True Partnership in Practice Management: Beyond the Vendor Relationship | Issue #23

In healthcare, words like “partnership” get tossed around so frequently that they risk losing their meaning. Nearly every management group, consultant, and vendor claims to be a “partner” to their hospital clients. But what does partnership truly mean in the complex ecosystem of modern healthcare delivery? More importantly, how can hospital leaders discern between vendors who simply use partnership language and organizations genuinely committed to authentic collaboration?

I’ve spent my career witnessing this distinction firsthand—first as an emergency physician, then as a department leader, and now as the Founder and CEO of Core Clinical Partners. The difference between transactional vendor relationships and true strategic partnerships isn’t just semantic. It represents fundamentally different approaches to hospital-based medicine that produce markedly different outcomes for patients, clinicians, and healthcare systems.

As we continue our growth trajectory—now managing 40 Emergency Medicine and Hospital Medicine programs in 10 states serving more than a million patients annually—I remain convinced that genuine partnership is not merely a competitive advantage but the only sustainable approach to physician services. This conviction formed the foundation upon which we built Core Clinical Partners six years ago, and it continues to guide every decision we make.

In this newsletter, I want to explore what hospitals should rightfully expect from a practice management partner, how to distinguish transactional vendors from strategic allies, and why this distinction matters more than ever.

The Evolution of Hospital-Physician Relationships

The relationship between hospitals and physician groups has evolved dramatically over the past several decades. What began as loosely affiliated independent practices gradually shifted toward more structured arrangements, from Professional Services Agreements (PSAs) to co-management deals to full employment models.

Along the way, something fundamental changed. Large national groups consolidated the market with promises of scale, efficiency, and expertise. The pitch was compelling: bigger is better. National scale would drive down costs. Sophisticated infrastructure would improve performance. Standardization would enhance quality.

But as I observed in an earlier newsletter, those promises haven’t fully materialized for many hospitals. Size did bring certain advantages, but it also created distance between decision-makers and the front lines of care. Efficiency sometimes came at the expense of physician engagement and local responsiveness. Corporate priorities occasionally misaligned with community needs.

In many cases, what began as a partnership evolved into something more transactional—a vendor relationship focused on contractual obligations than collaborative problem-solving.

Transactional Vendors vs. Strategic Partners: Understanding the Difference

What distinguishes a vendor from a true partner? It’s not about size, resources, or even capabilities, though those certainly matter. Instead, the difference lies in approach, alignment, and accountability.

Vendors Provide Services; Partners Share Outcomes

The most fundamental distinction is the distribution of risk and reward. Vendors deliver contracted services and collect their agreed-upon compensation regardless of outcomes. Their primary accountability is to their own financial performance.

True partners, by contrast, share in both risk and reward. They align their incentives with the hospital’s goals and accept accountability for outcomes, not just activities. At Core, we’ve structured our agreements to ensure we succeed only when our hospital partners succeed, whether that’s measured by quality metrics, patient satisfaction, clinician retention, or financial performance.

When we partnered with St. Francis Medical Center in Louisiana to provide physician services and emergency medicine management, we demonstrated our commitment to shared outcomes in concrete ways.

Rather than simply staffing the emergency department, we retained 100% of the emergency physicians, nurse practitioners, and physician assistants who were already serving the community. We also hired more to continue providing excellent service and quality care.

As St. Francis’ Vice President of Patient Care Services and Chief Nursing Officer stated, our partnership ensures they continue to be “the hospital of choice for quality emergency care delivered in the compassionate manner St. Francis is known for in Northeast Louisiana.”

This kind of investment in community continuity is what distinguishes a true partner from a vendor simply fulfilling a contract.

Vendors Execute Contracts; Partners Solve Problems

Another key distinction is how organizations respond to unforeseen challenges. Vendors operate within the confines of their contract, often requiring amendments or additional fees to address emerging issues. Partners, on the other hand, view challenges as shared problems requiring creative solutions.

