CMG has served clients in over 20 states. Four recent illustrative case studies follow:

• This 60+ bed Southwestern county-owned rural community hospital sought help in responding to surgeons' plans to build an offsite ambulatory surgicenter. The hospital CEO understood that a physician-financed surgicenter reflected a lack of physician-physician understanding and agreement about physicians' shared self-interest in having a financially viable hospital. Physicians working at this hospital invited CMG to assist them in developing physician-physician communication and in building consensus around clinical priorities. The ambulatory surgicenter has become a physician-hospital joint equity venture on the hospital campus.
  
  
• This 300+ bed metropolitan West-coast community teaching hospital sought help in planning for new hospital construction required for compliance with state earthquake mandates. The CMO and CEO felt that physician morale had deteriorated as a result of decreasing reimbursement and increasing regulations, expenses, and expectations, making it difficult for physicians and management to work interdependently. The physicians invited CMG to facilitate an 8-month structured dialogue process in which a medical advisory panel composed of practicing physicians heard from presenters from 25 departments about their departments' recommendations to improve care in the community over the next 3-5 years. Physicians working with management and the Board plan to implement their top 3 priorities this year, including a multidisciplinary acute stroke center and task forces to study and improve throughput in the Operating Room and in the Emergency Department. Physicians and management are also in discussion to build a joint outpatient cardiovascular imaging center.
  
  
• This 300+ bed Northeastern community teaching hospital sought help in dealing with an annual operating loss of $20 million. Management was concerned that physicians lacked a sense of accountability for the hospital's success and survival, viewing financial losses on items such as expensive prostheses as the hospital's problem. Physicians asked CMG to help them with a structured dialogue process because they felt that physicians needed a voice in clinical priority setting. By participating in the process, physicians helped to reset the strategic direction away from competing as a high-tech provider toward improving service to patients and their families and toward improving the practice environment for physicians.
  
  
• This 250+ bed Rocky Mountain regional referral hospital sought help in improving physician confidence and collaboration. In letters to the local press, physicians wrote that management had jeopardized safety and clinical quality to maintain the annual operating budget. The CEO also recognized that poor physician-physician communication had resulted in a drop of regional referrals and a significant loss of market share to the regional competing hospital. Physicians invited CMG to assist them in sorting out the physicians' shared clinical priorities. A $120 million rebuilding program is now underway based on the collective priorities that the physicians identified in their report.