In these turbulent times for the business of anesthesia groups, in which the pace of, to use Joseph Schumpeter's term, creative destruction, is quickening, it is more important than ever to take a strategic approach to the way in which exclusive contracting and group structure and group functions are intertwined. To simply keep on keeping on with a pure focus on patient care, thinking business success, or even business survival, will follow, is folly.Consider this very instructive example:In the late 1920s, Walt Disney had his first big commercial success with a cartoon character named Oswald the Lucky Rabbit. Disney had an exclusive contract with Universal Pictures for the distribution of Oswald cartoons.  It paid Disney a tidy cut, but not nearly enough. So Disney, based in Burbank, set off on the train for Universal’s headquarters in New York City to renegotiate the terms of the deal. But Universal knew he was coming. And...