Game Theory and CRNAs - Part IV

The Fourth Part of a discussion of Game Theory based on the book Co-opetition

Friend or Foe ?

In the game of business, who are your friends and who are your foes ? Sounds like an easy question. You have three groups of friends and one group of foes right? Customers, suppliers and complementors are all on your side, while competitors clearly are not.

In fact we know that can't be quite right. People understand intuitively that along the vertical dimension of the Value Net there is a mixture of cooperation and competition.

It's cooperation when suppliers, companies and customers come together to create value in the first place. But when the pie has to be divided up, customers press for lower prices and suppliers want their slice too. So its competition when it comes to dividing the pie. It's the duality that best describes your relationship with customers and suppliers.

In a hospital setting a GI Doctor is considered a friend, they have no vested interest in the expense or revenue generated by anesthesia, and appreciate the anesthesia provider that can let them focus on their task; but move to a free standing endoscopy center and suddenly the revenue of anesthesia services comes into play and your piece of the pie becomes very tempting.

Added Value

The key to understanding who has power in any game is the concept of "added value". Added value measure what each player brings to the game. Take the size of the pie when you and everyone else are in the game, then see how big a pie the other players can create without you. The difference is your added value.

It's hard to get more from a game than your added value. What you can take away from a game is limited by what you bring, and what you bring is your added value. If you ask for more than you bring, what you've left for everyone else to divide is less than the pie they could create without you. Why should they agree to this ?

Let's step away from theory for a moment and take a hard, honest look at your situation. Maybe you work in a mega-practice working for "the man" or perhaps you work in an independent setting where you are "the man". What value do you add to this practice ? What happens when the case load drops and there are too many providers or someone else moves into town and offers a better deal ? Are you expendable, replaceable by a new grad or an AA ? What do you bring to the table besides your fork ?

We're not talking about competition with other providers but rather complements to the anesthesia service. Is your practice or group stronger and more valued because of you ?  Prove it !

An obvious complement to an anesthesia service is a chronic pain service. You could encourage a pain practioner to provide this service, but beware, it might be better to provide this service yourself. Yes, it is quite a commitment and in comparison to your anesthesia practice it may not make much money, but it complements your service AND now you are viewed as someone who brings customers in and therefore makes the pie bigger (and adds value).

Next up Rules