Loyalty Lost
Cardiology has been one of Floyd Memorial Hospitals’ most stable physician groups. We have been lucky enough to have two main groups very dedicated to Floyd and performing the vast majority of their procedures here. Both groups have been actively recruiting new physicians and one group has two new physicians joining and the other group is looking for their third associate. This would bring our primary cardiologists to a total of nine if they are able to recruit to their groups.
It takes a lot of time, effort, and money to recruit and build the practice of a new cardiologist and there are only a fixed number of patients and referrals from this area. It is unlikely that many Kentucky patients will come to this side of the river for their cardiac care.
Recently, these two cardiology groups had gotten word that Floyd was considering a recruitment package for some cardiologists who are now practicing in Louisville. These cardiologists would directly compete with the current two groups and basically dilute the fixed number of patients between additional cardiologists. This would result in lost revenue for the current groups and a more difficult time for their new members to build a practice.
This has caused some very emotional responses by all parties involved. It has contributed to the increasingly tense relationship between physicians and the CEO. The trust issue continues to decline because of repeated poor choices.
The CEO reportedly told one of the cardiologists that he was directed by the Board to increase the Cardiology numbers because they continue to be below the projections. This is of questionable accuracy because the discussion came up last year when I was on the Board and we specifically voiced our opposition to recruiting a competing group of cardiologists. We knew that it would destroy the working relationship we currently had with our present cardiologists.
But since the the current situation at Floyd is that they are below their projections in cardiac procedures and below virtually all of their financial goals for the year as well as struggling with satisfaction numbers, someone decided to consider a rash decision that in actualilty would probably cause even more lost revenue because of lost loyalty. But like many other decisions, they are very shortsighted.
The cardiologists that were being considered are reportedly very good friends with some of our hospitalists who started last year. If they were to come to Floyd, they would likely get the referrals from the Hospitalists. These are not necessarily new patients to our hospital system, but captive ones by the fact they are admitted here and would normally go to our current cardiologist groups. The hospitalists do not have an outpatient practice and it is unlikely they would get many referrals from the private physicians because our relationships and referral patterns are already established with the current groups.
Luckily, someone has been able to stop this recruitment process, but not before the ill-will and strained relationships between the CEO and physicians worsened. You cannot place a dollar value on relationships, but you can certainly feel the financial impact of broken relationships when referral patterns and loyalties change. This is happening repeatedly because of decisions being made by those in charge.
Why would anyone think it was a good idea to actively recruit competition directed at your two very loyal cardiology groups who have been practicing primarily at Floyd for more than 20 years?
This current situation has caused our cardiologists to think long and hard about their future here at Floyd.
Physicians understand competition and we certainly welcome other physicians on our staff who wish to work hard and build relationships and trust. We do not understand why the Hospital would financially support an endeavor that would directly hurt its current cardiology groups that are trying to recruit themselves and increase the care they currently provide mainly to Floyd.
It takes a lot of time, effort, and money to recruit and build the practice of a new cardiologist and there are only a fixed number of patients and referrals from this area. It is unlikely that many Kentucky patients will come to this side of the river for their cardiac care.
Recently, these two cardiology groups had gotten word that Floyd was considering a recruitment package for some cardiologists who are now practicing in Louisville. These cardiologists would directly compete with the current two groups and basically dilute the fixed number of patients between additional cardiologists. This would result in lost revenue for the current groups and a more difficult time for their new members to build a practice.
This has caused some very emotional responses by all parties involved. It has contributed to the increasingly tense relationship between physicians and the CEO. The trust issue continues to decline because of repeated poor choices.
The CEO reportedly told one of the cardiologists that he was directed by the Board to increase the Cardiology numbers because they continue to be below the projections. This is of questionable accuracy because the discussion came up last year when I was on the Board and we specifically voiced our opposition to recruiting a competing group of cardiologists. We knew that it would destroy the working relationship we currently had with our present cardiologists.
But since the the current situation at Floyd is that they are below their projections in cardiac procedures and below virtually all of their financial goals for the year as well as struggling with satisfaction numbers, someone decided to consider a rash decision that in actualilty would probably cause even more lost revenue because of lost loyalty. But like many other decisions, they are very shortsighted.
The cardiologists that were being considered are reportedly very good friends with some of our hospitalists who started last year. If they were to come to Floyd, they would likely get the referrals from the Hospitalists. These are not necessarily new patients to our hospital system, but captive ones by the fact they are admitted here and would normally go to our current cardiologist groups. The hospitalists do not have an outpatient practice and it is unlikely they would get many referrals from the private physicians because our relationships and referral patterns are already established with the current groups.
Luckily, someone has been able to stop this recruitment process, but not before the ill-will and strained relationships between the CEO and physicians worsened. You cannot place a dollar value on relationships, but you can certainly feel the financial impact of broken relationships when referral patterns and loyalties change. This is happening repeatedly because of decisions being made by those in charge.
Why would anyone think it was a good idea to actively recruit competition directed at your two very loyal cardiology groups who have been practicing primarily at Floyd for more than 20 years?
This current situation has caused our cardiologists to think long and hard about their future here at Floyd.
