Every new year brings a clean slate. And for many medical executives, the turn of the calendar provides an opportunity to assess the progress of their organization--and their personal achievements.
For a lucky few medical organizations, 1998 was a year of promise and success. They were able to achieve new market leadership, add colleagues and improve efficiency while delivering high-quality patient care.
For the majority, however, '98 was a year of turmoil and confusion. It was marked by a meltdown of the PPM industry and at least one hospital bankruptcy that resulted from efforts to support unprofitable physician practices. Meanwhile, doctors fumed over the loss of autonomy they consider critical to providing good care.
So, as we begin the last year of the century, it's time to turn from the mistakes of the past to focus on the valuable lessons savvy medical executives have learned.
Lesson one: You can't simply turn over the management of your medical practice to an outside organization and walk away. Some medical groups saw the arrival of PPMs as the opportunity to leave the dirty work of management to someone else and return to the good old days of practicing unfettered medicine. Clearly, today's successful medical group must find a way to focus on clinical issues and pay suitable attention to business operations.
Lesson two: One model does not work for all. On page 28, reporter Bob Cook profiles Arizona Community Physicians, an organization that opted to avoid both PPMs and hospital managers and create a unique model that combines group practice strength and solo practice independence. Finding the right model requires the courage to avoid current fads and strike out in your own direction, but after five years, Arizona Community appears to be thriving.
Lesson three: No one--including hospitals, PPMs or government--is going to protect physicians from the whims of marketplace competition. Today's patients are voting with their feet for excellent customer service. At some point in the not-too-distance future, medical outcomes will determine customer choice, and healthcare organizations that want to succeed need to prepare for that day.