Mitlyng Associates Inc.

“Leaders are like combat fighter pilots. They are continually scanning the horizon, looking for opportunities to make their organizations and themselves successful – and threats to avoid.”

Publications

A New Tool for Hospital/Physician Strategic Alignment: The Subsidiary Physician Corporation

The Physician Executive, Vol. 34, No. 4, July-August 2008
Joseph W. Mitlyng, MBA, FACMPE and Robert J. Laskowski, MD, MBA

Physicians’ and hospitals’ strategies often diverge—with poor results for both. The causes of this divergence are many. They include different methods of payment, divisive governmental regulations, and cultural differences. In particular, physicians often desire economic independence and practice autonomy. Hospitals desire strategic control.

During the 1990’s, many hospitals began to buy physicians’ practices and employ doctors as a means of assuring strategic alignment. The financial and managerial results were often catastrophic. In purchasing practices and employing doctors, many hospitals found that the theoretical advantages of strategic alignment were overwhelmed by financial and managerial problems.

In this article, we describe our experience with a model of physician practice which uses the tool of hospital ownership strategically, preserves the financial advantages and accountability of private practice, and affords physicians very significant autonomy in their practice – the Subsidiary Physician Corporation (SPC)

The SPC recognizes that physician practices and hospitals are separate businesses. Physicians often do better “running their own show”; and, while efforts by the hospital to manage the day to day operations are often unproductive, expert managerial advice and support from the hospital can be helpful.

An SPC which is owned by the hospital as the “Sole Member” can meet the strategic interests of both the physicians and the hospital. Such a structure can enable the physicians to retain operational control of their practice, and gives the hospital strategic control over the practice in return for specific, limited financial benefits to the physicians.

Leaders As Combat Fighter Pilots

The Physician Executive, Vol. 27, No. 6, November-December 2001
Joseph W. Mitlyng, FACMPE, D. Max Francis, FACHE, and Frederick J. Wenzel, FACMPE

Leaders are like combat fighter pilots. They are continually scanning the horizon, looking for opportunities to make their organizations and themselves successful – and threats to avoid. Combat fighter pilots face a risk called “target fixation.” They become so focused on the target that they fly right into it.

Leaders need a conviction of what needs to be done and to act on that conviction. There are always challenges, obstacles to overcome, and a leader needs to be able to persevere to achieve success.

At the same time, situations change. Persevering blindly, without regard to information that becomes available over time, risks missing the signals that some element of the strategy is not working – signals that a change in strategy will be more successful. This article presents the findings of research on the challenges leaders face in seeing the signals – and steps that some leaders take to help see and act on the signals.

It Takes More Than Money -- Keys To Success In Leading And Managing Physician Groups

MGM Journal, Vol. 46, No. 2, March/April, 1999
Joseph W. Mitlyng, FACMPE and Frederick J. Wenzel, FACMPE

Hospitals, health systems and physician practice management companies acquired physician practices and lost millions of dollars on those practices. They wondered: “We’re paying those physicians a lot of money. They should be highly motivated employees. Why aren’t they?”

Strategic reasons led hospitals and health systems to acquire these practices, and while hospitals and health systems have now in many cases divested once owned practices, the strategic reasons to work well with physicians continue. The strategic needs are multiple, but dominant themes include: increasing or protecting market share, achieving increased strength in negotiating with payers, developing the best medical management model for the full continuum of care, documenting and reporting quality measures, and obtaining capital for the practices.

Managing physicians with compensation is not enough. To manage physician groups well, all the interests and values of physicians must be addressed. Managing a physician group requires a management style that actively involves individual physicians. This article presents our insights into structuring the leadership and management of physician groups. The group may be an employed physician group or an independent, private practice. The principles are the same.