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President, Latham Consulting Group, Inc., Chattanooga, TN. Latham Consulting Group helps medical group physicians make decisions, resolve conflict, and move forward. For more than twenty-five years Mr. Latham has assisted medical groups in the areas of strategy and planning, governance and organizational effectiveness, and mergers, alliances and networks. During this time he has: facilitated over 900 meetings or retreats for medical groups; helped hundreds of medical groups develop strategic plans to guide their growth and development; assisted over 130 medical groups improve their governance systems and change their compensation plans; and advised and facilitated the mergers of over 120 medical practices representing over 1,200 physicians. Latham has an MBA from the University of North Carolina in Charlotte and is a Certified Public Accountant. He is a frequent speaker at local, state and national, and specialty-specific healthcare conferences. He can be reached at (704) 365-8889 or wlatham@lathamconsulting.com.

Independent Anesthesia Group Practice: A Short Manifesto

"Most people will choose unhappiness over uncertainty. -Tim FerrisAnesthesia groups are facing great challenges in today's environment. I am sure you are aware of these various challenges so I won't belabor them.The question is: What do we do now?Some groups are throwing in the towel and selling out. It seems as though every few weeks another indep...
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Setting Your Strategic Goals in Motion: A How-To Guide for Anesthesia Groups

I find the great thing in this world is not so much where we stand, as in what direction we are moving: to reach the port of heaven, we must sail sometimes with the wind and sometimes against it—but we must sail, and not drift, nor lie at anchor. — Oliver Wendell HolmesIn earlier Communiqué articles ("Hope is Not a Strategy: A Primer for Anesthesia...
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Leading Leaders: Building Influence in a High-Talent Group

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TNIn despair at the way its programs were organized, the business school at one university recruited as the director of programs a successful businessman, who had made a modest fortune in his own business and wanted to move on to a new career. "I will soon put some order in thi...
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Disrupting the Disruptive Physician

One would think (or hope) that by the time anesthesiologists complete their training and begin practicing, they have mastered not only their clinical field, but also the ability to work well with others and behave appropriately. If you've spent any time as a member of an anesthesia group, however, you know that it is rare for all of the physicians ...
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Independent Anesthesia Group Practice: A Short Manifesto

"Most people will choose unhappiness over uncertainty. -Tim FerrisAnesthesia groups are facing great challenges in today's environment. I am sure you are aware of these various challenges so I won't belabor them.The question is: What do we do now?Some groups are throwing in the towel and selling out. It seems as though every few weeks another indep...
Continue reading
606 Hits
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Disrupting the Disruptive Physician

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TNOne would think (or hope) that by the time anesthesiologists complete their training and begin practicing, they have mastered not only their clinical field, but also the ability to work well with others and behave appropriately. If you've spent any time as a member of an anes...
Continue reading
780 Hits
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Leading Leaders: Building Influence in a High-Talent Group

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TNIn despair at the way its programs were organized, the business school at one university recruited as the director of programs a successful businessman, who had made a modest fortune in his own business and wanted to move on to a new career. "I will soon put some order in thi...
Continue reading
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Where Do We Go From Here? Choosing the Right Path in Turbulent Times

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TNThe environment continues to be a challenging one for anesthesia groups. Health systems are combining, stipends are under pressure and payment system changes loom. And there is always someone knocking at your hospital CEO's door saying they can do it better, faster and cheape...
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Effective Governance: Who Decides What?

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TN Over the years, you may have heard the old saying that "Nothing happens until someone sells something." With regard to anesthesia groups, we have found that "Nothing (good) happens until the group has effective governance."Without effective governance: The group lacks the ab...
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Effective Governance: Who Decides What?

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TN Over the years, you may have heard the old saying that "Nothing happens until someone sells something." With regard to anesthesia groups, we have found that "Nothing (good) happens until the group has effective governance."Without effective governance: The group lacks the ab...
Continue reading
839 Hits
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Hope Is Not a Strategy: A Primer for Anesthesia Groups on Strategic Planning

One of the most important responsibilities of any anesthesia group's governance is to develop a strategic plan for the group. For some groups this is the role of the Board. In other groups, all shareholders participate in this process.Unfortunately, it appears that for many groups, "hope" is their strategy.We are continually surprised to find group...
Continue reading
768 Hits
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Hope Is Not a Strategy: A Primer for Anesthesia Groups on Strategic Planning

One of the most important responsibilities of any anesthesia group's governance is to develop a strategic plan for the group. For some groups this is the role of the Board. In other groups, all shareholders participate in this process.Unfortunately, it appears that for many groups, "hope" is their strategy.We are continually surprised to find group...
Continue reading
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Hope Is Not a Strategy: How to Create Your Strategic Business Plan

