By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
I love feedback from readers. “Things I Notice,” which ran in the March issue, drew lots of attention. While I tried to reply to as many responses as I could, I received more than 250 emails, so if I missed you, I will continue to reply.
The comments were, as expected, polarized. But I was a little surprised at the overwhelming emails of support for my comments and observations. I have listed things that I noticed from last month, below, and excerpts from reader feedback. It is always helpful to see where you stand among your peers:
1. “Your facility is overstaffed by at least 10%.” Almost everyone agreed. Most commenters confided they had more staff than needed for a normal surgical schedule, but they admitted that they have “extra” staff employed in case of increased activity, staff with flu or other illness, maternity leaves, surgeon requests, etc. Many respondents agreed that no one in management seemed to notice or complain. When you are making money, you can do just about anything, but when you are not, you cannot do anything.
2. “Your inventory is too large.” No one disagreed except to say they had very little storage area to put the supplies.
3. “Most of your staff is insensitive to patient needs and rude when questioned by patients.” Although some agreed with this, most didn’t feel that was the case at their facilities. Comments like, “Every one of our patients is treated with respect and dignity,” and “We have had more negative comments by patients than normal,” were common. However, with rare exception, most believed they had more work to do in this area. Some took offense at the statement and chastised me for it, but most commenters believed their staff is overworked and sometimes short on courtesy to family members who complain about waiting time, etc. (See my response in next month’s SDS on “Requiring your patients to come to your facility two hours before surgery is ridiculous.”)
4. “Most of your professional staff is underpaid.” No one disagreed. There were three comments from receptionists who believe they are underpaid and should be considered part of the professional staff. The short answer is to go back to school and become licensed if you want to run with the pack. The long answer is that receptionists, even though they are not professional or licensed, have an important role to play in the success of their centers, and they should be paid appropriately.
5. “Your waiting rooms are third-world environments.” This point elicited no comments at all. I don’t know why that didn’t strike a nerve. I have been in some very nice waiting rooms, but they are rare. Most leave it to the outside cleaning staff, but someone should be assigned to walk through the waiting rooms once a day to make sure they are acceptable.
6. “Anesthesia will not help you in cost control.” There was overwhelming agreement, except from one anesthesiologist who is in charge of cost control for a facility.
7. “If you charge your patients to park while they use your facility, you are cheap and gouging them.” This drew the ire of, I think, senior managers from several hospital systems. They made attempts to justify why the charge is necessary and that it is outsourced to other companies (not the hospital) and other lame excuses. There was overwhelming support from surgical staff and three patients (apparently, a copy of SDS was in the waiting room), which I thought was very cool.
8. “Surgeons make no money between room turnover or waiting for delayed cases.” This was supported by a couple of dozen doctors who basically said that they don’t think that staff understands that they are the only people not being paid during these down times. Most other comments were attempted justifications for delays. Same old excuses for inefficiency.
9. “Most ‘pre-op’ testing is revenue-based and not in the patient’s interest or for their protection.” This statement irritated some, but not that many. Most agreed that spending $350 on pre-op lab work for a 10-minute local anesthesia for cataract removal and other minor procedures is ridiculous. Here’s a quick reminder that pre-op testing protocols typically fall under anesthesia and not the facility. It’s always nice to know where to point the finger.
10. “Hospitals offer no time incentives for their staff to turn over rooms quickly and start cases on time.” There were no negative responses except from hospital staff members who don’t understand why incentives cannot be offered. Several hospital department heads said that they do offer incentives, but the incentives they cited didn’t sound like incentives to me — more like just “feel-good chatter.”
Space will not allow response to all 19 of the “Things I Notice,” but I will do that next month.
Again, thanks for all the feedback. It’s nice to know people are reading and responding, and it’s all I can ask.
Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Earnhart & Associates can be reached at 5114 Balcones Woods Drive, Suite 307-203, Austin, TX 78759. Phone: (512) 297-7575. Fax: (512) 233-2979. Email: [email protected].Web: www.earnhart.com.
Author Stephen Earnhart shares feedback and reader comments from the March article "Here Are the Things I Notice."
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