5 Proven Ways to Increase ASC Case Volume
Healthy case volume is essential to the financial health of any center. Philip Grossman, MD, FACP, FACG, AGAF, FASGE, CEO, medical director and chairman of the board at Kendall Endoscopy and Surgery Center in Miami, offers five proven ways to increase case volume at your center.
1. Make your center more attractive for your current physicians. According to Dr. Grossman, financial ownership may not be enough of an incentive for your physicians to bring the most possible cases to your center. "Some people might argue that in an ambulatory facility, if you happen to be an owner, you're motivated to bring all your patients there anyhow, so you don't have to do anything in the way of customer service," Dr. Grossman says. "That's a fallacy because every practicing physician, even if they're the owner of an ASC, has discretionary activity along the way."
For example, he says a physician may have to do two cases at the hospital in the morning because the cases are appropriate for the hospital setting. If they have two cases in the afternoon that could be performed in the hospital or ASC, the physician may choose to stay in the hospital because of the convenience. "But if the ASC distinguishes itself, the doctor will say, 'You know, every time I bring a patient to the ASC, the patient thanks me because everybody was so nice to me,'" he says.
He says if your center is the best possible place to bring ASC-appropriate cases, your case volume will improve when your physician has a choice between the hospital and the ASC. Dr. Grossman recommends keeping extremely punctual start times, encouraging friendliness and respect toward physicians and promoting high patient satisfaction. A physician whose patients rave about your center will be more likely to send patients to your facility, even if sometimes the decision is less convenient.
2. Play to your strength: efficiency. By their nature, ASCs are usually more efficient than the hospital because cases are unlikely to be delayed or bumped because of emergencies. "In the hospital, you can very carefully schedule six outpatients with good intent, and then suddenly you have two GI bleeders or somebody with an impacted gallstone and your schedule goes to hell in a handbag," he says. "The second problem in the [hospital] environment today has become anesthesia. The non-invasive surgical procedures tend to take second fiddle, so you have anesthesia available to do a colonoscopy, and then there's a car accident 10 blocks away and your anesthesia is pulled."
He says ASCs should not simply depend on their natural efficiency, but instead build off that trait and make the facility as efficient as possible. He says if an ASC tells a physician he can start at 10:00, the physician should start at 10:00 because, unlike a hospital, an ASC has the ability to ensure that punctuality with a little effort.
The same applies to turnover. If physicians experience rapid turnover at your ASC, they will be able to fit in more cases and therefore build your case volume. "ASCs have a unique opportunity in the area of efficiency to really capture increased volume," Dr. Grossman says.
3. Meet with physicians in your community. Set up meetings with physicians who don't yet participate in your center, and offer the chance to visit and witness your operation. "Say, 'Listen, we've been operational for X amount of time. I know you typically go elsewhere, but we've done some pretty good things here. Why don't you come and take a look?'" Dr. Grossman says. He says if the physician stops by your center and decides the relationship isn't a fit, that's fine. Just reaching out and putting your name out in the community will help attract physicians to your center.
4. Fix the "splinter in the lion's paw." In terms of recruiting more physicians to your center, Dr. Grossman advises ASCs to think of the fable of the lion and the mouse, in which the mouse fixed a splinter in the lion's paw and was later remembered and rewarded. Find out what the physicians in your community are missing, and fulfill that need, he says. "I've done a tremendous amount of computer consulting at a variety of levels, including healthcare, and I use that as a driving force," he says. "Find out the things that are making life difficult for people and then fix them."
He says these difficulties will vary. "Is it the fact that they go to the hospital and can't start on time? Is it the fact that they don't have a particular piece of equipment that would really allow them to distinguish themselves and their specialty?" he says. "Is it that clerical staff can never get a patient registered without 15 follow-up phone calls?"
He says the most successful ASCs can actually build entire programs based on this philosophy. For example, imagine there's a new technique for colorectal surgeons, and the surgeons in your community are eager to do it but lack the equipment or trained nurses. If you introduce that equipment and trained staff into your facility, suddenly those surgeons will gravitate toward you because you offer something unique and desirable.
5. Watch for young physicians entering the community. A mix of older and younger physicians is critical to the continued success of an ASC, as older physicians will eventually retire, and younger physicians may be more engaged in ASC operations and growth. Dr. Grossman recommends watching for younger physicians entering the community in order to promote your center while they're still early in their career. He says the relationship between an ASC and a younger physician can be beneficial for both parties. The ASC gets the benefit of the younger physician's cases, and the younger physician learns from the more experienced staff members at the ASC.
Since it's increasingly difficult for new practitioners to start practices, new physicians in your community will likely join existing practices, he says. If those practices are already involved with your facility, you can use that connection to receive notification when new physicians arrive. "In every major city in the country, a high percentage of graduates from the local medical school want to stay in the community, so you want to keep your eye on who's coming out of surgical fellowships and get a feel for who they are," Dr. Grossman says. By establishing connections to credentials committees and hospitals, you will likely hear when new physicians arrive in the community.
Read more about ASC case volume:
-5 Essential Steps to Turning Around a Struggling ASC
-11 Benchmarking Statistics About Physician Case Volume
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