As the ASC market becomes more and more competitive, surgery center administrators must take viability into their own hands.
Lexa Woodyard, administrator for Cabell Huntington (W.V.) Surgery Center, knows that keeping surgeons happy and at ease is crucial to increasing business and profits for her center.
That's why she and her staff have worked to implement a strategy of saying "yes" to surgeon requests and needs.
"It's time to change the culture of how we think of surgeons and our relationship with them," she says. "We have to remember the surgeons are our customers. Without surgeons, we don't have patients, and without patients, we don’t have jobs."
Ms. Woodyard shares her top tips for attracting and retaining surgeons.
1. Make it easy to post patients with poor payor/case combinations. Many surgery centers will turn away patients with poor payor and case combinations for fear of losing money, but creating barriers for surgeons to post their patients could end up deterring a physician from working with an ASC.
"We let them post whatever, regardless of payor and case combinations, and we earn their trust," Ms. Woodyard says.
Letting the surgeons post the cases they have regardless of payor and case combination will build their trust and your capacity. Meanwhile, monitor the profit and loss by a surgeon for their total cases for a year. You may find that a surgeon may bring your ASC some cases that lose money in a year but they also bring profitable cases which outweigh the loss from less-profitable cases; don’t let the minority prohibit your ASC from capturing the profitable cases.
"You might find they only bring a handful of cases that are a loss and they are bringing you far more cases to break even or make you money," she says.
2. Keep anesthesia availability and surgery times convenient and consistent. Ms. Woodyard says she and her staff notice that inconsistent or inadequate anesthesia coverage or start times for surgery can affect their patient volume. Sticking to a predetermined schedule can put surgeons at ease. "Surgeons are creatures of habit," she says. "If they know they can't do surgery without changes or surprises, they won't use your surgery center."
She recommends staying flexible and keeping in mind how busy each surgeon's schedule already is. "They can't just change their schedule at a moment's notice to accommodate the center's schedule," she says. "It's important to periodically reevaluate block times to monitor staffing and anesthesia availability."
By always working on the same timetable, ASCs build a positive rapport with surgeons. "Consistency is key," she says. "That's what they look for."
3. Treat surgeons as individual customers. When ASCs don't treat their surgeons like individual customers, it's easy for the physician to become disengaged and take his or her patients elsewhere. Meeting a physician's needs and requests, no matter how small, can make all the difference.
Taking care of surgeons can mean having the most up-to-date surgical equipment, or it can mean making small gestures to show the center's appreciation. "It could be as simple as having Dr. X come in and knowing he likes to use his favorite blue pen in pre-op, so we'll have that ready."
Ms. Woodyard advises not to compare surgeons with their peers, since each one works differently. Instead, help them see their preferences are important. "Just remembering to treat each as an individual is important," she says. "Don't try to fit them into a mold. You'll see the surgeons you are targeting will use your center more often if you're catering to them like you want them to come back."
4. Remove unnecessary patient admission barriers. Some ASCs may have patient admission requirements that are outdated or create unnecessary barriers for surgeons trying to post patients. For example, an ASC’s anesthesia admission criteria might mandate the surgery center does not permit patients with latex allergies to be scheduled at the surgery center. In many centers, this decision was made years ago due to the cost of some latex free items, Ms. Woodyard says. She says most items are now latex-free, and while the new items are sometimes more expensive, surgery centers can assemble a latex-free kit to be used on a case-by-case basis to save money. A special latex screening questionnaire should be put in place for the pre-operative call to detect potential allergies or sensitivities.
“If a surgeon has a patient with a potential latex allergy and your ASC isn’t receptive to this population of patients, the surgeon will likely end up scheduling a day’s worth of cases elsewhere to provide care to the patient with the latex allergy,” Ms. Woodyard says.
"Review the anesthesia admission criteria annually to see if it needs to be updated to adequately provide service to a patient population that you might be missing," she says, adding, "If a surgeon has a patient with a latex allergy and your center isn’t receptive to these patients, they may take that case and an entire days worth of cases elsewhere."
Work to detect allergies or other similar challenges ahead of time, and find ways to accommodate patients' particular needs rather than refusing admittance.
5. Allow surgeons to work with their preferred team members. Since surgeons work habitually, surround them with the same team for the entire surgical process. "If you don't have a surgeon's team in pre-op, in the OR and post-op, you'll have a dissatisfied surgeon. Anything new or different, especially surprises they consider undesirable, creates dissatisfaction," Ms. Woodyard says.
