From the Editor RobFromberg_2012_r1 

Robert Fromberg, Editor-in-Chief

Lately, I've noticed that my shoelaces come untied with annoying frequency.

I don't know whether I've lost the ability to tie my shoes, but I do know that my boss, seeing my untied laces, told me it would be a personal inconvenience to her if I tripped and hurt myself.

The problem with my laces reminds me of a woman I know whose son always had his shoelaces untied. "Tie your shoes; you'll trip and break your leg!" was her refrain to him. One day in the park, I saw her son hobbling along with a cast on his ankle. "Don't tell me…" I said to her. "Yep," she replied. "He tripped on his shoelace and broke his ankle!" There was a hint-just a hint-of glee in her voice. I had never heard such a big, beautiful opportunity to say, "I told you so." And it struck me that a worthy goal in life is to avoid putting yourself into a position to hear, "I told you so."

In this month's issue of hfm are several articles focused on long-term planning. These articles outline strategies from merging to cutting costs to integrating with physicians, all of which are full of pitfalls that have tripped many hospitals in the past. Take physician integration. An observer could pick from a long list of potential problems: Owned practices lose money. Physicians are lone wolves and won't work toward hospital goals. Physicians won't change their practice patterns. Integration will disrupt relationships. The technology support to link practices to the hospital is lacking.

Assuming that hospital leaders view physician integration as a strategy critical to delivering value, a reasonable goal is avoiding hearing "I told you so" after falling into any of these well-known pitfalls.

In "Are Your Current Physician-Integration Strategies Sustainable?" authors James J. Pizzo and Todd Fitz outline a systematic approach to avoiding these and other pitfalls. The authors first show the importance of tailoring the approach to integration to fit a hospital's market and strategic objectives. They then help readers assess-and avoid-risks related to financial resources, financial performance, functional capabilities, communication, connectivity, and culture.

"By approaching transformation as an evolutionary process and not as a discrete event, organizations can better shape their own destinies," the authors advise.

The careful planning and ongoing assessment outlined in this and other articles in this issue are critical to hospitals reaching strategic objectives that require drastic changes in structure, incentives, relationships, and processes. With any luck, preparation will mean never having to hear, "I told you so."

Now, excuse me while I tie my shoelaces.

Publication Date: Thursday, November 01, 2012

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