It's no accident that the best-branded health care organizations are those with physicians tightly integrated into the cultural and decision-making fabric. Mayo, Cleveland Clinic, Kaiser, Geisinger, Virginia Mason, to name a few, have a decided advantage over the more traditional private practice model where physicians are, at best, an arms length away and, at worst, strong competitors. I remember making a site visit to one of the above-named organizations, and hearing the CEO (a physician) say very clearly "Our customer is the patient. Period. Anybody not agreeing doesn't work here!" Wow, now THERE'S the platform for an enduring competitive advantage. Everything in that organization - the people, the processes, the planning, the facility, the scheduling, everything - is all directed toward acting on that "patient as customer" premise. I'm sure there's internal debate about a great many things, maybe even an argument or two, but the basic, c...