Physicians understand competition and we certainly welcome other physicians on our staff who wish to work hard and build relationships and trust. We do not understand why the Hospital would financially support an endeavor that would directly hurt its current cardiology groups that are trying to recruit themselves and increase the care they currently provide mainly to Floyd.
posted by Anonymous at 6:20 AM
10 Comments:
It is sad you cannot see the difference. Your personal bias towards physicians is apparent and evidently clouds your judgement as it does so many others. You lump physicians into one big pot when they are all independent. From a hospital perspective, each one is an independent entity just as any other outside vendor or customer and has to be managed accordingly.
The hospital could spend upwards of $200,000 to recruit the cardiologist in the hopes of increasing the procedures and revenue all while directly impacting their current cardiologists who are currently generating revenue for them. There is not a continued increasing number of cardiology patients and they will not pull from Louisville. In fact, they will probably take the patients they do get back to Louisville where their primary practice resides. This will force the local cardiologists to begin taking more of their outpatient revenue to their own facilities and feeling less and less obligated to stay at Floyd.
When the new hospital is built, these cardiologists will certainly have less of an incentive to continue working at Floyd.
None of these cardiologists we are referring to are recruiting another hospital. In fact, there is an extremely limited amount of physicians currently loyal to Floyd even involved in the new hospital. This endeavor is primarily being managed by Louisville physicians who will bring many Kentucky residents to this side of the river.
You need to better understand the facts and the dynamics.
A lecture about hospital/doctor loyalty from Dr. Dan is about as appropriate as a sermon on marital fidelity from Bill Clinton.
So, Louisville doctors at the new hospital will bring patients with them to Indiana but Louisville doctors at Floyd will steal patients back to Louisville?
Why the perceived difference?
Louisville doctors will own the new hospital and want to keep their patients here because they have control of care as well as a financial investment whereas Louisville physician who just have priveleges at Floyd will take the patients back to their private offices where it is more convenient for them and they can control the care.
It is not time or cost effective to go to a hospital and only see one or two patients when you can work them in your office and maintain better efficiency and quality.
Absolutely, competition makes everyone better.
Physicians have always had to compete and the laws are set up so we cannot negotiate as a group. We will continue to invest more in our own offices to make up for lost revenue that occurs from competition or the hospital. There is nothing wrong with that.
As the hospital, why would you spend money directed to promote competition at one of your largest revenue producers who will then be forced to make decisions that will negatively impact the hospital. If they get really frustrated with Floyd and the new Hospital is right down the road, they could then choose to do more and more of their elective outpatient procedures there.
This is where I continue to say that relationships are key. Physicians get to choose where they go. Hospitals have to rely on the choice of physicians. It has always been that way. With more choices, it becomes even more critical that hospitals maintain an even better relationship.
This is the ongoing problem when you have administrators from the old way of thinking and cannot see the paradigm shift. Those hospitals will struggle as we are seeing at Floyd
T
In a situation where physicians are employed by the hospital and not putting up the numbers, that would be an acceptable way to manage it. But these are independent contractors who can choose to take even more patients, procedures and revenue away.
The hospital needs to widen its service area to attract more patients. They need more relationships with primary care doctors in outlying areas of southern indiana that can then refer patients to the cardiologist.
The vast majority of cardiology patients come from primary care doctors. There needs to be more patients coming in. Diluting the current patient base amongst more cardiologist will not increase the procedures and revenue. It will just cause more hard feelings and lack of trust.
It was a bad idea and even though it got nixed, it caused more distrust.
That would be a wonderful idea and it would allow Harrison County to do some caths but allow Floyd to accept referrals that would require bypass.
Floyd leaders would only see this as losing those cath patients and would not value the new relationship and potential benefits.
All of that is true, but Harrison county has patients that we do not have and for the past several years, when they needed heart procedures, they would be referred over the river.
Building a new relationship would help gain new patients and loyalties to Floyd. It may cost some money in the short run, but would make money in the long-run.
Shortsighted thinking is plaguing our hospital and our County
I fail to understand what the problem is, one of the leading cardiology Doctors at FMH had no problem with sending patients to Jewish,(but of course this was before the NEW UNDERSTAFFED, OVERDONE, LARGER THAN LIFE, HEART
WING was finished) was there not someone in Floyd County that could have performed the needed services?
Why is everyone crying now about losing business and money, if people are satisfied with the service they receive at FMH and the good Doctors of Floyd County decide to take their insurance their should be nothing to worry about. On the other hand, if the Doctors in Floyd County decide they can't take the heat of competition, I certainly wouldn't be trying to pick and choose my patients based on who their Insurance Carrier happens to be. As I've said I have seen one of our leading FC Cardiologist running from the Heart & Lung Center across to Jewish Hospital many times. Could it be that the people of Floyd County are tired of being jerked around by the Powers that be and will take the initiative to take the matter of Healthcare into their own hands, and all that will be left are the people that either do not care or can't afford to pay. Let the games begin. Most people will go where their Insurance will pay and pick up the difference and not have to put up with paying for everyone else. The Louisville Doctors are coming over to Indiana for a reason. Maybe they are trying to accommodate all those Aetna and US Healthcare patients that went to Louisville when FC ran them out of town. Think about it.
Sorry, I made a typo I meant to say United Healthcare, not US Healthcare
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