Will Latham, MBA President, Latham Consulting Group, Inc., Chattanooga, TNIn the previous issue of The Communiqué ("Hope Is Not a Strategy: A Primer for Anesthesia Groups on Strategic Planning," Fall 2016) we described the need for strategic planning and described the overall process. This process includes: Developing mission and vision statements ...
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Hope Is Not a Strategy: A Primer for Anesthesia Groups on Strategic Planning

One of the most important responsibilities of any anesthesia group's governance is to develop a strategic plan for the group. For some groups this is the role of the Board. In other groups, all shareholders participate in this process.Unfortunately, it appears that for many groups, "hope" is their strategy.We are continually surprised to find group...
Continue reading
891 Hits
0 Comments

Hope Is Not a Strategy: A Primer for Anesthesia Groups on Strategic Planning

One of the most important responsibilities of any anesthesia group's governance is to develop a strategic plan for the group. For some groups this is the role of the Board. In other groups, all shareholders participate in this process.Unfortunately, it appears that for many groups, "hope" is their strategy.We are continually surprised to find group...
Continue reading
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Advice For Strengthening Your Board

Effective anesthesiology group governance is no longer a luxury but instead an important survival skill. Why?

  • The external environment is threatening— changes in reimbursement, threats from competitors, hospital consolidation—all add up to the need to make decisions, change and adapt.
  • The internal dynamics of many groups are challenging—getting “the entire herd roughly moving west,” dealing with disruptive physicians, developing an agreed upon group strategy—all require a well organized governance system.

Whether your group’s Board includes all the shareholder physicians, or you have chosen a subset of the shareholders to serve as the Board, there are a number of steps that you can take to strengthen your Board’s performance. Here are several of the most important steps that an anesthesiology group Board can take.

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Strengthening Your Board

Effective anesthesiology group governance is no longer a luxury but instead an important survival skill. Why? The external environment is threatening— changes in reimbursement, threats from competitors, hospital consolidation—all add up to the need to make decisions, change and adapt. The internal dynamics of many groups are challenging—getting “the entire herd roughly moving west,” dealing with disruptive physicians, developing an agreed upon group strategy—all require a well organized governance system. Whether your group’s Board includes all the shareholder physicians, or you have chosen a subset of the shareholders to serve as the Board, there are a number of steps that you can take to strengthen your Board’s performance. Here are several of the most important steps that an anesthesiology group Board can take. Improve Board Meetings We begin with Board meetings. Why Board meetings? No matter your group’s size, meetings are a tool that all groups use in their governance processes....
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Improving Board Performance

The Scene: Monthly Board Meeting  Gotham Anesthesia Associates is a 45-physician anesthesiology group providing services to patients in and around Gotham, New Jersey. Several years ago the group agreed that it was too large to have all members of the group involved in every issue the group considers. At the time they developed a five-physician “Board” that was to guide the day-to-day, week-to-week operations of the group. The group settled on five members to allow for representation of each of the major service locations and/or subspecialty area. The Board meets once a month at 6:15 PM. Unfortunately, typically only Dr. Jones (the group’s President) and the Administrator are present at 6:15 PM. Other physicians join the meeting at various points and business typically gets started by 6:45 PM. Dr. Peters never arrives before 6:45 PM because, he says, “we never start until then anyway.” The group’s agenda is sent out three...
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Anesthesia Group Mergers: Strategies for Success

In today’s anesthesiology environment, all groups are trying to size up their best option to survive and thrive into the future. Some try to go it alone and others sell out to practice management firms, while others seek or are forced into hospital employment. Another option that many groups are considering is merging with other anesthesiology groups. Why are anesthesiology groups considering mergers? Mergers: Allow them to maintain a higher level of autonomy than any other option, Prevent the groups from being played off against each other by hospitals or managed care companies, Build clout, Create the ability to hire needed management expertise, and Allow them to move towards economies of scale. In addition, today’s healthcare environment is influencing many hospitals to merge or join systems. When hospitals integrate they often want to work with a single anesthesiology group to cover all their facilities. When this happens, many anesthesiology groups consider...
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Strengthening Your Anesthesiology Group

“Most people choose unhappiness over uncertainty.” — Timothy Ferris Anesthesiology groups are facing unprecedented challenges. How will the Affordable Care Act affect them? What will happen when ACOs get up and running? Should our group sell to an investment group? Should we pursue hospital employment? These are truly uncertain times. Unfortunately many groups are in a reactive mode, struggling with how to deal with threats and opportunities in the marketplace. This is often because their governance and management processes were formed at a time when there were fewer stressors and challenges. Some group are sprinting towards relationships that appear to offer financial reward and some level of security, but at the same time have the potential to severely limit the group’s and the physician’s autonomy. While there are situations where employment may be appropriate, many groups that pursue this course are “choosing unhappiness over uncertainty.” If your group intends to remain...
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