Physician satisfaction is crucial to building a good reputation in the community, recruiting new providers and providing efficient, high-quality care, says David Milton, administrator of Phoenix (Ariz.) Surgicenter, the first surgery center in the United States. Here he discusses six ways to keep your surgeons happy and productive.
1. Prioritize surgical equipment/instruments over marketing. Mr. Milton says the majority of your "marketing" budget should go towards providing physicians with the things they need rather than posting billboards in the community. "I used dollars from marketing to buy surgical instruments when faced with adding pediatric surgeons and being unprepared with instruments," he says. "If you think about it, a surgeon would rather have the instruments he needs than go out for a meal." He says if you meet your physicians' requests for new surgical instruments, word will get around that your surgery center treats its physicians well. This is more likely to attract new physicians to the center than an ad in the local newspaper, he says. Physicians may only work at one surgery center, but many see each other in the same hospital, and they do talk, he says.
Of course, buying surgical equipment, instruments and supplies can become very expensive very quickly, and many surgery centers operate on a tight budget. Mr. Milton says many physicians are cornered by vendors at conferences or in the office and convinced to try a new product or device. "I have worked very closely with the physicians at Surgicenter about not committing us to something without speaking with me first," he says. "They trust me and the OR manager to make good decisions."
2. Find workarounds when requested equipment is very expensive. Sometimes a physician will request a new piece of equipment the surgery can't afford, or a new physician will want to bring cases the center isn't equipped for, Mr. Milton says. When these scenarios arise, he recommends looking for a cheaper workaround. For example, when a potential new ophthalmologist met with Mr. Milton, he stated what he was looking for and outlined his usual case load. The surgeon's request required the purchase of two microscopes and two phaco units.
"Our facility only has one room equipped for cataract surgery, and this surgeon was to work when another eye surgeon was there," Mr. Milton says. Instead of purchasing equipment that would have cost hundreds of thousands of dollars, Mr. Milton is working with a cataract outsourcing company for a per-case fee. They bring the equipment and charge by the case, which Mr. Milton feels is a smarter solution than investing in the capital equipment upfront.
3. Ask staff to thank physicians whenever they see them. Mr. Milton says small gestures can go a long way in a surgery center. "As we go forward, I'm instilling with my staff that there are two words we can say to our doctors that carry more weight than any checkbook: thank you," he says. "We have staff tell every doctor, 'Thank you for being here today, and thank you for bringing this case.'"
He says while some surgery centers view patients as their customers, the real customer should be the physician. Make sure physicians know that you understand they could take their business elsewhere and that you appreciate them choosing your facility. "With 65 percent of the physicians that bring cases here as non-partners, 'thank you' can go a long way," he says.
4. Be honest with new recruits. Mr. Milton doesn't do a lot of advertising for new physicians — in fact, he hasn't made a cold call in years. Instead, he pays very close attention to what is happening in the marketplace and talks to vendors and medical staff on physician opportunities at Surgicenter, which performed the first case ever in an ASC in 1970. In the past 24 months, 30 physicians have joined his facility.
When meeting with new physicians, he is sometimes asked about equipment or start times the surgery center simply can't provide. "I am always brutally honest when talking with physicians, especially when we can't meet their need," he says. What we do today is our reputation tomorrow. Always be truthful." He says it all boils down to honesty: If you give an honest response, a physician may say no today but yes in the future.
5. Invest in an experienced scheduler. Mr. Milton's scheduler has been with the surgery center since it opened. He says she is essential to physician satisfaction at the center; after all, if a physician can't easily schedule a case, he'll take it somewhere else. "If the doctor asks for a time that isn't available, the first thing she'll do is offer alternatives," he says. "If that's not doable, she'll get with me or the OR director and look at the schedule to see if we can move anyone's case. Our partners have been very amenable to accommodating non-partner cases."
He says if a physician can't be accommodated on the schedule, honesty is the best policy. He recommends telling the physician as soon as possible that they won't be able to accommodate the 7:30 a.m. start, for example, and bringing up the schedule to demonstrate why.
6. Provide free lunch. While amenities aren't everything, Mr. Milton says his surgery center makes sure to provide lunch to physicians who bring cases over the lunch hour. "It's such a small investment, but it pays off," he says. He says the center also has coffee machines in the break room so that physicians can refuel throughout the day.
