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February 20, 2020

While You Were Working

Back in the 90s, I had a client in the software development business.  Being smart guys, they decided the consulting game of trading hours for dollars to build something for someone else was not, well, smart.  They looked around and found an industry where the software solutions were pitiful.

‘We’ll build a better mousetrap,’ they said. ‘We’ll dominate and then sell for a wheelbarrow full of money.’

Their ideas on the better mousetrap were, indeed, much better than the junk being sold to the industry at the time. They locked themselves in the room and went to work, writing and testing and revising code.

Things being the way they are, the project was harder than they imagined.  They were, after all, taking on a rewrite of the software that ran an entire industry (think the equivalent of replacing your EMR as well as your systems for billing, accounting, payroll and inventory management).  What was to take 18 months took four years.

Finally, they emerged from the cave with their gleaming new software, ready to take over that little corner of the world.  Unfortunately, while they had their heads down working, the market moved.  What was innovative in their design four years ago was now a standard feature for the incumbent vendors.  Their ‘wow’ was now a baseline expectation.

Since it was the 90s, everyone wanted stock in the next big thing.  Instead of taking cash for my services, I, too, took stock options.  There was no wheelbarrow of money, but that is another story.

Here’s the point…

Last week I was with one of my favorite groups of physicians. Fourteen years ago, a group of small practices came together to form a larger entity.  Part of the conversation that night was a reflection on their journey.  What they did at the time was really bold and innovative; what they have built since is impressive and has them in a much better place.  In fact, without what they did they’d all be hospital employees right now.

But one of the people there at the beginning made an interesting observation.  If the practice had then been the size it is now, they would have been one of the largest provider organizations in that region.  But now, they are nowhere close to being large enough to matter as they would like to in the market.  Hospitals have consolidated; payers have as well; new entrants, many with a lot of financial backing, have entered the space.

While they were working, the market kept moving.

It can be discouraging when you have busted your tail to make progress and you just want to pause for a bit and catch your breath.  But the market does not pause.

An old quote from an entrepreneur best summarizes it for me…

‘Running my business seems a lot like one of my kid’s video games.  You fight like crazy to survive, just to find out the next level is even harder.’

Tim Coan
Tim Coan

CEO and founder

Tim Coan, ALN’s CEO, writes an insightful and witty blog weekly about a variety of topics relevant to independent physician practices.