For one hospital’s integration effort, the third time is the charm

Sometimes your best successes will come from learning from the times you do not succeed.

Several years back, I was fortunate to lead a team toward a fully subscribed joint venture. It was a very well-received and successful joint venture including a surgery center, pain management center and endoscopy center.

When asked how we were able to pull together such a strong venture, I replied, "it was easy after we failed the first two times."

The first time we tried, there were not too many joint ventures, yet our health system knew it was a better long-term care model to collaborate with our local physicians. When we approached the physicians, they were reluctant and decided not to participate because there was little known about joint ventures. Even after sharing what was starting to take place around the nation, they declined. We agreed to consider reviewing the possibility in the future.


The next time around, there was more physician interest, yet it was mainly geared toward just one to two physicians wanting more power and shares compared to the other investors. It was a "win-lose-lose-lose" situation.

The third time around, we were able to find a "win-win-win-win" between the health system, the surgery center, endoscopy center and pain management center. There was equal say on our board and there was a compromise toward a shared vision instead of just benefitting a few. There were still some who almost decided against it if they could not have more shares than their other physician partners. That was not an option, and the other physician investors made that clear. A few physicians backed off the venture for that reason, and it ended up better for the group. The physician investors wanted other partners who were willing to share equally as opposed to making it one-sided.

A few things stood out that probably made that third time work and sustain over years:

  • We developed a shared vision
  • We understood what was most important to each party in the short and long run
  • We made compromises without changing what was most important to each of us and still in alignment toward a shared vision
  • We created a shared governance model to support this vision, and we communicated regularly and honestly
  • We genuinely believed in each other as team

Fellow healthcare leaders, I look forward to hearing about your successes.

Scott Kashman serves as the chief administrative officer of Cape Coral Hospital, part of the Lee Memorial Health System in southwest Florida.