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Competition: An Opportunity to Improve Physician-Hospital Collaboration?

In Chapter 3 of my book Better Communication for Better Care, I offered a 3-part strategy for dealing with competition:

1) Proactivity

2) Collaborative Conflict

3) Containment

I will address proactivity today and discuss the other parts of the strategy in subsequent ezines. Hospital executives bring considerable resources to the table. As a result, negotiations with physicians do not need to become defensive. Here are some examples of what hospital executives can offer:

• Access to capital at a lower rate of interest than physicians generally can obtain on their own
• Participation advantages in the purchase of expensive, rapidly changing high-tech equipment, such as CT and MRI scanners
• Market power to obtain reimbursement from payers for cutting-edge services
• Access to land near the hospital that the hospital may own
• Experience with federal, state, and local regulatory agencies related to certificate of need, zoning issues, environmental impact, and compliance with Stark and anti-kickback laws
• A known identity for patients that can provide comfort, security, and credibility

Used with permission from Better Communication for Better Care: Mastering Physician Administrator Collaboration, by K.H. Cohn. (Chicago: Health Administration Press,2005)18-19.

Points to remember include:

• Most physicians are putting up money to be used for children’s education, weddings, or retirement and thus want to minimize risk and uncertainty
• Nothing in medical school, residency, or fellowship prepares physicians for business ventures
• Physicians generally want to be part of deals that give them increased control over scheduling and increase the volume of patients that they can see and treat in a given day
• Outside turnkey promoters’ percentage fee of gross revenues may eat up a substantial share of physicians’ profits
• Money that goes to outside national chains generally leaves the community rather than being reinvested in local institutions

If new medical ventures were easy, they would be even more widespread than they are now. In the next ezine, I will cover communication issues and hot-button words to avoid.

©2006 Kenneth H. Cohn, M.D., MBA, FACS

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