The end of a business partnership can be almost as devastating as the loss of a family member or a friend. Two recent health system divorces illustrate the frustration and rancor that can conclude something created out of goodness and hope.
In rural West Virginia, the remnants of a two-hospital joint venture that derailed after 21/2 stormy years left the president of one parent organization howling that "we're almost pretending it never happened."
In cosmopolitan Northern California, the split of two academic medical centers has been so bitter that officials at Stanford University and the University of California at San Francisco apparently want little to do with one another. The interim chief executive officer of UCSF put it bluntly: "There will not be a lot of common activity, if any."
That's a shift from an initial separation plan, which called for the former lovebirds to maintain joint programs in pediatrics, obstetrics, purchasing and information technology.
The many lessons learned from these and other nasty healthcare dissolutions will fill managerial textbooks for years to come. Those still smitten with integration must realize its limits. First, mergers, joint ventures and collaborations will not guarantee lower costs and greater profits. Second, owning medical practices will not enhance physician productivity. Third, the equal sharing of decisionmaking, governance and power may create harmony at the outset but result in organizational chaos.
If the parties agree on cultural integration, cost-cutting strategies and leadership responsibilities before the deal takes place, the chances of success will increase. Failure to agree will lead to the types of outcomes that occurred in the woods of West Virginia and the hills of San Francisco.
Those destined to go through the agony of ending a business relationship should recall the philosophy of Elisabeth Kubler-Ross, M.D.
In her 1969 book On Death and Dying, Kubler-Ross outlined the five stages of dying-denial, anger, bargaining, depression and acceptance. She maintained that understanding these phases helps the terminally ill die in peace and their loved ones live without guilt or fear. Healthcare executives, take note.