Why do we need to prepare to lead change? Why not just get on with it? There are many reasons that an EM group needs to prepare to lead change, but chief among them is both the recognition and acknowledgement that there is a problem with the practice and the physician group is part of ...
Question: How many independent EM group owners does it take to change a light bulb? Answer: As many as there are plus one–because everyone has a different idea and at least one can’t make up his or her mind about how best to do it. Organizational decision-making in equal ownership EM groups tends to be ...
The ACEP Scientific Assembly in Las Vegas was abuzz over the resurrection of the EM practice acquisition market due to one of the large contract management groups once again having public money to spend. At the other end of the EM practice model spectrum there was a lot of talk about the increasing pace of ...
To survive and prosper under healthcare reform emergency medicine (EM) must redefine and reinvent itself. EM will not be able to continue doing business as usual, standing on the Prudent Layperson dictum that “the patient defines the emergency.” As currently envisioned Accountable Care Organizations could not possibly be accountable for their patient care and cost ...
There are four kinds of work in an emergency medicine (EM) group practice: clinical, leadership, administrative/management and ownership. Each of these consists of a distinct and objectively measurable set of tasks and since this is the case it is possible to gauge individual performance and hold those performing each set of tasks accountable for their ...
Patient Experience Defined No binary (‘yes’ or ‘no’) patient service satisfaction question is of greater importance to the ED and hospital than “Will you return to and/or recommend our hospital?” In this era of ever-expanding access choices like extended hours primary care, urgent care centers and freestanding EDs customer retention is what will increasingly be ...
The current issue of the Journal of Healthcare Management has a thought-provoking article written by Nathan S. Kaufman that may partially explain the growing trend of seemingly competent independent EM groups suddenly being supplanted by one of the larger contract management groups. The title of the article is Three “Brutal Facts” That Provide Strategic Direction ...
In a recent emergency medicine listserv exchange several posters commented on the widespread abuse of emergency physicians made possible by their lack of due process “rights.” Perfectly innocent emergency physicians, nay even model citizens, it was alleged, had been terminated on the spot purely on the whim of some grumpy hospital administrator with not a ...
An entitlement culture is one in which the prevailing attitude is one of “you owe me” because of who I am or what status group I belong to; because of what sacrifices I think I’ve made, or simply in the interest of what I perceive to be social justice. Such a culture has been recently ...
In Part I of this series we discussed the wisdom of separating clinical practice compensation from ownership, leadership and management compensation, and of paying everyone practicing EM on an equal basis. We also discussed representative democracy and the need to empower the group’s leadership to independently make as many decision as possible. In Part 2 ...