6 Ideas to Keep the Best Surgeons Coming Back to Your ASC

OperationHere are six ideas for ambulatory surgery center administrators to make sure top surgeons continue bringing cases into the center.


1. Make sure they can schedule cases easily. A major cause of dissatisfaction is problems with scheduling, Robert Carrera, president of Pinnacle III, says. He recommends keeping a "turn down log" at the front desk, where any case that's rejected is written in the log. If physicians complain that they can't get cases on the schedule, you can refer to the log and determine whether the "turn down" was warranted.  

David Milton, administrator of Phoenix (Ariz.) Surgicenter, says his scheduler is essential to physician satisfaction at the center; after all, if a physician can't easily schedule a case, he'll take it somewhere else.

"If the doctor asks for a time that isn't available, the first thing she'll do is offer alternatives," he says. "If that's not doable, she'll get with me or the OR director and look at the schedule to see if we can move anyone's case. Our partners have been very amenable to accommodating non-partner cases."

He says if a physician can't be accommodated on the schedule, honesty is the best policy. He recommends telling the physician as soon as possible that they won't be able to accommodate the 7:30 a.m. start, for example, and bringing up the schedule to demonstrate why.

2. Talk to each surgeon at least once a week.
Aim to build a strong relationship with your surgeons from day one, says Jenn Hunara, administrator of the Surgery Center of Allentown (Pa.), an AmSurg facility. Don't let weeks slip by without talking to them; if you do, you'll look up after a year and discover your surgeons don't know you and don't feel comfortable coming to you with concerns.

"There are very few physicians that I don't see or talk to once a week," she says. "It's not always shop talk, sometimes it's just, 'How did things go today? Do you have any vacations coming up?' We spend a lot of time getting to know them both as professionals and as people."

She says the more you get to know your physicians as people, the better you will understand them as professionals. "I know what my docs like. From equipment preferences down to what they take in their coffee," she says. To maximize your contact with your physicians, spend with them during their first year at the center in the operating room while they operate. Eventually you will build up a rapport and discover what they like and don't like about working in the ASC.  

3. Respond to complaints quickly and fairly.
Keeping physicians happy and satisfied is the key to keeping them at the ASC. Sandra Jones, executive vice president of ASD Management, says physician satisfaction can be tied to how quickly an administrator responds to complaints or issues in the ASC. When a physician comes forward with a problem, she recommends asking questions to determine the root of the problem. For example, maybe a physician feels undervalued or financially burdened. You won't be able to fix the problem until you find out what really brought about the complaint.

Sometimes physicians will have with problems that can be fixed, and sometimes there will be no immediate solution. Ms. Jones says it's important for administrators to differentiate between the two situations and explain the difference to physicians.

"They may complain because they want a different type of instrument or a newer technology, and your resources just aren't going to allow that because of continuous cutbacks on reimbursement," she says. "It's tough to have the latest and greatest in everything."

4. Serve surgeon lunches.
Karen Reiter, administrator at DISC Sports & Spine Center in Marina del Rey, Calif., says when surgeons perform multiple cases at the facility over the lunch hour, DISC buys their lunch. DISC has a "two-case minimum" lunch special, which means if surgeons do back-to-back cases the staff buys them their lunch.

"We ask where they want lunch and make a special order for them," says Ms. Reiter. "Adding a free lunch increased the case volume a little bit and makes surgeons feel good about performing multiple cases at the center."

5. Assign consistent and competent staff members to cases.
Surgeons want to know and respect the OR staff they work alongside, Mr. Carrera says. Try to schedule the same staff members for each physician to improve efficiency, quality and interpersonal relations in the OR. Make sure any complaints about staff ability are dealt with immediately.

6. Check equipment and update it appropriately.
Implement regular equipment checks to ensure you're providing your surgeons with the proper tools for patient care. If a surgeon requests a piece of equipment, take the request seriously and determine when the center's budget can accommodate the request, says Mr. Carrera. Too many "no's" may make the physician feel undervalued.

Sometimes a physician will request a new piece of equipment the surgery can't afford, or a new physician will want to bring cases the center isn't equipped for, Mr. Milton says. When these scenarios arise, he recommends looking for a cheaper workaround. For example, when a potential new ophthalmologist met with Mr. Milton, he stated what he was looking for and outlined his usual case load. The surgeon's request required the purchase of two microscopes and two phaco units.

"Our facility only has one room equipped for cataract surgery, and this surgeon was to work when another eye surgeon was there," Mr. Milton says. Instead of purchasing equipment that would have cost hundreds of thousands of dollars, Mr. Milton is working with a cataract outsourcing company for a per-case fee. They bring the equipment and charge by the case, which Mr. Milton feels is a smarter solution than investing in the capital equipment upfront.

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