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1. Prioritize surgical equipment/instruments over marketing. Mr. Milton says the majority of your "marketing" budget should go towards providing physicians with the things they need rather than posting billboards in the community. "I used dollars from marketing to buy surgical instruments when faced with adding pediatric surgeons and being unprepared with instruments," he says. "If you think about it, a surgeon would rather have the instruments he needs than go out for a meal." He says if you meet your physicians' requests for new surgical instruments, word will get around that your surgery center treats its physicians well. This is more likely to attract new physicians to the center than an ad in the local newspaper, he says. Physicians may only work at one surgery center, but many see each other in the same hospital, and they do talk, he says.
Of course, buying surgical equipment, instruments and supplies can become very expensive very quickly, and many surgery centers operate on a tight budget. Mr. Milton says many physicians are cornered by vendors at conferences or in the office and convinced to try a new product or device. "I have worked very closely with the physicians at Surgicenter about not committing us to something without speaking with me first," he says. "They trust me and the OR manager to make good decisions."
2. Find workarounds when requested equipment is very expensive. Sometimes a physician will request a new piece of equipment the surgery can't afford, or a new physician will want to bring cases the center isn't equipped for, Mr. Milton says. When these scenarios arise, he recommends looking for a cheaper workaround. For example, when a potential new ophthalmologist met with Mr. Milton, he stated what he was looking for and outlined his usual case load. The surgeon's request required the purchase of two microscopes and two phaco units.
"Our facility only has one room equipped for cataract surgery, and this surgeon was to work when another eye surgeon was there," Mr. Milton says. Instead of purchasing equipment that would have cost hundreds of thousands of dollars, Mr. Milton is working with a cataract outsourcing company for a per-case fee. They bring the equipment and charge by the case, which Mr. Milton feels is a smarter solution than investing in the capital equipment upfront.
3. Ask staff to thank physicians whenever they see them. Mr. Milton says small gestures can go a long way in a surgery center. "As we go forward, I'm instilling with my staff that there are two words we can say to our doctors that carry more weight than any checkbook: thank you," he says. "We have staff tell every doctor, 'Thank you for being here today, and thank you for bringing this case.'"
He says while some surgery centers view patients as their customers, the real customer should be the physician. Make sure physicians know that you understand they could take their business elsewhere and that you appreciate them choosing your facility. "With 65 percent of the physicians that bring cases here as non-partners, 'thank you' can go a long way," he says.
4. Be honest with new recruits. Mr. Milton doesn't do a lot of advertising for new physicians — in fact, he hasn't made a cold call in years. Instead, he pays very close attention to what is happening in the marketplace and talks to vendors and medical staff on physician opportunities at Surgicenter, which performed the first case ever in an ASC in 1970. In the past 24 months, 30 physicians have joined his facility.
When meeting with new physicians, he is sometimes asked about equipment or start times the surgery center simply can't provide. "I am always brutally honest when talking with physicians, especially when we can't meet their need," he says. What we do today is our reputation tomorrow. Always be truthful." He says it all boils down to honesty: If you give an honest response, a physician may say no today but yes in the future.
5. Invest in an experienced scheduler. Mr. Milton's scheduler has been with the surgery center since it opened. He says she is essential to physician satisfaction at the center; after all, if a physician can't easily schedule a case, he'll take it somewhere else. "If the doctor asks for a time that isn't available, the first thing she'll do is offer alternatives," he says. "If that's not doable, she'll get with me or the OR director and look at the schedule to see if we can move anyone's case. Our partners have been very amenable to accommodating non-partner cases."
He says if a physician can't be accommodated on the schedule, honesty is the best policy. He recommends telling the physician as soon as possible that they won't be able to accommodate the 7:30 a.m. start, for example, and bringing up the schedule to demonstrate why.
6. Provide free lunch. While amenities aren't everything, Mr. Milton says his surgery center makes sure to provide lunch to physicians who bring cases over the lunch hour. "It's such a small investment, but it pays off," he says. He says the center also has coffee machines in the break room so that physicians can refuel throughout the day.
Related Articles on ASC Turnarounds:
45 New Statistics on ASC Specialist Compensation
5 Smart Moves for ASC Administrators
7 Cost-Cutting Tips From Experienced Surgery Center Administrators