Editor’s Note: What’s the Big Idea?

December 15, 2008
Bob Keaveney

Every few years, a “big idea” emerges. The latest big idea has hospitals and practices aligning more closely together. Read this month’s Your Best Practice to see how it all affects your practice.


Every few years, it seems, a Big Idea in healthcare group management emerges. The new Big Idea is supposed to be a response to the old one, which turned out not to be such a great idea, after all. Remember all those hospitals that, in the 1980s and ’90s, were buying up independent practices like crazed brides at a wedding-gown expo? What a terrific Big Idea, we were told: The hospitals would gain referrals and the practices would get a deep-pocketed big brother.

The hospital buying spree didn’t work because the hospitals managed the practices poorly. The physicians didn’t take well to suddenly being employees of what had been their own practices, and they were no longer tied as closely to the groups’ success. A lot of deals unraveled amid some very hard feelings.

So we’ll forgive you if you’re skeptical about the latest Big Idea, which again has hospitals and practices, including oncology groups, aligning more closely together. But this time, it seems the hospitals, determined to learn from their mistakes, are employing a greater variety of alignment models, most of them subtler than outright ownership. Simultaneously - and in oncology in particular - practices are banding with each other to form larger groups.

Still, if hospital/practice partnerships didn’t work before, why should anyone think they’ll succeed this time?

That’s one of the questions Shelly K. Schwartz asks in her cover story, “All Together Now.” She puts the new models (and others) under the microscope and asks what it all means to oncologists. In this edition of Your Best Practice: A Practice Management Supplement for Oncologists and Hematologists, we’re also offering some insight into the difficult process of educating patients who don’t hear a word you say after “cancer,” and some advice on moving an oncology practice over to an electronic records system.

Welcome to the fall edition of Your Best Practice. As always, our goal is to offer you the practice-management information and advice that just isn’t available for your specialty anywhere else.

This article originally appeared in the September 2008 issue of Your Best Practice.