Tag Team Recruitment — 6 Steps to Drive Profitably: A Success Story From Melville, N.Y.

In order to run a truly profitable surgery center, case volume is as important an ingredient as any. The success of any turnaround or de novo project hinges on the ability to attract great surgeons to the ASC. ASCOA assumed the management and development responsibilities of The Long Island Surgery Center in Jan. 2006. The center had several problems. Once the ownership had been restructured, the name changed to The Melville Surgery Center, and the operational concerns of the business entity addressed, it was time to recruit physicians and grow the center. As in any effective partnership, cooperation and communication drove the overwhelming success of MSC. This article will examine my development efforts combined with the valuable assistance of Dr. David Benisch from the Melville Surgery Center.

Step 1: Create a working environment that your partners can be proud of. In most failing surgery centers, morale is low and, as a result, the working environment suffers. Hiring the right staff that has the same goals for success and shares the vision of the partners is crucial. In the case of MSC, the facility itself also needed a facelift and so plans were put in place to impress both patients and staff.

David Benisch: Renovating the surgery center was a key component in our recruitment efforts. By promoting the facility as a "modern, state of the art surgery center," we were able to successfully attract new physicians and patients. We also needed staff that would be able to execute on a high level. With turnaround times of less than 10 minutes, we were able to attract high volume surgeons who were disgruntled with wasting time in the hospital waiting for ORs to be turned over.

Step 2: Identify surgeons to utilize the center. The partners were asked to come up with a list of unaffiliated colleagues who would be assets to the center.

DB: The best sources of information regarding potential physician recruits are other well-known, respected and trusted colleagues. The partners have insights both personal and professional. We knew who would potentially be a good fit and who best to avoid.

Step 3: Introductions are very important. Busy surgeons are constantly being approached by vendors and sales representatives. A personal call or conversation with a colleague is the best way to get the attention of these prospects. One example: If a surgeon is experiencing frustration with the hospital, having a partner there to advocate for his/her surgery center can provide the perfect opportunity to capture new business. Once a dialogue has been opened and interest established, it is time to set up a formal meeting to discuss the opportunities that exist at the center. Having a surgeon partner help to get a foot in the door is invaluable.

DB: If the first contact is made by a physician already utilizing the center, we found a greater success rate in attracting new physicians. A physician reaching out to a colleague will always have a greater impact than a representative from the center or from management. I've found that casually mentioning the surgery center while in conversation is a good way to gauge interest. If it seems like there is potential, I will ask that they accept a formal invitation from an ASCOA representative to discuss the details of the center. Conversations with a prospective surgeon regarding the specifics of utilization and potential ownership can be sensitive and therefore best handled by a third party. It's best to keep physician involvement on the professional level and leave the logistics to management.

Step 4: The sale or the transition into the ASC can carry with it some trepidation for the new recruit. A physician partner can share his/her own personal experience and highlight all the benefits of working at the center. Certain hospital pressure and uncertainly can be overcome by the tremendous benefits that are provided at the center.

DB: Physician to physician contact was the best initial approach to identify candidates who were frustrated with the environment in the hospital operating rooms. Once interest was established, we sold them on the short turnover time, user friendly atmosphere, low infection rate and ease of parking. We emphasized that extra office time would be a byproduct of a more efficient surgical environment and this would result in greater productivity and more free time. There were instances when the hospital threatened to take away block time. We explained that after experiencing the efficiencies at MSC, they would be happy to give away these blocks.

Step 5: The trial period is the time to prove to the new surgeon that taking their cases to the ASC is the best professional choice they have ever made. It is important to roll out the red carpet. Familiarize the staff with the surgeon, his/her preferences and any special needs of his/her patients. Whenever possible, a dry run before the first case is a good way to insure a smooth first day. Have the surgeon visit the center, meet the staff and review the instrumentation.

DB: We went to great lengths to prepare for any new surgeon and we made sure we had the equipment and materials that they would need BEFORE their arrival. We would often have another physician partner in the same specialty at the center to facilitate the first operative experience for the new physician.

Step 6: A personal follow up is a great way to further ingratiate new surgeons. Find out if there is anything the center could be doing better to accommodate them or their patients. The ability of the current partners to be flexible with scheduling is also important. Once all the needs of recruits are met, the ASC will be well on its way to having new productive members driving profits and moral to new heights.

DB: We attempt to accommodate new physicians' scheduling needs by requesting that current partners be as flexible as possible with their block time and scheduling. We want to ensure that the transition from hospital to the surgery center is as smooth as possible. We have found that surgeons have trepidation to some degree in changing their routine so ease of transition is a critical element in new physician satisfaction.

DB: A cooperative approach utilizing the trust and insight of physician to physician relationships followed by the involvement of ASCOA has produced results far exceeding our expectations.

Endnote: Since Dr. Benisch and ASCOA have made the efforts to help turn around Melville Surgery Center, its income has moved from quite negative to very positive and it has thrived as a leading ASC in the greater Long Island area.

Dr. David Benisch (herniadoc1@gmail.com) is a general surgeon and president of The Melville Surgery Center on Long Island, N.Y.

Mr. Tyler Merrill (tmerrill@ascoa.com) is a vice president of acquisitions & development for Ambulatory Surgical Centers of America.