The Two Cornerstones of Physician Alignment

We’re living in a world where we continue to see mergers of physician groups and acquisition of physician groups by private equity, hospitals and health systems, as well as a myriad of other affiliation structures.

In this world, alignment is critical for success. We know by experience that alignment of physicians within a single group practice can often be a formidable exercise. When bringing together multiple groups, the risk of misalignment is exacerbated.

How can we address this? As I have often said in this column, it is not easy, but it doesn’t have to be this hard. Let’s consider the two foundational pieces to ensure proper alignment.

Vision. It all starts with vision. What is the vision of each party in the arrangement? How does each actor in the discussion define vision? I look at vision as how a group defines success in the future. What does it look like? What are the components of success?

Is success work/life balance? Is success earning as much money as possible? Is success working 7 days a week, or working 4 days a week? Is success willingness to work at satellite offices, or only working at the main office? Is success being able to determine your schedule, or having it dictated to you?

Two visions. First, what is the group’s vision for the future: how will the group define success? The second vision is that of the physicians. And the critical question is, are they in alignment? If in alignment, good merger or acquisition. Out of alignment, a very bumpy road. In fact, I often recommend against merger if the visions are terribly out of alignment, and there is little or no hope of having them line up.

Culture. Edgar Schein, with MIT’s Sloan Management School of Management, defines culture as a pattern of shared basic assumptions that the group learned as it solved its problems of external adaptation and internal integration, that has worked well enough to be considered valid and, therefore, to be taught to new members as the correct way to perceive, think, and feel in relation to those problems.

Many feel that culture is the glue that binds the group together and the compass that points the way. Culture, along with vision, points the way. The proper culture, with positive, supportive, innovative and collaborative traits, breeds a strong organization, and helps stabilize alignment discussions.

Culture and vision are the defining factors in ensuring and maintaining solid physician and organizational alignment in reaching the strategic goals and vision of the organization, and the physicians.

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If you are interested in learning more about physician alignment, please contact Ken Hertz at khertz@mgma.com.