Physician recruitment is one of the key growth strategies for ASCs. Surgery centers can either attract physicians to bring cases or new physician investors to boost case volume, add specialties or prepare for the center's founders to retire.
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Here are key concepts for recruiting, credentialing and onboarding new physicians.
Physician recruitment timeline
1. Decide what type of physician you're looking for based on a conversation with current physicians and analysis of the ASC's needs. Outline the skills and necessary certifications candidates must have before accepting applications.
2. Determine whether to develop a recruitment team in house or hire a firm. If you hire a recruitment firm, you can choose to retain the firm or work with a contingency firm, which accepts its payment after the physician is placed at your center.
3. Discuss why your center needs a new provider with all current providers. In some cases, the new provider will replace one that left the center; in other cases, the ASC may need to increase case volume or net revenue per physician.
4. Outline how the current physicians will mentor the new physician, especially if it's that physician's first time in the ASC environment. The mentoring process could include regular meetings, training on equipment and introduction to the staff and anesthesiologists.
5. Current physicians can begin the process by networking with their colleagues to see who might be interested in joining the ASC.
6. Connect with a firm if internal recruitment isn't fruitful.
7. Once a candidate is identified and meets all the prerequisites, bring the physician and the physician's spouse to the center for in-person meetings. Give them a chance to learn more about the center and current physician partners. If the candidate is from out of town, show him/her around the local community.
8. Be sure to double-check the physician's credentials and verify the physician doesn't have outstanding malpractice issues. At this point, check references as well as speak with the nurses and administrative staff the physician previously worked with to learn more about how the candidate works in the operation room.
9. Query the National Practitioner Data Bank and the Office of the Inspector General for any Medicare violations, licensing issues or disciplinary action against the physician.
10. When the current partners agree to move forward with a candidate, follow up to gauge the candidate's interest. It may take additional trips to the center and discussion about the center's strategic goals to help the candidate make a final decision.
11. Invite the physician for a second visit if necessary.
12. Schedule a few dates for the physician to bring patients to the center for a "trial run" to identify any potential issues before the physician comes on full time. The trial runs will also give the physician a chance to see workflow at the ASC and decide whether the arrangement will truly work with his/her practice.
13. Credential the physician at your center. The credentialing process could take months, so begin the process as soon as both sides make an agreement.
14. Decide on a start date when both sides are ready to accommodate the arrangement. The surgeon may not be ready to invest in the center right away, but can perform cases there and discuss investment again later on when the physician is in a better spot financially or feels more comfortable about making the commitment.
How to attract new physicians
15. Current physicians can network with colleagues at the local hospital, society meetings and other events to identify potential candidates for the center. Conversations about the benefits of performing cases at the ASC, and eventually investing in a center, can make a big difference.
16. Surgery center administrators and leaders can also consistently reach out to physicians beyond their center's doors will yield better results. Connect with the physicians' practices with current partners and any new physicians who come to the area to form a relationship that could eventually lead to a future partnership.
17. Include the physician's staff in the recruitment efforts. The ASC works with physician offices to credential physicians, schedule cases and collect patient information before surgery, so the relationship with staff members is very important.
18. The best way to outshine competition is by being the most attractive offer. Physicians often want to use ASCs because they can perform their cases more efficiently, are able to use new technology and don't have to deal with the bureaucracy of the hospital. ASCs with a welcoming environment, friendly staff, good reputation and high patient satisfaction scores can help new physicians build their practice. Eventually, ownership at the center and receiving distribution payments could be an attraction.
How to make sure the surgeon will be a good fit
19. Take a hard look at the surgeon's reputation and surgical skill. It's easier for ASCs to bring on surgeons with established practices because they will have a more immediate impact; junior surgeons trying to build their practice often perform fewer cases initially.
20. The dynamic at the ASC will change when the new surgeon joins. If the new surgeon is bringing a new specialty to the center, it will require resources to purchase new equipment, train staff and become familiar with the details associated with that specialty. If the surgeon's specialty already exists at the center, make sure there will be enough volume so the current partners don't have to compete with the new physician.
21. A new surgeon's personality will also change the group dynamic. Consider whether the new surgeon's clinical and business philosophies will align with the current partners. It may also be important to assess the new surgeon's personal preferences — such as work/life boundaries, leisure activities and politics — won't disrupt the current culture.
22. Connect with the surgeon's previous OR teams to gauge any personality issues. The surgeon's personality in the operating room impacts staff members and the ASC's reputation. Surgeons are often accustomed to running the show with an iron fist, but disruptive personalities in the operating room leave the door open for harassment and malpractice suits.
23. Surgeons must communicate well with patients, other physicians and staff members. ASCs run a lean and efficient business, so communication is essential to keep patient flow. Staff members need to know how to schedule the surgeon's cases, what materials surgeons need and any other preoperative requirements to avoid cancellations.
24. Design a protocol to meet the specific surgeon's needs to ensure their cases will contribute to the surgery center's financial well-being. Contact the physician's office to learn more about their preferences and how their orders are typically handled to make the transition as smooth as possible.
25. The Joint Commission released a tool for surgery centers covering physician credentialing and accreditation updates:
• Define the surgeon's scope of care.
• Identify licensed independent practitioners and make sure they are practicing within state laws and regulations.
• Each licensed independent practitioner should have an identified scope of practice that meets state laws and regulations.
• Define qualifications for licensed independent practitioners to practice at your facility, including education and training as well as board certification.
• Place a formal request for privileges from each practitioner to provide care. The request can be in a letter form, application or documented conversation with the medical director.
Tips for an efficient credentialing process
26. Assign someone at the ASC to keep track of credentialing every clinician at the center. This person can update credentials and license information when necessary and take new physicians through the credentialing process.
27. It takes 60 to 90 days for surgery centers to collect all credentialing material required. ASCs can grant temporary permission for surgeons to perform cases without all credentials in place, but it's prudent to conduct a background check on surgeons first to establish they don't have a higher number of adverse events that could put the center at risk.
28. There are several forms physicians and their offices must fill out to obtain credentials at the ASC. Stress the importance of filling the forms out fully before returning them to the ASC; otherwise, there will be more back-and-forth between the physician's office and ASC, adding time to the process.
29. Keep credentials up-to-date to avoid medicolegal issues. If malpractice occurs and the physician's credentials are outdated, the ASC could run into legal issues.
30. Keep a calendar of the important licensure updates and credentialing dates to track updates throughout the year. There are automated systems available to help with this process and notify administrators 30 days before a physician's license, board certification, certificate of insurance and more expires to allow ample time for renewal.
31. Each state has different requirements for physician credentials, but many follow similar rules to accrediting bodies. Make sure you know the rules for your state and accrediting body so you're prepared when the surveyor arrives.
32. Regularly audit files to ensure there aren't omissions in a physician's credentials. Staff members may initially overlook a mistake or forget to update credentials.
Mistakes to avoid
33. Here are 10 common credentialing mistakes that surgery centers make:
· Not having an appropriate employee who is skilled and knowledgeable in the credentialing role.
· Not having a predefined process for application requests.
· Not having intuitive and user-friendly credentialing software.
· Not updating clinical privilege forms.
· Not having completed files before committee action.
· Not following regulatory and accreditation standards.
· Not following the facility's governance documents.
· Not linking quality to appointment of physicians.
· Not understanding the approval process.
· Not engaging everyone in credentialing.