Adam Hauser, MD, an anesthesiologist who is medical director of the Surgery Center at Brinton Lake in Glen Mills, Pa., is always on the lookout for a new surgeon to work at his five-OR ASC.
Working one day a week at the nearby hospital, Crozer-Chester (Pa.) Medical Center, he is paired with many different surgeons, knows their operating style and can decide whether they'd fit in over at the surgery center.
He recently had to say no to a young general surgeon who wanted to join Brinton Lake. Dr. Hauser told him: "The problem is that you take too long to do your cases. You need to get faster."
"He was very offended," Dr. Hauser recalls, "but I can't have a guy who takes longer than anyone else to do his cases."
If Dr. Hauser hasn't worked personally with a surgeon, one of his anesthesiologist-colleagues has. "I can call any number of friends and ask them, 'What is this guy like?' If they give him the thumbs up, he can get privileges, but he still has to prove himself," he says.
Newcomer surgeons who are slow or are late for their time slots may not be able to get onto the ASC schedule for future procedures. "I warn them, if they don't perform well, we're not going to have time for them," he says.
"I'm kind of self-interested," says Dr. Hauser, who is also a leading investor in Brinton Lake, a multispecialty facility. "We're under pressure to squeeze in as many cases as possible. That means being a little pushy sometimes."
He scrutinizes the schedule for the day. An ophthalmologist has 14 or 15 cataract cases that will probably go from 7 a.m. to 2 p.m., leaving room for another surgeon in the afternoon. A plastic surgeon has nine cases, which he would be hard-pressed to finish before the next surgeon is due. The plastic surgeon likes to get in at 7:30 a.m., but Dr. Hauser wants him to start a half hour earlier.
There are several ASCs in the area and a new one is about to open. But Dr. Hauser is not concerned about competition because the 17 physician-owners and are still going to bring their cases to Brinton Lake.
Strong growth through new opportunities
Dr. Hauser works closely with Gina Espenschied, administrative director of Brinton Lake, to keep the ASC as efficient as possible. The surgery center, a joint venture between physicians and Crozer-Keystone Health System, started four years ago, doubled its business in the past two years and is making a 15-20 percent margin this year.
The center's list of specialties include orthopedics, ENT, opthalmology, urology, general surgery, gynecology, plastic surgery, oral surgery and pain management, but every so often Dr. Hauser finds something new. He found out recently that a group of pediatric dentists was not happy at one of the local hospitals. "I heard they were getting bounced around, so I thought, why not have a talk with them?"
The group has a lot of Medicaid patients, which made him worry about low payments. But it turned out that the patients are in Medicaid managed care, which pays better, and the managed care plan was happy to switch from the hospital to Brinton Lake because the ASC could charge one-third of the hospital's rates.
The surgery schedule is filling in nicely, but Dr. Hauser is not satisfied yet. Afternoons in many of the ORs still go unfilled. "I would be happy to work right up to 5 p.m.," he says. The ASC has one shelled OR but it won't be opened until volume rises from the current 600 cases a month to at least 750 cases a month, he says.
The ASC will need to buy an EMR system in the next few years and "we need to make the money for that," Dr. Hauser says. Then there are all the requests from surgeons for new equipment. "I understand what hospitals have to go through," he says. "There's always some piece of equipment that someone wants."
Learn more about Surgery Center at Brinton Lake.
Working one day a week at the nearby hospital, Crozer-Chester (Pa.) Medical Center, he is paired with many different surgeons, knows their operating style and can decide whether they'd fit in over at the surgery center.
He recently had to say no to a young general surgeon who wanted to join Brinton Lake. Dr. Hauser told him: "The problem is that you take too long to do your cases. You need to get faster."
"He was very offended," Dr. Hauser recalls, "but I can't have a guy who takes longer than anyone else to do his cases."
If Dr. Hauser hasn't worked personally with a surgeon, one of his anesthesiologist-colleagues has. "I can call any number of friends and ask them, 'What is this guy like?' If they give him the thumbs up, he can get privileges, but he still has to prove himself," he says.
Newcomer surgeons who are slow or are late for their time slots may not be able to get onto the ASC schedule for future procedures. "I warn them, if they don't perform well, we're not going to have time for them," he says.
"I'm kind of self-interested," says Dr. Hauser, who is also a leading investor in Brinton Lake, a multispecialty facility. "We're under pressure to squeeze in as many cases as possible. That means being a little pushy sometimes."
He scrutinizes the schedule for the day. An ophthalmologist has 14 or 15 cataract cases that will probably go from 7 a.m. to 2 p.m., leaving room for another surgeon in the afternoon. A plastic surgeon has nine cases, which he would be hard-pressed to finish before the next surgeon is due. The plastic surgeon likes to get in at 7:30 a.m., but Dr. Hauser wants him to start a half hour earlier.
There are several ASCs in the area and a new one is about to open. But Dr. Hauser is not concerned about competition because the 17 physician-owners and are still going to bring their cases to Brinton Lake.
Strong growth through new opportunities
Dr. Hauser works closely with Gina Espenschied, administrative director of Brinton Lake, to keep the ASC as efficient as possible. The surgery center, a joint venture between physicians and Crozer-Keystone Health System, started four years ago, doubled its business in the past two years and is making a 15-20 percent margin this year.
The center's list of specialties include orthopedics, ENT, opthalmology, urology, general surgery, gynecology, plastic surgery, oral surgery and pain management, but every so often Dr. Hauser finds something new. He found out recently that a group of pediatric dentists was not happy at one of the local hospitals. "I heard they were getting bounced around, so I thought, why not have a talk with them?"
The group has a lot of Medicaid patients, which made him worry about low payments. But it turned out that the patients are in Medicaid managed care, which pays better, and the managed care plan was happy to switch from the hospital to Brinton Lake because the ASC could charge one-third of the hospital's rates.
The surgery schedule is filling in nicely, but Dr. Hauser is not satisfied yet. Afternoons in many of the ORs still go unfilled. "I would be happy to work right up to 5 p.m.," he says. The ASC has one shelled OR but it won't be opened until volume rises from the current 600 cases a month to at least 750 cases a month, he says.
The ASC will need to buy an EMR system in the next few years and "we need to make the money for that," Dr. Hauser says. Then there are all the requests from surgeons for new equipment. "I understand what hospitals have to go through," he says. "There's always some piece of equipment that someone wants."
Learn more about Surgery Center at Brinton Lake.