Administrator of Boston Out-Patient Surgical Suites Gregory P. DeConciliis, PA-C, CASC, has been at the helm of BOSS since it opened in July 2004 and instrumental in its growth.
The center's orthopedic and pain physicians perform more than 500 procedures per month at the three-OR, one procedure room facility. The center recently added total joint replacements as well.
Here, Mr. DeConciliis outlines the three core concepts for running a successful ASC and three important qualities of an ASC leader.
Question: What are your three core concepts for being successful in business?
Gregorgy P. DeConciliis: 1. The surgeons — surgeons who perform surgery well with good outcomes, of course. But, our success is also based on surgeons who are willing to participate in business operations. That's not a huge time commitment, just monthly or quarterly meetings and willingness to engage in exercises to improve the bottom line, whether that be cost containment, trying new products or even assisting with vendor negotiations and standardization. Also, they have to lead from the top and be good to the staff and be willing to reward them monetarily and with a good working environment.
2. A good staff — there's no question a strong staff that works hard and has experience can improve your efficiency and bottom line because they know what the surgeons use (and won't waste supplies by opening lots of 'stuff' that's not needed). They have to be committed to success all around, and be willing to go the extra mile for the facility. This culture, again, is often created from above by good surgeons and management.
3. Management — I'm not being selfish here; it's really not even me. It's surrounding myself with good staff but also good managers to lead them; managers who have experience and know how to run the place efficiently. Those managers can deal with issues in a sensible manner, work hard and lead by example. I will include the materials manager here as well, because for us as a busy center, a materials manager spearheading all ordering, negotiations, etc., with equipment and supplies is key to success. Managers have to run things lean but not too tight, and have experience to know what surgeons use and what options we can have for lower-cost alternatives. They have to be excellent negotiators too. I would also like to include anesthesia here because they are so key to making our facility run smoothly.
In terms of core concepts for myself as a leader, I would say simply:
1. Work hard — be willing to put in the extra time, especially when something is new or you're not as familiar with it (i.e. new procedures, new surgeons). If someone doesn't have experience, like I did when I started, you need to put the extra time in to learn how to do your position well. There's not a formal education process or avenue for what we do, so there is a lot of hands-on time and work that needs to be put in on a consistent basis. Again, especially at the beginning of a career, a new job, or with a new specialty or surgeon.
2. Lead by example — this somewhat goes along the lines of above. Work hard on busy days and work alongside the staff so they know you are there with them. Don't be afraid to swing a mop or take out that bag of trash. There is no question that the staff work more effectively when management is around, so face time is key to support, as well as success.
3. Surround yourselves with good people — of course this means good physicians, but sometimes you have no control over that. What you do have control over is recruitment, so don't be desperate and go after a surgeon who is inefficient or has a poor reputation. It's not worth it in the end. But, staff makes or breaks a facility. If someone is not working out, replace them.
When hiring, do your homework. Check references provided and don't blow off the interview. Also, pay them well. If you can't pay them well, perhaps get a bonus structure approved based on metrics that impact the bottom line like volume, cost savings, efficiency and patient satisfaction. That will pay for itself, believe me. If money is tight, and even if it's not and you pay them well, always treat the staff with respect. Involve them in decisions and communicate well. They will feel valued and respected, and this will go a long, long way with employee retention.
I can't overstate effective communication. Communication with the surgeons through face time and ensuring they are aware of changes is so key. Email and text messages can sometimes works well to deliver simple messages. Of course frequent face-to-face meetings are the best. Communicate changes and issues always!