group Strategy


Are you actually preventing your medical group’s success? Listen to Does Your Medical Group Have A Success Prevention Department?


Top level hospital-based groups cannot merely be concerned about maintaining a relationship; they must be concerned about delivering a transformational experience to their relationship partner. Listen to Creating Transformational Contracts


Independent anesthesia groups must develop strategies tied to the segmenting market. Listen to Independent Anesthesia Group Success In a Segmented Market


Is that carve out from your exclusive contract really a kickback to referring physicians? Listen to Carve Outs As Kickbacks In The Hospital Setting


For physicians, protecting your turf requires a balanced approach. Listen to Are You Protecting The Right Turf?


A recent trip to a restaurant and the post office illustrate the difference between entrepreneurial medicine and the brave new bureaucratic world of healthcare. Listen to Entrepreneurial Practice vs. Bureaucratic Existence.


Risk to your medical group can be broken down into two elements, both of which can be managed. Listen to Probability of Loss  - Prevention and Contingent Mitigation of Business Risk


Mark Weiss interviews Reed Tinsley, CPA on the business challenges facing medical practice. Listen to The One With Reed Tinsley of Reed Tinsley, CPA – Podcast


Medical practice is complex but your practice’s business should strive for simplicity. Listen to Strive For Simple

Be honest: Do you own your practice or does it own you? Listen to Do You Own Your Practice Or Does It Own You?


Can the traditional hospital-based group service model survive? Listen to Is The Traditional Hospital-Based Service Model Dead?

Entrepreneurial thinking is the cure for dissatisfaction with Obamacare. Listen to The 83% And Concierge Care.

Most medical groups are out of balance and easy to tip over. Listen to How to Create the Balance Your Group Needs in Order to Thrive


The paradigm for physician hospital relations is completely at odds with society's other trends.Listen to Breaking The Physician Hospital Paradigm

There is no question that the healthcare market is changing rapidly. This means that groups must have the ability to make business decisions rapidly. Listen to Who's Driving Your Practice's Bus? II

Many medical practices operate as if no one is driving the bus. Listen to Who Is Driving Your Practice's Bus?

The perception of the truth plays an important role in group and individual physician success. Listen to Verisimilitude and Success

How to develop the skills and strengths to guide your group's future. Listen to I Don't Even Know Where To Begin

To succeed, groups must strategize for their own desired future and that involves telling the truth about the current state of affairs. Listen to It Is What It Is .

Mark Weiss interviews Greg Zinser of Medac. Listen to The One With Greg Zinser of Medac

Does your medical group have a strategy to succeed, or are you simply hoping  not to fail? Listen to Are You Playing To Win Or Just Playing Not To Lose?

Hiring for skills alone is a shortsighted game plan. Listen to What A Plumber Can Teach You About Hiring Physicians.

Success is as dependent on what you decide not to do as it is on the. Listen to Avoid The Error Of Measuring Success Only By Action

Your compliance system has a leak. Listen to Jurassic Park And PHI - Leaks Are Inevitable

Why are you convinced that you have to work your way up the ladder? Listen to

Your contract's real term is how quickly it can be terminated. Listen to Yin and Yang. Contract Term And Termination.

You need to hire for more than clinical competence or even clinical excellence.  Listen to I’d Rather Go Somewhere Else.

Consistent with the communal notions of the "We" society, physicians are being told by politicians, pundits and the press that you are in social services – do you really believe this?  Listen to Is Your Medical Practice A Social Service Or A Business?

You, not your competitors, control your future - why would you think otherwise?  Listen to Why Let Your Competitors Control Your Future?

For many physicians, the winds of change are of hurricane force. Consider how they can be harnessed.  Listen to Resolving Healthcare Market Pressure.

Mark Weiss interviews Earl Ongman of Sierra Health Services.  Listen to The One With Earl Ongman of Sierra Health Servcies.

Many physicians, even physician group leaders, have trouble with the notion of transformational change because today’s payor and hospital centric status quo is their “normal.”  Listen to Breaking The Chains Of The New Normal.

The battle between patients' physicians and hospitalists rages on. But who asked the patient?  Listen to Who Asked The Patient If She Wants A Hospitalist?


Do you know the secrets of using fear of loss as a tactic in hospital negotiations? Listen to The Only Thing The Hospital Has To Fear Is Fear Itself.

Employment by hospitals is no safe harbor for physicians; in fact, it's quite the opposite. Listen to Hospital Employment Is No Panacea For Physicians.

National groups often over-promise and under-delivery. Take advantage of it. Listen to The Promise-Delivery Gap.


Did you notice that the Super Bowl was all about medical group success?  Listen to The Super Bowl and Medical Group Success.

Someone's strategizing to take over your practice; it might as well be you.  Listen to Shadowing The Competition.

As hospitals quicken their pace to replace physicians with paraprofessionals, physicians must brand their role in healthcare or suffer the consequences.  Listen to Physicians Must Brand Their Role in Healthcare.

