Not for Businessmen Only

Evolving as fast as the business models that drive it, the practice of medicine has changed perhaps more radically than any other profession in the past decade or so. What was once a purely personal encounter between patient and physician is now scrutinized, dissected, and legislated.

Accompanying this sea change is exponential growth in the number and complexity of relationships physicians face day to day. Whether they are seeking patient referrals, recruit-ing nurses and other staff in a time of worker shortages, finding more space for ambula-tory surgery, or battling an inflexible bureaucracy, physicians must rely on an ever-widening circle of friends, colleagues, and professional contacts to keep up and remain successful.

Enter "networking," that vague collection of skills that successful businesspeople seem to use effortlessly. Net-working, when handled skillfully, is, like medicine, more art than science. Whether its simple rules are followed by either a college graduate or veteran physician, networking can produce decided benefits to the practitioner.

Getting a group rate

Two healthcare professionals, each with years of experience in their respective fields, illustrate how networking helped them accomplish their very different goals. Patrick Lloyd had 22 years of practice administration behind him when he helped form the Patient-Physician Alliance Corp. in Memphis, Tenn.

"Group practices were facing declining revenues and, as a result, decreased patient access because of the paperwork requirements of managed care companies," Lloyd says. "Rather than be confrontational, we decided to put a different twist on things and gather the business administrators of the city's group practices together to rate the HMOs. It wasn't adversarial. It was a concerted effort to improve the process by providing feedback to and working with the insurers."

Utilizing the network of professionals he had cultivated over the years, Lloyd identified the physician practices that had been affected most by declining revenues. Over lunch, he laid out the problems common to all the attendees. "Everyone's issues were the same - pediatricians' were no different than the OB/GYNs'," Lloyd explains.

As the concept of an alliance began to resonate with the physicians and the administrators, "everything just fell into place," Lloyd says. "We developed a mission statement and retained a legal consultant."

Among the first tasks the new alliance undertook was a random survey of physicians, their practice administrators, and their patients. Its first report card was just issued, giving Memphis HMOs "average marks" for performance. Some 400 Memphis-area physicians are now part of the alliance.

"It seems to be working," says Lloyd. "We all know each other's pain."

Back to school

Robert Winn, MD, did not have the luxury of making a plan and devising a strategy for networking. As one of the founders of what is today Park City Family Health and Emergency Center in Park City, Utah, he just dove in and "networked like crazy" to save his practice and his livelihood.

"Five years ago, we were looking for a partner and we chose the University of Utah," Winn explains. "We signed non-compete clauses. As time went on, the system changed, developing different values than our clinic and the community we serve."

When negotiations for a new contract failed late last year, the university reminded the physicians of the non-compete clauses they had signed and threatened to enforce them. The clauses stipulated that in the event of a termination of the contract, the physicians would be prevented from practicing in Wasatch or Summit counties for two years.

That's when Winn went to work.

"I went to the university's board of trustees, the government, politicians, and people at other universities," Winn says. "Most of all, I networked with our patients at the market, on bike paths, and in the office." Meanwhile, the clinic filed suit in district court, asking the judge to make a declaratory judgment for them on the grounds that the university's actions violated public policy. At the same time, the clinic's patients filed their own lawsuit.

All of Winn's networking paid off.

In a courtroom filled with supportive patients, Third District Judge Robert K. Hilder determined that the university had "behaved egregiously" and nullified the non-compete clauses. Judge Hilder rebuked the university by saying that a non-compete clause is "intended to be used like a shield, but you have used it as a Draconian sword to clean house."

Now vindicated, the clinic soon will be free of its university bonds. As Winn puts it, "Our relationships in Park City are very deep and strong - this issue brought everyone together."

Jean Sheriden can be reached at editor@physicianspractice.com.

This article originally appeared in the January/February 2001 issue of Physicians Practice.