Jenn Hunara, administrator of the Surgery Center of Allentown (Pa.), an ASCOA facility, discusses how to improve physician satisfaction in a busy ambulatory surgery center.
1. Talk to them at least once a week. Aim to build a strong relationship with your surgeons from day one, Ms. Hunara says. Don't let weeks slip by without talking to them; if you do, you'll look up after a year and discover your surgeons don't know you and don't feel comfortable coming to you with concerns. "There are very few physicians that I don't see or talk to once a week," she says. "It's not always shop talk, sometimes it's just, 'How did things go today? Do you have any vacations coming up? We spend a lot of time getting to know them both as professionals and as people."
She says the more you get to know your physicians as people, the better you will understand them as professionals. "I know what my docs like. from equipment preferences down to what they take in their coffee," she says. To maximize your contact with your physicians, spend their first year at the center with them in the operating room while they operate. Eventually you will build up a rapport and discover what they like and don't like about working in the ASC.
2. Learn what different physicians like. Every specialty and every physician has unique needs, and meeting those needs will improve the environment of the ASC and increase the likelihood physicians will bring more cases. Ms. Hunara has spent a lot of time talking to her surgeons to determine their values and priorities. "My orthopods want the freedom to try and use different implants, while my ENTs want to ensure they have the latest equipment, such as a sinus navigation system, and a special area to recover pediatric patients. You need to get a feel for what each specialty is about."
She says some physicians will hate paperwork and want everything done online; others will shy away from technology and prefer the feel of a paper chart. Some like to have coffee or some type of snack waiting for them as they are coming from another facility or office hours and haven’t had time to eat. "It's the small stuff that sounds trivial but takes providing service to them to the next level because they don't get it at the hospital," she says. "Working toward giving them a great experience every single time says, 'This is your place and we recognize that it's your place.'" Meeting these needs will sometimes mean accommodating a surgeon when it's not completely convenient for you. If a physician calls and asks for his or her day to start earlier or later, think of the long-term repercussions and accommodate them whenever possible.
3. Let them be selective in recruiting. You may want to push to recruit every physician who can contribute strong case volume to your center, but listen to your physicians when they have a concern. They may know something you don't. "While somebody might look great on paper with high volume and the ability to generate a ton of revenue, there may be a partnership piece that has to be addressed," Ms. Hunara says.
To create a satisfying work environment for your physicians, you need to create a cohesive group at the board level. This will be best accomplished if different specialties don't engage in turf battles over purchasing and scheduling. A negative physician can easily disrupt a friendly group dynamic and turn specialties against each other, so pay close attention to personality when recruiting. "If our board of directors know the potential partner had issues at the hospital, they may opt not to offer them partnership here," Ms. Hunara says. "It's not just about whether you can do the job but also the impact the potential partner will have on the culture of the organization."
4. Case cost to explain your decisions. Your ASC can't feasibly buy every piece of equipment a surgeon requests. Sometimes you will have to come down on the side of one specialty while denying another, which can cause problems if physicians don't understand the reasons behind your decision. Like most other ASCOA centers, Ms. Hunara's facility performs case costing every quarter to examine spending and profit for every case performed at he facility. "We present data on every case done throughout the quarter but we also present a summary sheet that shows the highest revenue earner down to the lowest," she says. "It's not blinded. It's there for everybody to see."
Case costing will help your BOD rationalize choices with hard numbers, she says. If an surgeon who brings in high revenue for the center asks for an expensive piece of equipment, you may agree to purchase the equipment because the physician's cases contribute substantially to your profitability. If a purchase is not feasible, you can show a surgeon that his or her revenue does not offset the price of the equipment. Physician-investors are generally committed to the financial profitability of the center and will rarely fight you on a decision that will obviously hurt your budget.
