Forming a New Surgery Center: 3 Solutions to Common Mistakes

When forming a new ambulatory surgery center, there are several common mistakes physician-partners make that are easily avoidable. Tom Jacobs, CEO and co-founder of MedHQ, discusses the solutions to three of these mistakes.

Mistake #1: Selecting the wrong administrator. Physician-partners can easily hire the wrong administrator for their ASC, which can continuously cause problems. "If you have a good administrator, that can do so much for the start-up process," says Mr. Jacobs. "If you get the wrong administrator, there can be problems down the road. You need to attract and interview the best administrators for the practice to stave off a lot of issues that could happen later on."

The solution: Give yourself enough time and create a good culture. The best administrator for your center will be attracted to your culture and environment because it matches his or her values, says Mr. Jacobs. Give yourself enough time to interview several candidates and select the best one from a pool of talented professionals. "The owners should decide what the core values of the center are before the hiring process," he says. "For example, do the owners want a 'family-like' feel among the staff, or a more corporate/professional approach? Neither is the right or wrong way, they're just different approaches. Whatever the choice, those things can be taken and put into interview guides and then can be used to screen for candidates who have those values."

Mistake #2: Hiring subpar staff members.
If the hiring process isn't performed correctly and the strongest candidates aren't attracted to the ASC, you might have to hire a less-qualified candidate to staff the position. "During the hiring process, there are so many things going on to put together the right staff and you need an efficient way to attract and screen the best candidates," says Mr. Jacobs. "If you aren't careful, you [may end up] hiring an individual who is available and making due with subpar talent. If you do have an effective process, you're putting the right person into the job."

The solution: Put together accurate job descriptions and attractive benefit plans. Before beginning the hiring process, define the key attributes for the staff you want to hire for each position, and create job descriptions and interview guides accordingly. Additionally, offer competitive benefit programs for employees to give your ASC the edge in hiring staff members. "A professional employer organization (known as a PEO) or a good benefits broker should be engaged early on to put in place competitive benefit plans for the staff," says Mr. Jacobs.

Mistake #3: Letting go of all controls.
One of the most attractive reasons for forming a physician-owned ASC is the independence involved, so it can be easy to eliminate too many of the controls and processes that are necessary for a healthy business. "Sometimes physicians decide they don't need all the business controls and processes they lived under in the hospital environment," says Mr. Jacobs. "That's true to some extent but you don't want to go too far." For example, without proper oversight and guidance, an administrator might establish pay rates that are inconsistent with the local market because he or she thinks the market justifies it. This can cause financial problems for the ASC. Another ASC might be overly exposed to potential fraud or theft because processes and responsibilities aren't well defined, resulting in poor oversight and security.

The solution: Designate specific roles and don't over burden any one person. Designate specific roles to each staff member or leader within the ASC with the help of an accounting professional/CPA, and make sure there is proper oversight of the decisions made at the center. An administrator shouldn't decide alone to make raises for the staff without approval from anyone else. Similarly, there should be some controls over purchasing and allowing new vendors into the ASC to avoid the chance of theft or inaccurate records. Clearly designate a staff member to approve check writing, record invoices and deal with other aspects of the surgery center's finances. However, Mr. Jacobs cautions against giving all these responsibilities to the same person. "You don't want to have over burdensome types of processes and you don't want to go too far," he says.

Learn more about MedHQ.

More Expertise From MedHQ:

Are You an Excellent Employer?: Professional Employer Organizations for Your Healthcare Human Resource Functions

Critical ASC Mistake: Hiring Colleagues to Staff a New ASC Without Conducting Full Search
Tom Jacobs of MedHQ on Impact of ACOs, Value of Outsourcing

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