They sought a trust relationship with the rehab– one that would continue through future referrals as well as the current one.

It’s a common argument in sports management: should your team seek out and recruit players who fit your current style of play, or should you design your style of play to fit the talents of your current players?

This never gets resolved, by the way. As arguments go, it’s a hardy perennial.

There’s a corollary in healthcare management. It’s the challenge of finding the right individual to do what needs to be done.

Example: Employee X has an outstanding reputation as a therapist. Hired as clinical director for a struggling outpatient program. Does well in clinical supervision of others but documentation problems continue and everyone is disappointed and frustrated. Employee X responds defensively and threatens to leave. ED doesn’t want to lose her because she’s a really good therapist, but…

HR expert on their Board analyzes situation and recommends following: Redesign the org chart to move some duties to another position, freeing up X to do what she does best. Alter other position description to emphasize management skills: scheduling, checking documentation, doing QI on access, dealing directly with payers on UR calls. Don’t cut anybody’s salary, just give employee Y a bump in status and bucks.

Three months later, all is well again. Improved revenue more than offsets added expense.

If that sounds a bit like cutting and pasting, well, that’s what it is. All that’s required is some objective analysis and a bit of organizational flexibility.

Here’s another example. Company Z operates addiction rehabs in major metro areas. Once again, revenues have declined and a new CEO is brought in specifically to increase them. His resume includes a successful run at a chain of outpatient surgical centers. His enthusiasm and expertise had so impressed the Board that they offered him a substantial salary and free rein over the change process.

Eager to duplicate his earlier success, he brings along two of his best marketers from the other company. They sell Company Z’s services using the same techniques that had done so well elsewhere. Yet again, the results were disappointing. Why isn’t it working?

In short, because the CEO had missed something crucial: the difference between rehab and surgery as a service. A surgical procedure might be considered a transactional product– limited in scope, a one-time event with an obvious endpoint and measurable outcome. Since the primary care physician is the usual referral source, marketers were accustomed to bringing lunch to the physician’s office in exchange for a chance to introduce their services to the staff. The relative simplicity of the process means no particular expertise was needed on the part of the sales rep — only a basic understanding of the product and a winning personality.

In the world of mental health, however, the bulk of the rehab’s patients were referred by therapists at outpatient clinics or in private practice. They asked more questions and delved deeper into the answers. Their main concern was how their patient and family would be treated, and their goal was a trust relationship with the rehab– one that would continue through future referrals as well as the current one.

Fortunately, the two marketers decided to return to jobs in their former field, and a new hiring process commenced, with its focus on recruiting clinicians to work closely with referral sources, through frequent contacts and informal consultation. Their goal was to become a resource for the customer, providing a range of services that extended well beyond the immediate need. It was a smashing success, including some national recognition for innovative practices.

An observation: it’s widely believed in some sectors that “business” is itself a skill and if you succeed in one area, you can rely on the same methods to succeed in most any business, regardless of type.

If only that were true. Life would be a lot easier.

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