ABSTRACT
If a hospital seeks a unified response with its medical staff to a health care payer system that is coalescing around many new forms of contracting,* more integration is better than less. The same goes for doctors, but they have a different perspective since they may have any number of choices based on their practice discipline and their time horizon left to practice. Why go through a transition that is costly and complex when one option may be to simply practice out to the end of a career and drop the keys on the carpet as you exit the building? Longevity and position in a market are different for a hospital than for a physician. Both need to operate from some kind of plan or vision of where they want to be in the near-term future.†
Planning should address the overall position of the health care system in the marketplace and the mission of the health system. Does the health system actually respect and follow its mission? Does it have a shared vision with those that it serves? What does the system stand for that is in any way remarkable? Can any guiding principles be enshrined on the wall for all to see? If we put them up (probably on a website and not on the wall), would others understand them and endorse them to patients, families, and friends?