Our operational leaders spend more time on-site than is typical in our industry, working directly with hospital teams to address issues as they arise. For example, during a large-scale program transition across multiple sites, we faced the challenge of building an entirely new clinical team due to restrictive non-compete agreements. Rather than seeing this as the hospital’s problem, we rose to the challenge by successfully recruiting and integrating 90 new clinicians into the Hospital Medicine program.

This strategic influx of skilled personnel was pivotal in fostering an immediate cultural transformation, enabling the rapid adoption and implementation of innovative processes. Our focused recruitment strategy, built on a deep understanding of hospital needs and a robust support system, ensured that we not only met but also exceeded the expectations of our hospital partners.

Vendors Assign Staff; Partners Build Community

Perhaps the most visible difference between vendors and partners is their approach to clinician leadership and engagement. Vendors typically focus on staffing to contractual requirements, assigning physicians and APPs to shifts without necessarily fostering connection to the hospital or community.

True partners recognize that sustainable success requires clinicians who are invested in local outcomes—clinicians who view themselves as members of the hospital community rather than employees of a distant corporation.

In one instance, following a transition to Core, a hospital system faced longstanding issues with clinician disengagement and turnover. Rather than simply staffing shifts, we prioritized rebuilding the clinical culture. We implemented leadership development tracks for physicians and APPs, created local governance structures to give providers a voice in operational decisions, and introduced ongoing engagement initiatives to strengthen team cohesion.

By investing in leadership, culture, and communication—not just coverage—we helped transform the clinician experience, resulting in improved retention, stronger hospital-physician alignment, and a more cohesive, community-focused environment.

What Hospital Leaders Should Expect from a True Partner

So, what should hospital leaders rightfully expect from a practice management partner? Based on our experience working with dozens of hospitals nationwide, I believe there are several non-negotiable elements:

1. Transparent Economics

True partners provide complete transparency into their economics, including clinician compensation, management fees, and any other costs. They’re willing to open their books and explain exactly how they allocate resources.

At Core, we rejected the common industry practice of obscuring margins or creating complex financial structures. Instead, we share detailed financial models with our hospital partners and engage in open dialogue about sustainable economics for all stakeholders.

2. Aligned Incentives

Partners structure their agreements to ensure they tie their financial success to achieving the hospital’s goals. This might include quality bonuses, risk-sharing arrangements, or performance guarantees.

Core’s growth has been 100% organic and is solely dependent on reference and referral, so we take our partnerships very seriously. One of our company’s OKRs is to have relationships with hospitals that are so good we could use any administrator at any of our hospitals as a reference. That level of excellence requires our teams to truly partner with their hospitals to ensure complete alignment.

3. Local Leadership with Decision Authority

Partners empower local clinician leaders with meaningful decision authority rather than centralizing control at the corporate level. They recognize that healthcare is inherently local, and that effective leadership requires deep understanding of community needs.

At every Core program, we identify and develop clinician leaders who have both the authority and accountability to drive performance. We support them with resources, analytics, and operational expertise, but we don’t micromanage from afar.

This approach has proven particularly effective across our partnerships, where we emphasize the importance of local leadership by assigning a Director of Operations (DOO), Director of Clinical Operations (DCO), Practice Coordinator, and a Medical Director to each site for onsite administrative support. This structure ensures local leaders have both the autonomy and support they need to achieve results.

4. Consistent Executive Involvement

True partners provide ongoing executive involvement rather than appearing only during contract negotiations or crises. Hospital leaders should expect regular, substantive engagement from their partner’s senior leadership.

At Core, our operational leaders spend more time on-site than is typical in our industry. We believe in building strong local partnerships with hospitals and communities, fostering collaboration, accountability, and alignment between clinical and leadership teams. This high-touch approach ensures we understand local challenges and can mobilize resources quickly when needed.

5. Innovation and Continuous Improvement

Partners bring innovation and best practices from across their network, constantly seeking ways to enhance performance rather than maintaining the status quo.

