By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
One question I’m frequently asked is how to increase referrals to surgeons in the hospital or freestanding ambulatory surgery center (ASC) arenas.
Hospitals are easier due to their greater resources and patient capturing services and programs, including their primary care physician base. Freestanding ASCs, not so much. But you do have other resources available to you if you have the space and the money. Always the money!
A great source of referrals for hospitals is the emergency department (ED). Several states allow physicians to have their own EDs, just like hospitals. They typically are very profitable in their own right, but they also refer many potential surgical patients! In highest to lowest referrals, based upon our records, are orthopedic, ENT, GI, and general surgery. If your facility has a relationship with these facilities, you could be the recipient of a steady stream of patients after they have passed the acute phase of their ED treatment. ASCs cannot provide services for emergency cases. Care needs to be taken to make sure that the ED docs are not investors in the ASC, as their referrals to your facility can cause problems. However, these are very compartmentalized facilities with no overlap.
One nice feature of these EDs is that they can’t continue to care for the patient after the emergency encounter, so they are very willing to pass the patient on to someone for follow-up care and surgical intervention if necessary.
How do you compete with the hospital’s primary care network? Visit with all the local urgent care centers (UCC) in a radius around your ASC. Unlike EDs, these facilities can and do very much want to provide follow-up services to patients using their facility. Some UCCs don’t hold on to a patient if another primary care doc recommends the UCC cover their patients after hours. But there are plenty of unfettered patients out there using UCCs who don’t have a relationship with another doc, so they are up for grabs.
Developing a relationship with either of these providers is good business for everyone. Patients have a trusted referral to see someone after their episodic encounter. The ED has someone who can provide quality follow-up services. And the urgent care facilities only want to make sure the patients are taken care of after they leave, and they hope the patients will continue to come back for more non-emergency encounters.
Be alert to new EDs and UCCs opening in your area, but you also can approach a facility that has been open a long time. Like many relationships, they can erode over time, and they might be dissatisfied with their current arrangement.
Many of these freestanding EDs and UCCs have a corporate player behind them. If you don’t have success with the individual approach, seek out the corporate owners and speak with them. Chances are they can see the bigger picture and can envision the benefit of such a relationship better than the local manager can.
But wait. There’s more!
Can’t find one to work with? They are all booked up?
Build your own! Neither is all that expensive, relatively, and if you have space available beside your ASC or in the immediate area, it can be a good investment for your surgeons. Discuss with your legal advisor the best way to structure such a venture, but they are very doable. In addition to being a good investment in themselves, they can benefit your ASC significantly. [Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Earnhart & Associates is located in Austin, TX. Phone: (512) 297-7575. E-mail: [email protected]. Web: www.earnhart.com.]
