Consider this (not uncommon) scenario: Sleepy Anesthesia Group (SAG) has been providing exclusive services at Hospital XYZ for over 15 years, and suddenly they learn that the hospital has put out a request for proposal (RFP) for anesthesia services. SAG feels caught off guard – what should they do?

Find the trigger: The first step is to assess why the hospital published an RFP. What triggered this? Possibilities include:

Understanding the trigger will help the group determine what to emphasize if deciding to respond to the RFP, which is really its first decision point. Does the group want to provide a response? If the group has been unwilling or unable to meet the hospital's needs, is it willing and/or capable of making the necessary changes to win the bid now? Are the parties aligned in their mission and/or goals for the anesthesia service? And if the hospital has unreasonable cost...

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