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There's More To A Name Than Just A Name

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, clarifying premise cuts rather quickly through the murk.

Importantly, there's minimal lip service, maximal forthrightness. "This is us. This is how we do business. If you don't like it you won't fit here."

Legions of consultants and seminars promise to deliver "the secret roadmap" to physician integration. I'll offer a modest, hard-won observation for free: no model, regardless of how elaborate or expensive, will work until freed from the scourge of lip-service, A.K.A. execu-speak for "We don't really want physicians involved and don't intend to communicate. In the meantime, we'll do our best to make sure they don't figure that out until it's too late..."

The Takeaway: Becoming "The Mayo Clinic of (Your Town)" takes more than consultants, lawyers and a new tax ID number. Create all the new legal structures you want. Along the way, recognize that the old models made certain toxic behaviors necessary for survival. Find them. Root them out. Unlearn them. Stop rewarding them.

The new models require new ways of thinking, of communicating and of implementing. New voices engaged in honest, sometimes difficult conversations. And, an understanding that "physicians at the table" doesn't mean creating another committee.

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