Greater Isn’t Better; Better Is Much Better
Breaking The Paradigm of Quantity: An Issue for Physician Leadership Certainly one of my favorite Jackie Mason jokes goes similar to this. A potential customer enters a store whose register the front window proclaims: “WE SELL Not Only BELOW RETAIL. WE SELL BELOW COST!”. He skeptically approaches the store’s proprietor and asks, “How can you have the ability to earn money selling below cost?” “Simple” answers the particular owner, “We make it up with volume!”
When I tell this joke to Hospital CEO’s or CMO’s they laugh until I propose which they could be doing a similar thing using their medical staff strategy: larger is better. The greater the medical staff and also the much bigger their referring volume the greater the hospital’s main point here. The much bigger the size of a physician’s practice the better the quality of the doctor. “He/she should be a great doctor, take a look at the dimensions of his/her practice and the way many patients he/she refers!”.
This unfortunate strategy has create a stampede of practice acquisition, joint ventures, and “institute models” which may have, for a lot of, succeeded in larger referral patterns for hospitals. Unfortunately, few of these larger systems are in fact better. Actually, the purchase of heterogeneous physician groups with the accompanying variation used styles, work ethic, quality and culture have made put further strains on the look for medicine’s ultimate goal: consistent, measurable, efficient and excellent outcomes.
One could argue that this course didn’t make a lots of sense regardless if it was embraced within the bygone times of fee for service. It made even less sense when DRG’s were introduced and will prove fatal once bundling of all services and ACO’s (capitation on steroids) take hold. Organizations that will succeed are those that invest now in developing excellent physician leaders: those that may influence, model and hold others accountable for consistent, measurable, efficient and excellent outcome. This may often require trimming instead of enhancing the volume of physicians with admitting privileges.
The winners here is going to be those systems that recognize greater isn’t better: better is way better.
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