Read more advice on running a successful ambulatory surgery center:
-10 Traits of Highly Successful Surgery Center Administrators
-5 Worst Specialties for Surgery Centers
-6 Ways to Address Feedback From Physicians, Patients and Staff
1. Talk to them at least once a week. Aim to build a strong relationship with your surgeons from day one, Ms. Hunara says. Don't let weeks slip by without talking to them; if you do, you'll look up after a year and discover your surgeons don't know you and don't feel comfortable coming to you with concerns. "There are very few physicians that I don't see or talk to once a week," she says. "It's not always shop talk, sometimes it's just, 'How did things go today? Do you have any vacations coming up? We spend a lot of time getting to know them both as professionals and as people."
She says the more you get to know your physicians as people, the better you will understand them as professionals. "I know what my docs like. from equipment preferences down to what they take in their coffee," she says. To maximize your contact with your physicians, spend their first year at the center with them in the operating room while they operate. Eventually you will build up a rapport and discover what they like and don't like about working in the ASC.
2. Learn what different physicians like. Every specialty and every physician has unique needs, and meeting those needs will improve the environment of the ASC and increase the likelihood physicians will bring more cases. Ms. Hunara has spent a lot of time talking to her surgeons to determine their values and priorities. "My orthopods want the freedom to try and use different implants, while my ENTs want to ensure they have the latest equipment, such as a sinus navigation system, and a special area to recover pediatric patients. You need to get a feel for what each specialty is about."
She says some physicians will hate paperwork and want everything done online; others will shy away from technology and prefer the feel of a paper chart. Some like to have coffee or some type of snack waiting for them as they are coming from another facility or office hours and haven’t had time to eat. "It's the small stuff that sounds trivial but takes providing service to them to the next level because they don't get it at the hospital," she says. "Working toward giving them a great experience every single time says, 'This is your place and we recognize that it's your place.'" Meeting these needs will sometimes mean accommodating a surgeon when it's not completely convenient for you. If a physician calls and asks for his or her day to start earlier or later, think of the long-term repercussions and accommodate them whenever possible.
3. Let them be selective in recruiting. You may want to push to recruit every physician who can contribute strong case volume to your center, but listen to your physicians when they have a concern. They may know something you don't. "While somebody might look great on paper with high volume and the ability to generate a ton of revenue, there may be a partnership piece that has to be addressed," Ms. Hunara says.
To create a satisfying work environment for your physicians, you need to create a cohesive group at the board level. This will be best accomplished if different specialties don't engage in turf battles over purchasing and scheduling. A negative physician can easily disrupt a friendly group dynamic and turn specialties against each other, so pay close attention to personality when recruiting. "If our board of directors know the potential partner had issues at the hospital, they may opt not to offer them partnership here," Ms. Hunara says. "It's not just about whether you can do the job but also the impact the potential partner will have on the culture of the organization."
4. Case cost to explain your decisions. Your ASC can't feasibly buy every piece of equipment a surgeon requests. Sometimes you will have to come down on the side of one specialty while denying another, which can cause problems if physicians don't understand the reasons behind your decision. Like most other ASCOA centers, Ms. Hunara's facility performs case costing every quarter to examine spending and profit for every case performed at he facility. "We present data on every case done throughout the quarter but we also present a summary sheet that shows the highest revenue earner down to the lowest," she says. "It's not blinded. It's there for everybody to see."
Case costing will help your BOD rationalize choices with hard numbers, she says. If an surgeon who brings in high revenue for the center asks for an expensive piece of equipment, you may agree to purchase the equipment because the physician's cases contribute substantially to your profitability. If a purchase is not feasible, you can show a surgeon that his or her revenue does not offset the price of the equipment. Physician-investors are generally committed to the financial profitability of the center and will rarely fight you on a decision that will obviously hurt your budget.
Read more advice on running a successful ambulatory surgery center:
-10 Traits of Highly Successful Surgery Center Administrators
-5 Worst Specialties for Surgery Centers
-6 Ways to Address Feedback From Physicians, Patients and Staff