Surgeon involvement generates financial rewards
By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
I'm following up on my last column in which I urged surgical programs to include surgeons in decision-making processes to help hospitals and surgery centers alike function better and become more cost-efficient. Talk is cheap, so here are some real-life examples:
• Dateline: Greater Orlando, FL. With the recent reimbursement cutbacks on gastrointestinal (GI) procedures, plans were scrubbed to construct a GI-only surgery center. The numbers worked before the cutback, but they didn't gel after January 2008.
We decided to move the cases into the existing hospital and essentially create a GI Center of Excellence within the not-for-profit hospital. We incorporated the same team of surgeons that we were using in this hospital/surgeon joint venture. We discovered some ingenious new ways to use existing hospital space to create a new, highly efficient, dedicated GI environment by expanding "dead" hospital space and back hallways into new waiting rooms and GI rooms.
Because the surgeon investors wanted a freestanding surgery center for the efficiencies and not for a profit motive, it worked out well for everyone. The hospital was able to avoid the loss of 50% of the cases at a greatly reduced reimbursement (via the joint venture arrangement), the new department is managed professionally by an outside company with a dedicated staff, and the surgeons were able to stay in the hospital environment in a new, efficient GI department. The input from the surgeons was instrumental in effecting this change.
• Dateline: Northern California. Much to the dismay of a local hospital, a corporate surgery center chain was soliciting its surgeons to develop a new surgery center that essentially would leave out the hospital. The perception was that this center basically would put the small hospital out of business.
The hospital hired a surgery center consultant to put together a team of surgeons loyal to the hospital to find a solution. Working together, the team proposed converting an existing hospital outpatient surgery center into a new, for-profit surgery center in which the hospital and the surgeons split equity ownership. The threatened surgery center company, not wanting to fight the hospital's loyal surgeons, abandoned their plans and left town.
• Dateline: Central California. A newly formed surgery center partnership between a not-for-profit hospital and local surgeons was having difficulty recruiting new surgeons to the center.
A team of surgeons was invited to help find a solution. Quickly it was discovered that the local surgeons were more comfortable speaking with a peer rather than the staff of the new venture. The center took their advice and hired a well-known, well-respected, and well-liked retiring general surgeon to be the administrator of the center. It worked!
• Dateline: Central Illinois. A new center was struggling with higher-than-average supply cost per case. A fact-finding panel consisting of 95% surgeons was put together (stacked with the surgeons whose supply costs were the highest). The group studied the preference cards of the specialties involved and within two months, supplies were standardized and the cost per case was decreased by 25%.
The bottom line? Surgeons can be your greatest ally if you genuinely let them.
(Editor's note: Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Contact Earnhart at 1000 Westbank Drive, Suite 5B, Austin, TX 78746. E-mail: [email protected]. Web: www.earnhart.com.]
I'm following up on my last column in which I urged surgical programs to include surgeons in decision-making processes to help hospitals and surgery centers alike function better and become more cost-efficient. Talk is cheap, so here are some real-life examples:You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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