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Navigating the Physician Services Market: 5 Pieces of Advice from Core CEO Dr. Boykin Robinson

Last month, Core CEO Dr. Boykin Robinson sat down to record a podcast with Dr. Leon Adelman, CEO of Ivy Clinicians. The two were classmates together at the Physician Executive MBA program at the University of Tennessee, an experience Dr. Robinson said has been invaluable as Core Clinical Partners has grown from managing one emergency medicine program in Georgia to more than 30 EM and HM programs around the country.

The two talked about the market opportunity Dr. Robinson saw in the physician services market, how he thinks about growth, leadership, team-building, and many more topics. The full podcast is available at Emergency Medicine Workforce, but below are five tidbits from the conversation:

1. Go in with a plan, but be flexible

When Dr. Robinson started Core, which is based in Atlanta, Georgia, he expected that growth would likely come in concentric circles moving out from there. Yet by being open to opportunities nationwide, Core has unexpectedly grown into new states across the Southeast, Midwest, and Southwest, with emergency medicine and hospital medicine programs everywhere from Georgia and Louisiana, to Kansas and Ohio, Oklahoma, and Texas.

“I actually pulled out the business plan I wrote for a startup emergency medicine company as part of getting that degree just to see how far off I was,” Dr. Robinson recalled. “My five-year projection was actually not too far off.”

2. Alignment can take different forms

As Dr. Robinson recounted both here and in his first From the CEO newsletter (“There is no one-size-fits-all”), his original plan was to give physicians “true, transparent ownership at the contract level.” But he had to pivot when, early in its growth path, Core rescued a failing group that was in danger of not even meeting payroll—and it would take time before the contract was profitable. It was an early lesson that not all hospital challenges can be fixed with the same approach.

As Dr. Robinson recounted in the podcast: “Since that time, as we’ve grown, we have sometimes employed an ownership model at the local level, but it’s harder to do than you would think. Many physicians don’t want to take the risk, and you can’t just give the ownership without the risk.”

What is really important is physician alignment: “The docs who work in a community must have their incentives aligned with the goals of the hospital serving that community.”

3. Growth follows from quality

When Core was still a small group, opportunities for growth came primarily through the personal networks of Dr. Robinson, his co-founders, and the initial leadership team. However, as the company grew, new opportunities arose from existing hospital partners who felt Core was delivering a high level of quality and service.

As Dr. Robinson recalled: “We’ve had a couple of new contracts that only happened because one of our current administrators said, Hey, would you mind if I gave your name to my colleague? And I love that, that’s my favorite kind of growth that tells me we’re doing it right.”

4. There are no magic bullets—it’s execution that matters

As Dr. Robinson described, Core works hard to ensure its clinical and operational leaders have the time and mental bandwidth to make wise decisions. Having access to a powerful analytics platform is one thing; having leaders with the experience, expertise, and mind space to make the best use of those analytics is another matter.

At one new emergency medicine program, the hospital’s leadership had informed Core that the ER was getting busy starting around 11 pm and needed additional staffing then. But a deeper dive on the analytics revealed a different issue: “The problem was that even though most ERs don’t get busy till 10am or 11am, this one got busy at eight. And so they were getting overwhelmed, not in a way they could notice, but patients just slowly started stacking up from 8am and they just never caught up.”

The solution was to bring in more staff earlier, not later—and left without being seen rates fell markedly as a result of the change.

5. Book recommendation: The Goal, by Eliyahu M. Goldratt

Asked to recommend a book or movie to their listeners, Dr. Robinson didn’t hesitate: The Goal, by Eliyahu M. Goldratt.

The book is a novel about a plant manager’s journey to save his factory and marriage in 90 days with the help of a former professor who introduces him to the Theory of Constraints (TOC). “It’s a page-turning novel,” said Dr. Robinson. “And you learn all about LEAN while you’re reading it.” 

Dr. Robinson said he still recommends it to Medical Directors as a lesson in management and process improvement. “I’d never read a book that gripping, one I wanted to pick up as much, that was absolutely about stuff I think about every day for work.”