Game Theory and CRNAs - Links Between Games

Scope
 

 No game is an island. Even so, people draw boundaries and divide the world up into separate games. It's easy to fall into the trap of analyzing these separate games in isolation - imagining that there's no larger game. The problem is that mental boundaries aren't real boundaries - there are no real boundaries. Every game is linked to other games - a game in one place affects games elsewhere, and a game today influences games tomorrow. Even the mere anticipation of tomorrow's game influences today's.

Understanding, playing off and changing links betwen games is the fifth and final lever of strategy. The first step is to recognize the links between games. The links are there. Even if you don't see them, you can still trip over them. Once you've seen the links, you can use them to your benefit. The links aren't ironclad - you can create new links between games or sever existing ones. And by doing so, you can change the scope of the game.

Links Between Games

Any two games, even if conceived of as games in their own right, are really only components of the big game. By definition, this mythical big game is a game without boundaries, without a defined scope. So PART - Players, Added values, Rules and Tactics - describes all the elements of the mythical big game.

Anytime there's a Player in your game who's also a player in another game, the two games are potentially linked. The players in common could be anyone in your Value Net - any of your customers, suppliers, competitors or complementors. It could also be YOU of course. The existence of a common player determines only the possibility of a link between games.

Links through Added values can arise whenever your customers or suppliers participate in more than one market. The other side of this equation is when, by entering another game, you end up competing with, rather than complementing yourself. You lower, rather than raise, your added value in the original game.

When we were involved in getting nurse anesthesia practice identified in our state law. The hospital association was our key ally in this "game". They realized that it was in every hospital's best interest to allow CRNAs to provide their full scope of practice within a hospital. However once the discussion moved to providing CRNA services outside of a hospital, the game got bigger. Now ASC's and Office Practice settings became players in the game and the hospital adopted the anesthesiologists' position requiring CRNAs to be supervised when outside of the hospital.

Rules impose constraints on what players can do, and these constraints can link what would otherwise be separate games.. We've already seen this effect when we discussed most favored customer clauses that prevents a provider from treating two otherwise independent negotiations with customers as separate games.

Finally, two games can be linked for no other reason than that someone perceives them to be linked. Thus, Tactics, by changing perceptions, can change the links between games. For example, issuing threats and establishing precedents are tactics that work by creating links across games.

The most important lesson of this section is that every game takes place in a larger context. This is what allows a games boundaries to be expanded or simply moved. Even when a player seems to be narrowing the scope of the game, it's the player's power in some bigger game that makes this maneuver possible. You may think you know what game you are playing, but that game is invariably part of a larger one.

The Bigger Picture

Finding a better game to play doesn't have to come at the expense of others. This perspective makes it easier to find the best strategies, whether cooperative or competitive. In some cases defeating others may be the best strategy and the results win - lose. But don't presume it's the only strategy. Oftentimes the best strategy has multiple winners. Looking for ways to expand the pie, while keeping an eye on capturing your share of the pie, helps promote a mutally beneficial attitude towards other players, while at the same time keeping you tough mined and protective of your own interests.

Business is cooperation when it comes to creating the pie, and competition when it comes to dividing it up. This duality can easily make business relationships feel paradoxical. but learning to be comfortable with this duality is the key to success.

By suggesting ways to change your perspective of the business side of our profession, perhaps we can challenge the status quo and show how things can be done differently and better. And that is my challenge to you.

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To better understand and appreciate Co-opetition I highly recommend the book by Adam M. Brandenburger and Barry J Nalebuff.

Blink by Malcolm Gladwell offers a fascinating perspective.

 The conclusion of our discussion of Game Theory based on the book Co-opetition.