The first steps are neither prohibitive nor sophisticated. On the contrary, the first steps in implementing medical management infrastructure are predicated upon the Hawthorne effect. Just paying attention to the necessary components produces improvement. Finally, information systems to drive the process are introduced. The intelligent physician-driven enterprise is born.
Capital is critical.
It is necessary both to build and support the infrastructure, and to provide the reserves necessary to bear the risk. Not only the risk assumed in managing the resources of care delivery, but the risk of entering into the fiercely competitive health care market. Over time, leadership and results will lead to strategic alliances. Until then, physician-driven enterprises can expect, and need to be prepared for, market reaction, the nature of which may take many forms as traditional paradigms of control shift. Capital, on the order of magnitude necessary to accomplish the goals and weather the storm, will undoubtedly require sophisticated capital partners encompassing the full spectrum of the investment community, willing to invest millions of dollars.