Inertia, force, and the strategic direction of the anesthesia practice

Sir Isaac Newton’s first law of motion is often called the law of inertia. Inertia states that an object at rest stays at rest and an object in motion stays in motion at the same speed and in the same direction unless acted upon by an unbalanced force. This law is universal.

For those who are entering the world of medicine, and more specifically anesthesia, it might come as a surprise that there are a host of unbalanced forces that are impacting practices across the country today. In many instances, anesthesia groups may feel a bit like a pinball, actively being bounced by forces that appear to influence both the clinical and business direction of groups.

Certain forces can result in both positive and negative outcomes. As a result of the COVID-19 outbreak, for instance, many anesthesia practices were asked to drastically modify their roles in the patient experience. Operating rooms were limited to only the most critical encounters. Anesthesia providers were called to the front lines in many locations to intubate patients who had contracted the virus and needed to go on a ventilator. Another outcome, in a broader sense resulting from the COVID-19 pandemic, is the evolution of telemedicine, a concept that had been slow to gain foothold and acceptance. Telehealth is now considered a mainstream and acceptable means of treatment and patient care. Specialty flexibility and telehealth can both be considered positive outcomes resulting from unbalanced forces.

Additional external forces continue to impact the specialty of anesthesia. Some of these forces include the market implications of state and federal balance billing initiatives, the increasing and expanding forces behind market consolidation, the resurging interest in hospital acquisitions and ongoing anesthesia group mergers.

From a micro perspective, internal forces also continue to impact the activities of anesthesia practices. Examples include the expansion of services outside operating rooms, the compression of professional service fees for under-compensated markets, ongoing complexities related to quality initiatives and a long list of practice and clinical management responsibilities. 

All of these forces are combined with the pressures of being in the midst of the greatest pandemic the world has seen for at least 100 years. Indeed, the days of remaining “at rest” in the anesthesia world seem a very distant memory.

Physician leadership members are busy and can feel the burden of an unending list of to-do items in the clinical setting. However, for groups motivated to set their own direction in the midst of competing and growing forces, it is critical to establish strong leadership and strategic direction. Creating strategic direction should prioritize driving efficiencies that allow group members to enjoy their work while achieving desired outcomes.

With this in mind, we recommend the following strategies as guiding principles through the COVID-19 pandemic and beyond:

• Set your vision – Establish what type of entity you wish to become. While forces abound, many groups can still choose to direct their own destiny. It is important to set a clear vision and establish your own force of strategic direction.

• Establish values – Group leadership has the ability and opportunity to establish the values of your organization. When these values are clearly articulated and implemented, day-to-day confusion is eliminated in the workforce, and your culture becomes a force that unites and compliments the group’s strategic initiatives.

• Set and align priorities – Meeting often as a leadership team is critical to gain alignment and buy-in involving strategic direction and initiatives. Clarity in leadership will energize the entire group. Leaders should prioritize initiatives as short and medium-term goals depending on their importance and complexity.

• Allow open communication – Organizational strategy requires some sense of formal structure in order to provide consistency of thought and direction. However, it is critical to allow open communication and free association of ideas within these forums of thought in order to foster the best and brightest ideas. This dialogue should have guidelines of respect and mutual understanding.

• Empower all members of your group – You are surrounded by a group of talented individuals. All members should be invested in the success and strategic direction of the group. By gaining access to opportunities to grow personally, employees gain strength and motivation that are critical for a sense of ownership. By fostering this type of partnership, the team’s energy will complement the vision, values and strategic direction as established.

Practices that have woven these behaviors into the fabric of their culture have maintained a stable and controlled environment during the COVID-19 pandemic. In many instances, groups have actually flourished during such difficult times. For some, hospital and peer relationships have been strengthened through deeper interaction and improved communication. For others, work schedules have been adjusted to accommodate those at higher risk or higher need, providing consideration and overall satisfaction to practice members. Practices have achieved financial recovery thanks to leadership that has successfully navigated its way through the various government assisted programs. 

Regardless of the challenges and decisions facing your group today, you can take control of your own vision and destiny by creating positive forces. May the force be with you as you work together through these confusing times by clearly setting a direction that drives positive inertia and elevates your group to new heights of success. 

_{About the Author}

_{Jason Davis is Vice President of Client Services at abeo, which provides advisory, analytics, management, billing and collections, and technology solutions to solve financial and practice management challenges faced by hospital-based physician specialties like anesthesia.}