5 Key Considerations for ASCs Adding Surgeons

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Dr. Gary Brazina on ASCsGrowth is an important aspect of any surgery center's strategic plan, whether they are looking to replace a retiring surgeon or bring more cases into the facility. It's important to understand your long term goals when recruiting new physicians, and bring on the right surgeons for your center, says Gary Brazina, MD, a board-certified orthopedic surgeon at DISC Sports & Spine Center.


"If you are just trying to increase volume, the type of cases you want to perform must dovetail with the equipment and capabilities you already have. The ASC may want to go out and look for specific types of physicians and see who might be available by word of mouth. Network in your community to find who is looking to make a move or expand and make sure they are a good fit personality wise for your practice."

Here are five considerations for ASCs when they are looking to bring on a new physician partner.

1. The surgeon's experience. Ambulatory surgery centers must consider where new surgeons are in their careers before they bring cases into the ASC. Surgeons just out of training have a different mindset, and will require different considerations than surgeons who have already established their practice.

"The biggest thing to look at when bringing on a new surgeon is the surgeon's reputation and surgical skills," says Dr. Brazina. "You have to determine whether you are bringing on an individual with an established practice or someone right out of residency. It's better for ASCs to bring on an established surgeon because it will increase case load immediately as opposed to bringing on junior surgeons who still need to build their reputations and skill level."

Many surgeons just coming out of residency predict they'll be ready to perform 25 to 30 cases per week, but the volume may not be there when they first start out.

2. Whether they synergize with current surgeons. Whenever groups bring on a new surgeon, the ASC dynamic will change. Consider what cases and services the staff surgeons are already performing and figure out whether the new partner will be able to develop in areas and uncharted territory.

"Figure out whether the new surgeon is bringing on a new skill set that can benefit the partnership or whether they are doing the same procedures as current partners," says Dr. Brazina. "If they are bringing in a new skill set, one of the issues that should be discussed is whether they'll need new instrumentation. If you are bringing on a partner who specializes in hip arthroscopy and you don't currently perform that procedure, you'll have to purchase a new set of instrumentation. That can be a significant financial burden."

The new surgeons must have the right personality to work with other surgeons at the ASC. Sometimes surgeon ego can get in the way of a perfectly good partnership.

"When you join an established group, one of the things you have to do is put ego in check because you may become a smaller fish in a bigger pond," says Dr. Brazina. "An ego can be a major sticking point in getting a good workable group. You have to use the same skills that you learned in kindergarten: play well with others and share your toys."

3. Their personality with staff members.
It's important for all surgeons to understand how their personality in the operating room impacts other staff members and the surgery center's reputation. Surgeons are sometimes accustomed to running the operating room with an iron fist, but this behavior doesn't always gel with the other staff members.

"I think nowadays there is more attention being paid to disruptive personalities in the operating room," says Dr. Brazina. "Disruptive surgeons may leave the door open for lawsuits with patients and malpractice, as well as lawsuits regarding harassment and personnel.  I think you need to do your due diligence and ask around about your potential new partner's reputation in the community."

The experienced surgeon should be able to function well with staff members and be attentive to responsibilities in the operating room.

4. How well they communicate. Surgeons can no longer expect to practice on an island; they must communicate well with their patients, partners and staff members at the surgery center to make sure the surgical process runs smoothly.

"The new surgeon must understand how cases are scheduled at the ASC, who to contact with issues and how to open the lines of communication between the practice and ASC and keep them flowing," says Dr. Brazina. "The associate staff must be aware of how to schedule the surgeon's case as well and let the surgery center know what materials, lab tests and pre-op clearance will be required."

All this information must pass from the surgeon's office to the ASC in a timely fashion, and the ASC should make it easy to schedule cases.

"The office should have a contact person who understands what specialized instrumentation and available implants are available for each case," says Dr. Brazina. "Otherwise, the ASC will have to order them. You have to do this in a specific timeframe and have the process laid out in advance so there is not miscommunication."

5. What their specific NEEDS might be.
Understand what a new surgeon's specific needs might be and how they will contribute to materials costs at the center. If you're not careful, your surgery center may end up paying more to perform the case than the extra volume brings in.

"For postoperative care, does the new physician have specific orders and are they communicated to the recovery room staff efficiently," says Dr. Brazina. "If the surgeon is using DME, what do they want available? Establish the way things are done at your center and write a protocol for each potential case situation."

The protocol should also include directions for who the office can contact with issues about physician preferences or specific orders that should be handled at the ASC. Communication is essential to make the transition as easy as possible for the new surgeon.

More Articles on Surgery Centers:

10 Tips to Make Efficient ASCs Even Better

8 Tips to Improve Surgery Center Operations

9 New ASC Openings or Announcements


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