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Lessons from a Business Organized to Foster Collaboration PDF Print E-mail
Written by John Weeks   

Rotary Club Service Model and Other Lessons from a Clincian Networking Business

Lisa Yater, founder of the Chicago-based Seek the Frontier Clinicians Network, is at a moment of re-thinking her business plan and model.

Yater had responded to the nation's emerging integration dialogue from a can-do perspective: Why not set up a structure for local healthcare professionals to get together, share clinical insights and review cases? Wouldn't this foster greater understanding, and thus better patient care? Numerous professionals and business people in other communities saw a similar value, and opportunity.

Yater's re-thinking is partly due to the experience of the first years of Seek the Frontier (STF). Her re-thinking is also due to a move away from her base of operations in the Chicago area. I spoke with her about her clinician network business, and the value and shortcomings
Image
Lisa Yater, Seek the Frontier founder
of her work. We then brainstormed about a new model -- what we called the "Rotary Club" model -- which might help provide a sustainable context for fostering collaboration between clinicians in diverse localities.

Seek the Frontier's Model

Yater's business began informally. A group of clinician colleagues (nursing, social work, CAM, behavioral medicine) formed what they dubbed a "Circle of Health." Participants met together. Some started setting up sample appointments to experience each other's care. Cross referral of clients developed.


Yater decided to create a business which could multiply these circles in diverse communities, regionally, and even nationally. The business, Seek the Frontier Clincians' Network, had the following goals:

  • Create a membership organization linking CAM clinicians to each other.
  • Provide services that increase clinician opportunities to meet and form meaningful relationships, through local study groups and regional presentations.
  • Design interdisciplinary teaching and mentoring programs to build clinical knowledge, understanding, and respect.


Participation in the
   Collaborative Circles  
is the core benefit
of STF membership.

The business grew to include four separate "Collaborative Circle" study groups in and around Chicago. Each met monthly, or quarterly. Most had a rotating facilitator. Each gathering included a clinical presentation from a group member or an invited guest.

These circles were STF's core membership benefit. STF also provided discounts at regional conferences (Yater convened two in 2005) and at an annual, one-day intensive retreat. These meetings were not large, but were well-received by the 20-40 professionals who participated in each. Recalls Yater: "We put a lot of work into these events."

Yater developed a data-base of 600 practitioners. Those who became members paid $95 a year. Yater linked them through her web site, a directory, and an STF newsletter.

Evaluating the Model


Yater found significant professional value in the exchanges with other professionals in the Circles and retreats. Others found similar value. But ultimately, Yater concludes, in "this type of group, inter-referring is the touchstone of success or failure." She adds: "People think it's great (to network and exchange information) but eventually - especially for busy clinicians - participants want to see energy coming back to their practices."


"For participants in this
type of group,
especially
busy clinicians, inter-referring

  is the touchstone of success or failure. 

They
want to see energy coming back
to their practices."

Lisa Yater, STF Founder



The business, in terms of revenue, "was never much," recalls Yater, "and all of that I plowed back into the cost of operating it." She concludes that her labor of love, to be successful as a business, needed to have more member benefits. She has considered working to get CEU credits for the seminars, anticipating that this will draw a larger audience.
Tele-seminars are another option for increasing member benefits, and revenue generation.

Yater reflects: "Honestly, I was a clinician racing to learn whatever I could about business to make this work. This has been an adventure for me. I have seen the benefits of our members not being stuck in their own training."

But why the for-profit model, if effectively there is no actual profit? Says Yater: "I am considering converting to not-for-profit. It might click better."

Comment and Discussion: Integration-Without-Walls

One view of the value of the STF-type Collaborative Circle is a that one is forming a virtual "integrated clinic." Practitioners don't work in the same office. But each becomes the hub of a practice with spokes of confidence, trust and mutual understanding emanating to members of the diverse disciplines who, in a given instance, might benefit a patient. Each has the

One view of the value
  these collaborative circles 
is a that one is forming
an integrated clinic
without walls.

phone numbers and the relationships to enhance their practice of integrated care. Such "integration-without-walls" is the most prominent form for CAM-IM "integration" and is likely to remain the dominant practice for the foreseeable future.

Many seasoned practitioners slowly build rolodexes of members of other disciplines or specialties for referral purposes. Yet often the hand-off decision is informed by little more than a prior phone call or a single lunch meeting. Communication is limited. "Collaboration" is perfunctory.

Yet few can deny the value of practitioners in distinct fields deepening their understanding of each other's potential value to patients. Because formal education of healthcare professionals remains largely in distinct, disconnected silos, the importance to quality integration of community-based structures, such as Yater has
worked to create cannot be

Because professional
education
remains in
disconnected silos,

 community-based
structures
such as Yater developed
are key to integration's future
.

denied. But what will keep practitioners interested?

The Rotary Club Model and a Service Mission

As we spoke, I recalled my father's Rotary Club involvement
over decades of his business life. He liked the networking, the habit of the routine, weekly lunch, and the speakers. Networking helped with business relationships, and community activities.

But with Rotary, and other service organizations, there is the binding dimension of "service." Rotary is a not-for-profit. Members endorse a mission to "promote world peace and understanding through local and global service projects." The stories my father brought to our family's Wednesday night dinners - after his Rotary lunches - were often about the organization's
local, national and international projects.

A Potential for Binding Commitment: Free Clinics for the Underserved


The missing piece in Yater's original network model may be a sense of purpose and mission beyond the initial excitement of cross-disciplinary exchange, and beyond the potential for referrals.

What if local collaborative groups were organized around a mission to offer integrated care to the underserved?  Too often, integrated services are only available to individuals who can pay cash-out-of-pocket. Participants in these new collaborative circles could agree to work together in offering free clinics at regular intervals through local care delivery organizations.

Arrangements might be made with community health centers, AIDS clinics, or with CAM schools to use their clinical facilities. Every metropolitan area has diverse sites for meeting

The missing piece in the model
may be a sense of purpose
beyond the initial learning or
referrals. Maybe such
groups
 need a broader mission -
such as 
serving the underserved. 

 
needs poorly met by the rest of the care system. (Location will limit types of care offered.) We already know that community health centeres and community-based programs, with their focus on respect for cultural diversity, and their own service orientation, are the part of the mainstream delivery system with the most openness to CAM-IM.  Across the country, schools of massage, acupuncture and Oriental medicine, naturopathic medicine and chiropractic have already forged such relationships. A proposal from a "Collaborative Circle" to offer special services could be well-received.

With such a mission, participants in a local CAM-IM clinician network will move from what-if, to actual, shared experience -- even if limited somewhat by the facility. They would learn about each other through working together on patients.

The anticipated outcomes? Better understanding, closer relationships, enhanced health opportunities for an underserved population. Not bad. Who knows, the participating practitioners may even find that the experience of working together also stimulates more of the cross referrals which will help their bottom lines.


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