Not only will familiar teams keep surgeons happy and returning to an ASC, but patients will also reap the benefits of having a staff that has built a comfortable rhythm with each other.
"We want to have the same staff pre-op and in the OR that the surgeon is used to working with so they can be familiar with their team," she says. "A surgeon with the same staff in pre-op can get a patient into the OR more quickly. And in the OR, they can even shave minutes off of the surgery time, which makes everyone happy."
6. Be kind to a surgeon's office staff. While catering to a physician's needs is important, surgery center leaders shouldn't forget the importance of building a good relationship with the physician's office staff. "They are really the gatekeepers when it comes to where surgeon's post cases," Ms. Woodyard says. "Unless a surgeon has a really strong opinion about the facility, they just let the office staff post cases wherever. That's why anything we can do to make it easier on them makes it easier on everyone and gives us the opportunity for more business."
When Ms. Woodyard's staff treats a physician's staff respectfully and avoids pestering them with unnecessary phone calls or requests, the surgeon’s office will likely book more procedures with her center. "If a center is requiring an office to jump through more hoops to list patients or is calling the office more than the competition, you’ll see that surgeon's number drop off," she says.
If your ASC is calling the surgeon’s office to inquire about alternate phone numbers for patients and insurance information, determine whether your facility can be granted permission to have access to the surgeon’s practice patient database. If your ASC is calling the surgeon’s office to order or track down pre admission testing results required by your admission criteria, this might deter the surgeon and their staff from posting cases at the ASC. Since the pre-admission testing is required to give anesthesia providers the information they need to make decisions about patient appropriateness, the surgery process will flow better if anesthesia staff orders the testing as needed. They should also have designated personnel to relay orders to the pre-admission testing facility of the patient’s choice and retrieve the results prior to surgery.
"Volume is the key to success," she says. "If you don't have a high volume of cases with a good payor mix, you'll struggle to keep your head above water. Anything a surgery center can do to make their center more accessible, attractive and more reliable than the competition to surgeons and patients is necessary for survival."
More Articles on Surgery Centers:
5 Steps to Avoid Critical Mistakes in Building and Operating a Surgery Center
5 Ways to Attract Superstar Surgeons to Your ASC
Dr. Kenneth Pettine: 4 Points on Performing Spine Surgery in ASCs
Lexa Woodyard, administrator for Cabell Huntington (W.V.) Surgery Center, knows that keeping surgeons happy and at ease is crucial to increasing business and profits for her center.
That's why she and her staff have worked to implement a strategy of saying "yes" to surgeon requests and needs.
"It's time to change the culture of how we think of surgeons and our relationship with them," she says. "We have to remember the surgeons are our customers. Without surgeons, we don't have patients, and without patients, we don’t have jobs."
Ms. Woodyard shares her top tips for attracting and retaining surgeons.
1. Make it easy to post patients with poor payor/case combinations. Many surgery centers will turn away patients with poor payor and case combinations for fear of losing money, but creating barriers for surgeons to post their patients could end up deterring a physician from working with an ASC.
"We let them post whatever, regardless of payor and case combinations, and we earn their trust," Ms. Woodyard says.
Letting the surgeons post the cases they have regardless of payor and case combination will build their trust and your capacity. Meanwhile, monitor the profit and loss by a surgeon for their total cases for a year. You may find that a surgeon may bring your ASC some cases that lose money in a year but they also bring profitable cases which outweigh the loss from less-profitable cases; don’t let the minority prohibit your ASC from capturing the profitable cases.
"You might find they only bring a handful of cases that are a loss and they are bringing you far more cases to break even or make you money," she says.
2. Keep anesthesia availability and surgery times convenient and consistent. Ms. Woodyard says she and her staff notice that inconsistent or inadequate anesthesia coverage or start times for surgery can affect their patient volume. Sticking to a predetermined schedule can put surgeons at ease. "Surgeons are creatures of habit," she says. "If they know they can't do surgery without changes or surprises, they won't use your surgery center."
She recommends staying flexible and keeping in mind how busy each surgeon's schedule already is. "They can't just change their schedule at a moment's notice to accommodate the center's schedule," she says. "It's important to periodically reevaluate block times to monitor staffing and anesthesia availability."
By always working on the same timetable, ASCs build a positive rapport with surgeons. "Consistency is key," she says. "That's what they look for."
3. Treat surgeons as individual customers. When ASCs don't treat their surgeons like individual customers, it's easy for the physician to become disengaged and take his or her patients elsewhere. Meeting a physician's needs and requests, no matter how small, can make all the difference.
