Dr. Riemenschneider: Top Urology Issues for ASCs

At the 18th Annual Ambulatory Surgery Centers Conference in Chicago on Oct. 28, Herbert Riemenschneider, MD, a staff urologist at the Knightsbridge Surgery Center in Columbus, Ohio, spoke about the future of urology in ambulatory surgery centers.

Many urologic procedures are done frequently and quickly, and it's these procedures, which are done at a low cost, that can make a very significant contribution to the bottom line of a multi-specialty center, Dr. Riemenschneider said. An example of this is a ureteral stone patient that presents to the ER.

"Urological surgery is a valuable part of the multi-specialty ASC," he said.

The Knightsbridge Surgery Center has 25 urology staff surgeons: 15 members and 10 non-members. Urologic cases make up about 40 percent of the center's business.

Most of the staff surgeons cover the ER and are very well known to the ER staff physicians. For that reason, it is not unusual for the ER staff, after a brief review of a ureteral stone patient, to call one of the Knightsbridge urology staff members, Dr. Riemenschneider said. The patient is transported to the Knightsbridge Center and the stone is definitively treated. The patient is discharged from the center to home, in the time that some patients wait in the ER waiting room, he said.

"Because we've established a reputation for being efficient, the physicians in the ER — if they have a decent history on the patient — they'll call us before the patient is taken back," he said. "They'll refer them, and we'll see them in less than one hour."

Dr. Riemenschneider also feels internet remote surgery scheduling at the Knightsbridge Center makes scheduling very efficient and attracts surgeons. Another important reason why he feels the Knightsbridge Center is doing well in these difficult times is a strong partnership with OhioHealth, a large local health system in Central Ohio.

Research has shown that approximately 50 percent of the 10,000 urologists in the U.S. have an equity relationship with an ASC. He believes there are more than 4,000 urologists that could be considered good partners in multi-specialty ASC. This represents an excellent opportunity for growth. In 2009-2010, urology nationally had the second largest case volume in the ASC market with an increase of 6.8 percent.

Dr. Riemenschneider is also a proponent of online marketing and education. He also stressed the primary customers of the ASC is not the patient but the physician.

"We make the physician's life easy," he said.

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