Never Mind the Trick: The Best Offense is a Good Defense a/k/a Esnefed Doog a si Esneffo Tseb Eht

By Derrick B. Stark

​I know I have heard some derivation of this statement a million times and likely used it on occasion, but it struck me as wrong recently while reading an industry-related article. The best offense is a good defense...
 
Wait. What?
 
Defense does not put points on the board; you cannot win with defense. I decided to find the source of this oft-referenced wisdom and discovered instead:
 
“The best defense is a good offense.”
   – Carl von Calusewitz, Prussian soldier and German military theorist
 
Ain’t that rich? It is backwards. Clausewitz’s statement certainly makes more sense. If one perpetually charges the opponent, keeping them in a reactionary state, the opponent consumes themselves with not losing. That is not the same as winning.
 
We have not been winning, but we have real opportunities this year.

We can:

• Scramble for a bigger piece of a shrinking, more bitter pie;
• Cannibalize our own value proposition to fit current reimbursement; and
• Strain to justify our legacy role in a rapidly changing time and place.
  

Or I suppose we could go on the offense and:

• Demonstrate our commitment to our patients and the success of our businesses in spite of difficult regulation and collective misunderstanding;
• Focus on our specialty areas and move purposefully toward our specific, measurable goals;
• Gather meaningful data and overwhelming testimonials from referral sources and patients to make an irrefutable case that independent HME is inextricable from an accessible and affordable healthcare system;
• Work with Congress, CMS, and commercial payers to improve processes and controls that ensure accountability and eliminate those that distract and confuse; and 
• Align (or reconcile) our incentives with those of patients, physicians, and third-party payers.​
  

​If we want to win, the best offense is a good offense, and we are foolish to forget it.