Second, cooperative efforts make sense when competitors realize that they are common customers of a supplier, as well as competitors. As Bruce Mueller said, one of the things that health care organizations must learn is how to be more mature competitors, and they must understand the importance of recognizing that at any one time organizations are competitors, suppliers, and customers. The health care industry has not typically thought of health care providers as suppliers. Health care is an indirect activity in which the competing suppliers of care must realize that they need to work in a common environment and should take action to help make that a better environment by offering choices to consumers. A third opportunity for cooperative efforts makes sense when adverse outcomes occur rarely and competitors want to use scientific methods to help guide improvement.
Good examples are conditions for which the mortality rates are less than five percent.
It is difficult to conduct studies of these rare conditions in most health care organizations in a statistically varied way. Organizations could work cooperatively to do research and change the ways in which they care for such patients. For example, collaborative research on persistent left ventricular failure after coronary artery bypass grafting is an activity that could benefit competing organizations and the community. Cooperative efforts may make sense when there is only one delivery system, as is the case in many rural areas. Such circumstances pose considerable costs in setting up alternative systems and pose a risk that newly developed alternatives will take resources out of a community.