Hospital Strategic Partnerships – The Dance Is Worth It

Dancing Shoes

Steps that will help practice owners engage in strategic partnerships with hospital systems.

By Nicole Kluckhohn, PT, DPT, ATC*

It’s the classic middle school dance scenario.

There is someone you’d like to dance with on the other side of the school gym but the self-talk in your head causes you to quickly determine that regardless of all that you have to offer, they are never going to notice you, yet alone dance with you.

In the world of outpatient therapy, we often see the local hospitals as that unattainable partner. The assumption is made that they are set in their ways and only interested in feeding their internal hospital-based therapy departments. In reality, though, the hospital practice may be simply following the path of least resistance. Typically, they have not considered the benefits of partnering with a private practice in either a joint venture or management agreement to combine strengths and create a therapy department that is greater than the sum of their department and your private practice individually. There is often no reason that private practices cannot partner with them to provide optimal comprehensive care.

The common marketing strategy historically used has been finding an opportunity to get in front of an influential physician or hospital administrator and in a few moments, sell them on our experience and how great we are with patients. The problem with that approach is they are more interested in how we can make things better and easier for them, which might mean, for example, optimizing financial performance, improving patient satisfaction, or preventing “patient leakage” (the loss of patients as they transition to various providers within the hospital system). We need to ask ourselves how we can help in the hospital setting: How can we eliminate steps in their day? How can we expand patient access points? How can we prevent rehospitalization following surgery? How can we eliminate unnecessary physician visits by providing appropriate education and consistent messaging? How can we improve operating metrics and financial performance of the therapy department? How can we drive excellence across departments in the delivery of musculoskeletal care?

It’s time to walk across the dance floor and approach your prospective partner to better serve patients and therapy practices and hospitals alike. The steps are more strategic than complicated and involve more initial listening and observing than speaking. What are the current processes and steps for a patient with low back or shoulder pain? What clinical pathways exist to ensure they get the right care at the right time? What is the typical path, and how could that be improved? How many nonsurgical patients are currently being seen by orthopedic surgeons rather than by physical therapists? What is the typical wait time for an orthopedic appointment as a result of not having a standardized flow for patients? How is leakage prevented when wait times are more than a few days? How is the therapy department performing compared to national benchmarks? What are the obstacles? Where are the gaps? Where are the redundancies? Sometimes the hospital system is aware, but often, unless probed, they have just settled into the day-to-day rhythm and don’t have time to think much beyond, “This is just the way it is . . .” We can look closer and bring some new perspective and solutions to the table.

Step 1:

Lead with questions

Leading with questions allows both administrators and clinicians an opportunity to assess the performance of current conditions. This requires interaction with both administrative and clinical team members; that is, physicians, referral coordinators, practice managers, and medical assistants. What is the current flow for a patient from initial intake to final discharge? How are patients triaged? How are patients identified for surgery or therapy? What is difficult within that process? What is your biggest daily challenge? What could make your day-to-day job easier? What is important to the physicians? Think beyond the flow of patients to therapy and consider how therapy can improve the overall delivery of care for musculoskeletal patients. Keep your ears open for subtle frustrations due to a gap or an obstacle that current processes contribute to.

Step 2:

Define your value proposition

Outline the problems, inefficiencies, gaps, and opportunities identified with your questions. Determine what is solvable, what is worth solving, and what you and your team have the capacity to solve. What can you bring to the table that would create value for the hospital team? What is the combined financial impact of improving metrics, preventing leakage, and creating a more efficient system with therapists playing a larger role within the system? What business skills or knowledge do you have from your private practice experience that a physician practice wouldn’t have? Therapy-specific billing, coding, compliance, and practice management are all unique to therapy.

Step 3:

Build a vision of what is to be accomplished by working together

It may be as grand as becoming “The Premier Orthopedic Provider in the Region” or as simple as “Providing best in class patient care.” Prioritize solutions and look for opportunities to make the most impact with the least amount of effort or change. Sometimes the simplest shift is ultimately the most impactful. What is your goal or outcome for this partnership? What is the best legal structure to achieve this shared vision?

Step 4:

Clarify your elevator pitch

If you have two minutes or less in front of a decision maker for that physician practice or hospital, what will you say? Will you use it to laud your own knowledge and expertise, or will you use it to share with them the perceived obstacle or gap and how you can remedy that? Remind yourself: What will matter most to them? What you do? Or what you can do for them?

Step 5:

Network and present

Figure out who is most interested in seeing things improve and who would be most positively impacted. This could be an influential physician or a hospital administrator who oversees orthopedic or musculoskeletal care and shares a similar vision. Regardless, it may take months of showing up and consistently delivering on small promises that have positive impact until credibility and trust are built. Each interaction is a brick in the foundation of this credibility and trust. Do not let initial rejections or lack of interest or awareness keep you from continuing to connect and offering to be a resource. It is ultimately about the relationship. You need to prove that your priority is to help them, not serve yourself. Give them time; offer yourself as an educational resource on a topic that will positively impact their practice. The foundation of showing that you can partner well to work to create wins for the practice and ultimately create a better and more seamless process for patient care is what your partnership will be built on regardless of the structure.

Although it can be intimidating to start across that dance floor, the opportunity to partner well with a physician practice or hospital opens up a vast array of possibilities to truly create a comprehensive package for the patient. Communication will inherently improve between providers and their teams and trust built in a way that represents more of a team approach. The patient will feel and hear this as they receive similar expectations consistently throughout the process and their episode of care. Over time, you will be recognized as a valuable resource within the practice—not down the street or on a different floor—and you will be called on to help facilitate best pathways for their patients because you make things easy for them and get it done. If you begin the dance with nimble steps and a confident strategy, both patients and providers will ultimately reap the benefits.

Nicole Kluckhohn, PT, DPT, ATC, is a practice consultant with 8150 Advisors. She can be reached at

*The author has a vested interest in this subject.

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

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