Hospitals and the government have decided that physicians must collaborate financially in order to deliver quality healthcare. Of course, that's a lie.  Listen to Two Wolves And A Lamb.

RFPs for physician services come in several varieties - some real, some scams. Responding to any RFP takes considerable time and requires significant investment. So how much should your group charge to provide its proposal? Listen to How Much Should You Charge To Respond To That RFP?

Not only is fair market valuation resulting in a spiraling down of employed physician income, the same amount of money earned as an employee is worth less than that amount earned if you still owned the practice.  Listen to The Same Amount Of Money As An Employed Physician Is Worth Less.

In order to thrive in the “We” society sweeping through healthcare, medical groups must adopt a different focus. Listen to Protecting Your Practice In Today's "We" Society.


Most hospital based groups focus on outside competitors but ignore the threat from within.  Listen to The Two Classes of Hospital Based Medical Group Disruptors.


Hospital administrators are involved in ACO formation, but physicians are being asked to fully commit.  Listen to The Chicken, The Pig And The ACO.

Highly successful medical groups operate in concert with bureaucratic hospitals but avoid the taint of bureaucracy themselves.  Listen to Avoiding The Bureaucratic Web.

The hospital has written the script for your future. Don't like it? Grab Your Own Pen.  Listen to Don’t Worry About Your Future – The Hospital Has It All Planned.

Why are group-physician relationships so complicated when the rules are so simple?  Listen to

The first step in establishing your group's future is telling the truth about its present.  Listen to Do You See Your Group As It Is Or As You Wish It Were?

Hospitals are employing more physicians.  So why don't they want them to become really successful?  Listen to Why Hospitals Don’t Want Employed Physicians To (Really) Succeed.

Let other physicians worry about surviving the down economy:  Take these steps now in order to thrive.  Listen to Opportunities Knocking In Market Flux.


Problems happen.  But when they do, turn them into profit.  Listen to How A Hospital Based Group Can Profit From Problems.


If you want your group to have a future, stop being a vendor.  Listen to Is Your Group A Vendor Or A Partner?

Planning is less effective than strategy and strategy is most effective when strengthened through the Scenario Survey Process.  Listen to How Scenario Surveys Strengthen Medical Group Strategy.

If your medical group signals its weakness, it will become easy prey.  Listen to Ignoring The Perceived Bounds Of Weakness.

Stop kidding yourself that the delivery of expert, even world-class, medical care is sufficient to guarantee your group’s future.  Understand how to identify and incentivize high level customer service. Listen to How To Secure Customer Satisfaction.


The dominant business and financial paradigm for many physicians, especially hospital-based specialists, is that they are a commodity, a valuable one, perhaps, but a commodity nonetheless.  If you are ever to break out of the current paradigm, it will not be by benchmarking to the best practices of other groups headed downward in the same maelstrom. Listen to Creative Destruction.

Negotiation doesn't take place in a vacuum, it takes place within a context.  So why not control the context?  Listen to Context.To Control The Contract, Control The Context.

The talking heads of healthcare are at it again: A new acronym to save healthcare has arrived, the ACO, an "accountable care organization."  But to whom is an ACO accountable?  Listen to Accountable Care Organizations: Accountable To Whom.


How will physicians fit within the bureaucratically envisioned healthcare system of the future?  Listen to The Healthcare Con-Vergence.

Medical Groups and entrepreneurial physicians must learn to manage business risk as a part of their overall strategy.  Listen to Managing Risk: Required For Success. 

Are Physicians going each day to a factory . . . a factory of a different kind?  Listen to Are You Headed To The Healthcare Factory?

Socialism is alive and well within medical groups.  At best it will lead to dissention, at worst it will destroy your group.  Listen to Socialism Is Alive And Well Within Medical Groups.

Obamacare mandates that physicians participating in Medicare or Medicaid have operating compliance programs.  Turn the mandate into a strategic advantage.  Listen to How To Profit From Mandatory Compliance Programs.

The so-called “Company Model” of providing anesthesia services at an ASC presents serious kickback concerns.  But the problem is far greater than simply anesthesia deals.  Listen to The “Company Model:” More Than Just An Anesthesia Problem.

The tactics being used by proponents of accountable care organizations against physicians are eerily reminiscent of those used by auto manufacturers to crush the prices charged by their suppliers.  Listen to Negotiation Ploys – From Autos To ACOs.

How to apply, and defend against, psychological pressure during your next negotiation session.  Listen to Harnessing Group Pressure In Negotiation.
Most medical groups are unable to gain strategic advantage due to their own management bureaucracy.  Here’s the cure.  Listen to How To Cure Physician Group (Un)Governance.

Learn how valuation consultants' refusal to opine at higher than the 75th percentile is taking the fairness out of fair market valuation and robbing you of your income.  Listen to How the Downward Spiral of Fair Market Valuation Will Destroy Your Future.

Hospitals are disrupting their longstanding relationships with hospital-based\groups as they seek to cut stipends and get more for nothing.  The favored tool? A "weaponized" form of the request for proposal.  Listen to How To Navigate The Rising Tide Of Aggressive RFPs.