Our implementation of Agile frameworks in healthcare provides a perfect example. By adapting methodologies from the technology sector, we’ve created a more responsive, iterative approach to healthcare improvement. This allows us to break complex challenges like reducing length of stay into manageable tasks, enabling healthcare teams to implement precise, targeted improvements swiftly.

The Agile methodology promotes a culture of continuous improvement, collaboration, and adaptability—qualities that are increasingly vital in the fast-paced and ever-changing healthcare environment. We’ve successfully implemented this framework at one of our partner health systems to reduce length of stay and improve operational efficiency.

Building Partnership Culture: A Two-Way Street

While I’ve focused primarily on what hospitals should expect from their physician services partner, it’s important to recognize that genuine partnership requires commitment from both parties. The most successful hospital-physician relationships we’ve experienced have featured hospital leadership equally invested in collaborative problem-solving.

This mutual commitment creates what I call a “partnership culture”—an environment where hospital executives, physician leaders, and frontline clinicians work together with shared purpose and mutual respect. In such environments, challenging conversations become opportunities for growth rather than sources of conflict.

At Core, we combine the benefits and experience of a professionally managed group with an engaged physician team to create an unparalleled level of alignment for all involved. This alignment is key not only to better metrics but, most importantly, to better patient care.

The Future of Hospital-Physician Partnership

As we look toward the future, I believe the distinction between transactional vendors and true partners will become increasingly important. Several trends are converging to elevate the value of authentic collaboration:

First, workforce challenges continue to intensify across healthcare. The physician staffing industry has shifted dramatically, requiring deep alignment between hospitals and physician groups to navigate these complex dynamics effectively.

Second, financial pressures on hospitals show no signs of abating. Recent reports highlight these challenges: Ascension reported a $1.9 billion loss in Q1, citing “ongoing business conditions impacting healthcare providers,” including “higher operating costs coupled with sustained revenue challenges.” CommonSpirit lost $1.85 billion in 2022 and $658 million in Q1 of the following year, with staffing remaining “a pressing issue across the industry.”

With razor-thin margins the norm, hospitals need physician services partners willing to innovate on both clinical and economic fronts, finding ways to enhance quality while managing costs responsibly.

Third, the pace of change in healthcare continues to accelerate. From payment model evolution to technological advancement to regulatory shifts, hospitals need partners agile enough to adapt quickly to changing circumstances.

At Core, we’re responding to these trends by doubling down on our partnership approach. We’re investing in our infrastructure to support more customized, data-driven solutions for our hospital partners. We’re expanding our leadership development initiatives to ensure a pipeline of physician leaders equipped to drive continuous improvement. And we’re exploring innovative care models that leverage both technology and human connection to enhance outcomes.

Our addition last year of Dr. Rachel Thompson as Chief Medical Officer represents a significant step in this evolution. As the Immediate Past President of the Society of Hospital Medicine and a physician executive with extensive experience in quality improvement, Dr. Thompson brings invaluable expertise to our hospital partners. Her focus on developing a leadership community within Core will further enhance our ability to deliver on the promise of true partnership.

Partnership Drives Performance

Why does the distinction between vendors and partners matter so much? Simply put, because partnership drives performance.

Our Hospital Medicine group has successfully integrated various models to optimize practices for our clinicians, leading to impressive results across our partner hospitals. By implementing targeted strategies, we have reduced the length of stay by nearly a day, increased transfer acceptance by 99.2%, and saved one health system almost $100 million.

At Core Clinical Partners, we welcome scrutiny of our partnership approach. Our growth, including our recognition on the Inc. 5000 list for the third consecutive year, our status as the Fastest Growing Company among the top 40 middle-market companies in Georgia (ACG Fast 40), and my recent honor as a finalist for the Entrepreneur Of The Year^® 2024 Southeast Award, stems directly from our unwavering commitment to authentic partnership.

That’s the power of partnership—and it’s what every hospital deserves from their physician services group.

I welcome your thoughts on this topic. You can reach me directly at brobinson@coreclinicalpartners.com.