Taking care of surgeons can mean having the most up-to-date surgical equipment, or it can mean making small gestures to show the center's appreciation. "It could be as simple as having Dr. X come in and knowing he likes to use his favorite blue pen in pre-op, so we'll have that ready."
Ms. Woodyard advises not to compare surgeons with their peers, since each one works differently. Instead, help them see their preferences are important. "Just remembering to treat each as an individual is important," she says. "Don't try to fit them into a mold. You'll see the surgeons you are targeting will use your center more often if you're catering to them like you want them to come back."
4. Remove unnecessary patient admission barriers. Some ASCs may have patient admission requirements that are outdated or create unnecessary barriers for surgeons trying to post patients. For example, an ASC’s anesthesia admission criteria might mandate the surgery center does not permit patients with latex allergies to be scheduled at the surgery center. In many centers, this decision was made years ago due to the cost of some latex free items, Ms. Woodyard says. She says most items are now latex-free, and while the new items are sometimes more expensive, surgery centers can assemble a latex-free kit to be used on a case-by-case basis to save money. A special latex screening questionnaire should be put in place for the pre-operative call to detect potential allergies or sensitivities.
“If a surgeon has a patient with a potential latex allergy and your ASC isn’t receptive to this population of patients, the surgeon will likely end up scheduling a day’s worth of cases elsewhere to provide care to the patient with the latex allergy,” Ms. Woodyard says.
"Review the anesthesia admission criteria annually to see if it needs to be updated to adequately provide service to a patient population that you might be missing," she says, adding, "If a surgeon has a patient with a latex allergy and your center isn’t receptive to these patients, they may take that case and an entire days worth of cases elsewhere."
Work to detect allergies or other similar challenges ahead of time, and find ways to accommodate patients' particular needs rather than refusing admittance.
5. Allow surgeons to work with their preferred team members. Since surgeons work habitually, surround them with the same team for the entire surgical process. "If you don't have a surgeon's team in pre-op, in the OR and post-op, you'll have a dissatisfied surgeon. Anything new or different, especially surprises they consider undesirable, creates dissatisfaction," Ms. Woodyard says.
Not only will familiar teams keep surgeons happy and returning to an ASC, but patients will also reap the benefits of having a staff that has built a comfortable rhythm with each other.
"We want to have the same staff pre-op and in the OR that the surgeon is used to working with so they can be familiar with their team," she says. "A surgeon with the same staff in pre-op can get a patient into the OR more quickly. And in the OR, they can even shave minutes off of the surgery time, which makes everyone happy."
6. Be kind to a surgeon's office staff. While catering to a physician's needs is important, surgery center leaders shouldn't forget the importance of building a good relationship with the physician's office staff. "They are really the gatekeepers when it comes to where surgeon's post cases," Ms. Woodyard says. "Unless a surgeon has a really strong opinion about the facility, they just let the office staff post cases wherever. That's why anything we can do to make it easier on them makes it easier on everyone and gives us the opportunity for more business."
When Ms. Woodyard's staff treats a physician's staff respectfully and avoids pestering them with unnecessary phone calls or requests, the surgeon’s office will likely book more procedures with her center. "If a center is requiring an office to jump through more hoops to list patients or is calling the office more than the competition, you’ll see that surgeon's number drop off," she says.
If your ASC is calling the surgeon’s office to inquire about alternate phone numbers for patients and insurance information, determine whether your facility can be granted permission to have access to the surgeon’s practice patient database. If your ASC is calling the surgeon’s office to order or track down pre admission testing results required by your admission criteria, this might deter the surgeon and their staff from posting cases at the ASC. Since the pre-admission testing is required to give anesthesia providers the information they need to make decisions about patient appropriateness, the surgery process will flow better if anesthesia staff orders the testing as needed. They should also have designated personnel to relay orders to the pre-admission testing facility of the patient’s choice and retrieve the results prior to surgery.
"Volume is the key to success," she says. "If you don't have a high volume of cases with a good payor mix, you'll struggle to keep your head above water. Anything a surgery center can do to make their center more accessible, attractive and more reliable than the competition to surgeons and patients is necessary for survival."
More Articles on Surgery Centers:
5 Steps to Avoid Critical Mistakes in Building and Operating a Surgery Center
5 Ways to Attract Superstar Surgeons to Your ASC
Dr. Kenneth Pettine: 4 Points on Performing Spine Surgery in ASCs