8 Tactics to Bring Surgeons Onboard for Implant Standardization at Surgery Centers
1. Involve the physicians early on in the process. Engage the physicians early on in the process to standardize equipment so they are involved in making decisions. Gather all of the surgeon partners together to discuss standardization.
"Allowing them the opportunity to participate at the beginning of the process gives them a choice about which device to choose and how their decisions impact cost savings and overall profitability at the surgery center," says Ms. Pilla. "If the surgeons want to continue using the high dollar items then their monetary benefit will be reduced. It's important within the surgery center market to establish standardization for implants and other products."
2. Appoint a physician champion. The physician champion should be someone who is in a senior position at the surgery center and interested in promoting future cost savings through standardization. To appoint this person, bring all high volume surgeons from each specialty in one room to discuss supply chain management, liability and their commitment to success at the surgery center. During this meeting, a leader should come forward to really advocate for reducing costs by streamlining implants.
"Typically, physicians will listen better to their fellow surgeons than to someone from the outside," says Ms. Pilla. "Keep the physician champion in the loop about steps you are taking to standardize implants and communicate with them on a consistent basis. Additionally, if you come across someone who isn't willing to change, ask the physician champion to help stand with you from a united perspective to discuss the issue."
The physician champion will play the key role of influencing other surgeon partners to participate in the process and provide insight into the best method for standardization. Remind them that standardization of products in the market today does not necessarily mean "one" as it did historically. It could be just reducing the multiple suppliers to a much smaller number.
3. Establish a formal process for gathering information. Surgery center administrators looking to standardize and streamline implant purchasing and utilization should establish a formal process to gather information about surgery center cases and present potential cost savings to surgeon partners. The information should include the number of cases currently done at the center, cost per case and where the surgery center stands with multiple suppliers. Once the information is gathered for the surgery center as a whole — as well as individual surgeons — present that information in a formal setting such as the board meeting.
"When you show them moving from their current situation into a more streamlined approach and highlight the variable cost, they will consider moving to a more middle-of-the-road product that will cut costs at the surgery center without forgoing quality of care," says Ms. Pilla. "Often, they are not aware that there is a less expensive product available that provides the same clinical value as the newest and most expensive items."
You can provide the surgeons with blinded individual data describing the outliers, but not revealing who they are. "That generates a very excitable conversation because everyone is wondering who the outlier is," says Ms. Pilla. "By just sparking that curiosity, we can usually convince surgeons to move forward with some form of standardization."
4. Encourage discussion among the surgeons. When the data is presented at the board meeting, encourage surgeons who are outliers to discuss with their partners what they are doing differently and how they could stay in line with the pack. These meetings could spark new ideas not only for supply chain management but overall quality and efficiency at the surgery center.
"Having this data available opens up an opportunity for the surgeons to discuss and network," says Ms. Pilla. "There might be a conversation between a more senior person asking a more junior person as to what they are doing to achieve more efficiency or better cost savings with the same quality outcomes. They will talk about which method or techniques work the best and whether one surgeon is getting better outcomes than another."
With the chance to discuss the differences in their practice, most surgeons are willing to try something new to improve outcomes, efficiency and cost savings.
5. Engage suppliers in competitive standardization options. It's important to open up your options to several suppliers and do a formal Request for Proposal (RFP) asking them to bring you the best prices possible to share with your surgeons. When the suppliers have delivered the best deals they have, share this information with surgeons and discuss whether the products will meet the needs of their patient base.
"Surgeons know which products are the best, so make sure you ask them whether these new products are clinically acceptable, not just preferred," says Ms. Pilla. "Look at the data for surgeons who are using this product compared to those that are using more expensive products for similar procedures with the same case volume so surgeons can see what they are actually costing the facility. When they see their peers getting the same clinical outcomes, they don't want to be the outlier for price."
6. Narrow down your pool of candidates. When you have the best price from all suppliers and input from the physicians, remove the companies that won't work within the scope of your surgery center's needs. Begin by considering which specialties are at the surgery center and who requires more than just general surgical supplies; choose the suppliers that offer depth and breadth in these specialized areas which will prevent you from having to contract with multiple suppliers; then move forward by considering the quality and cost from the remaining companies.
"The goal is to streamline the number of suppliers and in order to do that we need a supplier who offers everything," says Ms. Pilla. "For example, if you have an orthopedic hand surgeon at your surgery center, not all suppliers will have the instruments and hardware the surgeon needs. You might be doing carve outs for this surgeon's instruments right now, and that's where you want to focus."
In this process, you will likely limit the number of suppliers down to a few key companies who offer what you need. Talk with these companies to see if you can get an even better contract in partnership with them. "The cost reduction comes when suppliers are willing to partner with you," says Ms. Pilla. "If you demonstrate your willingness to partner with them, they'll want to provide the best deals for you."
7. Work with senior leadership to convince skeptical surgeons. In a large group of surgeons, there will likely be one or two surgeons who are more skeptical than the others about standardization. If you show surgeons the data and they still aren't convinced, work with senior leadership to achieve alignment.
"If there is one surgeon who is truly adamant about not moving to a streamlined approach, we will engage the medical director or chief of that specialty and ask them to help us," says Ms. Pilla. "We work together to help the surgeon understand the benefits of committing to a reduced cost. If they are still adamant, we will present the unblinded data about supply costs per physician at the board meeting; showing each surgeon, by name; no one wants to be the outlier. This typically will help establish collaboration amongst the group and support our efforts."
If even peer pressure from the unblinded data doesn't work, take your case to senior leadership of the surgery center. Discuss the surgeon outlier in terms of how many cases he brings into the surgery center, his patient population and payor mix.
"Show the senior leaders what the cost per case is for him to work there," says Ms. Pilla. "When you get down to the granular details of all of this, they might determine that keeping him at the center is not profitable. Senior leaders are getting more serious about cost and they realize that even if the surgeon brings in a lot of cases, it might cost too much to keep him on staff. When surgeons know that senior leaders are taking that seriously, they are much more willing to cooperate."
8. Allow surgeons to make the final decision. After narrowing down the list of potential suppliers, allow the surgeons to make the final decision. The surgeons should make an informed decision about their supplies based on the cost and quality of the devices.
"Surgeons are becoming more educated now and they are recognizing that, with all the changes to CMS and hospitals purchasing physician practices, it's necessary to understand and partner with others on the business side of medicine," says Ms. Pilla. "I think this is where you are going to see some collaboration."
If the surgeons have a hard time making that final decision, remind them of the monetary benefit they will realize as well. "It's much easier to get all the surgeons on the same page about standardization when you point out that if they continue to use the high dollar items, they are reducing not only their monetary benefit, but the long term viability of practicing as well," says Ms. Pilla. "It's important within the surgery center market to standardize, but that doesn't mean you have to use just one company; standardization and streamlining through two or three companies will also realize cost savings."
More Articles on Surgery Centers:
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7 Ways for Surgery Centers to Make More Money Now
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