Answers to 4 frequently asked questions
By Stephen W. Earnhart, MS
President and Chief Executive Officer
Earnhart and Associates
Dallas
More than any other topic, readers ask me to discuss frequently asked questions in this column. Most of us are curious about what our peers are doing in other parts of the country. Many of us have questions but don’t have the time or inclination to ask someone. Hey, it’s a busy world. Maybe your questions are here.
First, some stats about this column. On average, I receive 56 calls, E-mails, faxes, or letters per issue. This year-to-date, the average is 85! Glad to see that so many are reading Same-Day Surgery newsletter and taking the time to respond! I take great pride in responding to every inquiry. Now, as some of you know, it might take a week or two before I get back to you, but I always do.
E-mails are the best way to contact me, because they are a quicker and less expensive way for me to communicate with you, and you can be anonymous if you want, as some of you already know. Thanks for the unsolicited pictures of your facility, staff, and other things.
The highest response I’ve received was 122 questions and comments for "The next generation ASC: the hybrid," which ran in the December 1996 issue of SDS. [Editor’s note: To order a back issue of SDS, contact our customer service department at (800) 688-2421.] The 1993 column on the "Art and science of physician recruiting" generated the least amount of reader response: I had exactly two calls both from MDs.
I guarantee that I will respond to every inquiry, so keep your responses coming. Here is the breakdown of reader responses: 48% request more information (I have a wealth of peer resources on most topics), 35% are supportive, 8% disagree with the topic, 7% offer other comments or ideas unrelated to the column, and 2% do not return my call in response to theirs. (Please don’t do that last one.)
These are some of the questions asked most often, followed by my responses:
1. Question: Why did Same-Day Surgery have a meeting in New Orleans in April while another one is planned for June in Atlanta?
Answer: The April meeting was not sponsored by SDS newsletter. Stay with the experts who have 20 years of experience in the field! To register for the SDS newsletter conference, which will be held June 8-10, call (800) 688-2421.
2. Question: Our hospital is doing a joint venture with our local physician group on a new surgery center outside the hospital walls. What’s the recommended partnership arrangement?
Answer: It used to be that everyone set up a limited partnership on these joint ventures. However, when hospitals got back into the picture, the government asked them why they would assume 100% of the risk in return for less than that in profit. Therefore, the newer limited liability corporations share the risk equally among the partners, hospital, and physicians. Check with your advisors to see if this type of partnership is best for you.
3. Question: Your article, "Simplify, simplify, simplify" (March 1997 SDS), was like music to our staff’s ears, especially the part about room turnover times getting a little crazy. We copied the article and put one in each physician’s mailbox and asked for their comments i.e. what turnaround time they wanted. We were shocked to hear that most of the physicians would rather have about 15 to 20 minutes between cases instead of the eight minutes we’ve been killing ourselves over. Did anyone else have this response?
Answer: I received many similar comments like this regarding turnaround time. We discovered that some physicians like the current arrangement, while others specified times that were more attractive to them. Three managers e-mailed me that they did not have the time to cater to each physician’s wishes all turnaround times were the same.
4. Question: We have a very busy ophthalmologist at our hospital center who is an absolute jerk. He insists on having two rooms running back to back so he can go from one room to the other and have almost no turnaround time. We try to accommodate him, but most of the time we just cannot. He always threatens to leave and start his own ASC if we cannot respond to his demands. Can he?
Answer: This is a paraphrased question of many calls I get about this subject. Fact: The typical surgical ophthalmologist needs, depending upon many variables, about 750 cataract procedures to make his or her own ASC financially profitable. Very few do that volume of surgery. However, profit from the facility fee may not be their motive; they, like many other specialties, are faced with declining professional fees and must become more efficient, hence the above dilemma.
My advice is to try to accommodate them as much as humanly possible. You want and need their cases. The supply cost per case for cataract surgery is about $200 to $300 (including the intraocular lens); the reimbursement is about $900. Do the math. While your surgeon may ot have the volume to run an ASC alone, he or she may join others and combine volume to make it work.
Try blocking two rooms for a single afternoon or morning each week, but keep the cases. As Bill Wilcox, past president of the recently sold Medical Care International, would say, "Cases are good!"
(Editor’s note: To provide feedback about this column or to suggest ideas, contact Stephen W. Earnhart at Earnhart and Associates, 5905 Tree Shadow Place, Suite 1200, Dallas, TX 75252. E-mail: surgery@ onramp.net. World Wide Web: http://rampages. onramp.net/~surgery.)
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