Answers to 6 questions that puzzle SDS readers
By Stephen W. Earnhart, MS, CEO, Earnhart & Associates Houston, TX
Question: Our facility will not buy us lunch! Is that not the cheapest thing you have heard? Most of us work through our lunch break anyway and are so busy turning over the rooms that we don't have the luxury of going someplace to get something to eat. We do, like, 40 cases a day here, so it is not like they don't have the money. We are too embarrassed to keep asking the vendors to bring us food. My question is: How many places do you know where the surgical facility will buy the staff lunch on busy days? Please include the address if they are in the Denver area! (Editor's note: The reader didn't identify whether the employer was a hospital or freestanding center.)
Answer: First, thank you for the LOL! Our clients are about 50/50 hospitals and surgery centers, and I can tell you that I don't know of any hospital that we work with that will pay for staff lunches. I don't think it is because they are cheap. I think it is more of the fact that they have many employees, and it would not be right for them to do for one what they cannot do for another. If you are in a surgery center, I cannot think of a surgery center that will not buy lunch for staff on busy days! There are exceptions, but they are rare. As far as the vendors bringing lunch in, most of them actually have budgets to do that, so don't feel bad about asking them.
Question: Why is our hospital charging us to park? It is sometimes $6 to $10 per day! I don't understand why we are paying parking fees. Anyone else out there doing this?
Answer: I agree with you! I don't understand why patients who are paying thousands of dollars per day are charged to park at hospitals. I feel the same about staff. If I had to pay to park to go to the food store or mall, I would find another store. I do know that many hospitals hire outside firms that run their parking garages or spaces. They don't come cheap either. But still, I agree with you, that if you have to recoup those fees, add a little more to the bill to make up for it rather than hourly parking fees.
Question: You said in a recent column that electronic medical records need to be implemented in every center. You never said how. I have only two other people in my business office, and there is no way we can scan hundreds, if not thousands of patient records. Who is going to do that?!
Answer: Rarely does that staff do it. It is far too time-consuming, and it distracts from normal operations. Many facilities hire outside companies to do it over weekends and evenings. There are ultra high-speed scanners out there that can scan incredibly fast that you can rent to get caught up.
Question: We had a patient come into our center last week with a dog. I love animals, but not in the operating room! She said her pet was an "emotional support animal" (ESA), and she had documents stating such. She told us we were required to let her bring her pet into the facility and even into the operating room when she had her augmentation procedure. She said it was an ADA (Americans with Disabilities Act) requirement that we had to comply with. Have you ever heard of this?
Answer: Yes, I've heard of it. An ESA certificate is valid. You can take you pet on planes, and some hotels honor the certification. But, unlike other animal certifications, such as seeing eye dogs, you cannot bring your pet into a place of business that will not allow pets in the first place the operating room or even your center being examples. You are right to deny the pet.
Question: Our hospital is going to build a surgery center about five miles from where we are now. They are not going to allow the surgeons to invest in it like the one across the street. Why would they do this?
Answer: By not allowing physician investment in the center, the hospital can receive hospital reimbursement rates, which can be as high as 40-50% higher than a joint-ventured facility. They also don't have to share the revenue with the surgeons. Hospitals have learned over that past 30 years that freestanding surgery centers are more efficient, both in time and dollars, than hospitals. There are many reasons why a hospital would want to build its own surgery center. They are looking for a lower-cost facility to perform outpatient surgery. It's as simple as that! A freestanding surgery center is much less expensive to build than expanding current hospital operating rooms.
Question: Our surgery center is now on Facebook and other social media sites. I fail to find the rationale for this. Is there any value in this?
Answer: I like the social media phenomenon that is pulsating around us. I think it is dynamic, exciting, and will continue to grow and influence many aspects of our lives, including being a driver in healthcare decision-making for patients. Social media has the ability to draw together, or polarize, diverse groups with shared interest. But surgery? I scratch my head and wonder why some surgery facilities have a "like us" tab on their website. Why would I "like" it? Maybe some of our readers can give feedback to us based on their experiences. [Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Earnhart & Associates' address is 238 S. Egret Bay Blvd., Suite 285, Houston, TX 77573-2682. Phone: (512) 297.7575. Fax: (512) 233.2979. E-mail: [email protected]. Web: www.earnhart.com.]
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