As healthcare becomes further integrated, independent anesthesiology practices realize the criticalness of adapting to remain competitive in the changing field.
Healthcare no longer resembles a neatly segmented process, but rather an interconnected unit in which surgeons, nurses, hospital staff and anesthesiologists all work together, simultaneously. Patients only receive optimum care when strong communication and flexibility exists between healthcare providers across the field.
"It's a cohesive unit now," said anesthesiologist Nishant Shah, MD, of Midwest Anesthesia Partners in Park Ridge, Ill. "It's a great concept that encourages all healthcare providers involved in a patient’s care to be more proactive and take on more responsibility."
For anesthesiologists, being more proactive includes promoting themselves more by demonstrating their capabilities to hospitals and ASCs. By joining committees and seeking more leadership position opportunities, independent anesthesiologists place themselves in the direct view of possible business opportunities.
"Anesthesiology services are needed in a variety of settings and we have to be readily available to offer our services for anything that comes our way," said Dr. Shah.
Enhancing business relationships
He sees building relationships with hospitals and ASCs as a crucial measure to enhance an anesthesiology business and provide patients with the best care. He said the hospital needs to know "you are available and capable of providing in every which way," and that you are an essential part of "improving hospital and patient care."
By settling into their permanent spots in this new integrated model of healthcare, anesthesiologists make it clear to the hospital/ASC and patient that they are present at all stages of surgery, before the patient undergoes surgery all the way to the recovery process.
"Post-op readmission is something that hurts us and hospitals," said Dr. Shah. "In order to prevent this, we are more involved in all aspects of patient care even after the perioperative period is over."
The Perioperative Surgical Home model proves essential to this all-encompassing surgery engagement process, placing anesthesiologists in the ring of relationships between surgeons and patients.
Anesthesiologists' evolving role in ASCs
With ASCs increasingly in the mix, Dr. Shah said that he is flexible with surgeon needs in ASCs, but he remains unyielding on some issues.
"We have to be willing to step out of our scope of practice," said Dr. Shah. "Things are moving towards ASCs…but we have to be firm when certain procedures cannot be done in ASCs due to the safety of the patient."
For anesthesiologists in particular, Dr. Shah said they "need to make sure [they're] doing the right things within the confines of where [they] are."
When in an ASC operating room, Dr. Shah said everyone is responsible for a little more, because they have to do everything that is done in a hospital, but within their own staff. Without an entire hospital staff around, everyone "wears a lot of different hats."
ASCs are their own community, in which everyone is providing services to patients from preoperation to recovery. In that kind of responsible environment, Dr. Shah said he has to have a lot of confidence.
Building a lucrative business
In addition to building strong relationships with ASCs and hospitals, independent anesthesia groups must embrace efficient business models to stay lucrative.
Dr. Shah said decreasing reimbursement for the same procedures is hurting anesthesia business. The time/cost ratio is not adding up, with anesthesiologists trying to get more done in the same amount of time.
"We're trying to be more resourceful with the same amount of materials," said Dr. Shah. To remain profitable, anesthesiologist businesses focus on cutting costs, meaning there needs to be a very specific reason for administering a specific drug.
This cost-saving thinking predates surgeries, with anesthesiologists preemptively dealing with pain control and nausea. Avoiding readmitting patients is the ultimate goal, and also lowers costs.
"The business of anesthesia is not only about making a living," said Dr. Shah. "But also making sure you're taking care of people well."
Hear Dr. Shah discuss the business of anesthesia with Jeffrey Peters, MBA, president of Surgical Directions, Michael Hicks, MD, CEO of EmCare, Rafael Cartagena, MD, president of North American Partners in Anesthesia and Jeffrey Weiss, DO, president of TeamHealth Anesthesia, East Division, at Becker's ASC 22nd Annual Meeting: The Business and Operations of ASCs, October 22-24, 2015 at the Swissotel Chicago.