What is it that’s prompting the low surgeon satisfaction scores? If you said problems with the OR, pat yourself on the back. According to the report, in the OR specifically, surgeons are least satisfied with the ease of scheduling inpatient surgery (a satisfaction score of 72.3). Ease of scheduling outpatient surgery isn’t far behind: Physicians gave that factor a 72.4 satisfaction score.
"Scheduling cases in the OR is a chore and not surgeon friendly," says one physician quoted in the report. "Often, the surgical consult is not timely at all — they are not placed during work hours but late at night when the patient has been in the hospital all day."
They are slightly happier with how up-to-date the medical equipment is (75.5), and are much happier with anesthesiology services overall (80.4). While a score is not listed, it seems physicians are also not entirely satisfied with the efficiency of hospital ORs.
"We should have an 8:00 a.m. ‘cut time,’" says a surgeon quoted in the report. "We do not. Since complaining has fallen on deaf ears, perhaps the competition of a local surgery center will wake up the OR."
Ah, dreaded competition. But when you look at how the surgical specialties rate their satisfaction, it’s not surprise physicians have taken matters into their own hands: 12 of 14 reported levels below the mean satisfaction score, and four of the five least-satisfied specialties were surgical (though, admittedly, the bottom three were inpatient-geared specialties — cardiovascular, vascular and thoracic surgery).
Oral surgery was the only surgical specialty to make the top five; ophthalmology was also above the mean satisfaction score of 72.5. In descending order of score, gynecology, gastroenterology, other surgical specialties, urology, orthopedics, neurological surgery, plastic surgery, anesthesiology and general surgery all garnered satisfaction ratings below 72.5. It is further interesting to note that physicians employed by their hospitals/facilities (20 percent of those surveyed) reported higher overall satisfaction (75.2 satisfaction score) compared with those who are not (72.4 satisfaction score). In particular, surgical specialties not employed by hospitals reported lower satisfaction with their practice at the hospitals.
Press Ganey reported the specific satisfaction of just three surgical specialties employed by hospitals: gynecology (75.0 satisfaction score), general surgery (72.9) and other surgical specialist (72.5). Far more surgical specialties made the non-employed list: ophthalmology (74.6), urology (72.7), gynecology (72.4), orthopedics (70.5), other surgical specialist (70.3), anesthesiology (69.5) and general surgery (69.4).
"The hospital administration isn’t doing enough to advertise the hospital as a surgical center and has not adequately addressed the fact that surgical cases are dropping and surgeons are getting older and leaving," says another physician quoted by the report. "Money is being lost because surgical cases are not increasing and they aren’t using OR time effectively."
Based on the scores and comments, it’s clear physicians largely turn to ASCs and surgical hospitals for convenience, efficiency and ease of practice (not so they can perpetrate self-referrals and overutilization of services, as some would like you to believe). If you’re thinking about opening your own center, check out our package on construction and real estate development beginning on p. 38. There, you’ll find tips from experts, administrators and physicians for success, a discussion of current real estate issues and sample pro formas and costs for building, owning and leasing.
If you’re not interested in the ASC route, know that the hospital administration isn’t necessarily on a different page entirely
"Administrators regularly cite physician-administrator relations and physician retention as two of their top concerns, and they know that alienating physicians can lead to physician attrition and lower patient volumes," says the report. Further, "Press Ganey research also shows that the most satisfied physicians refer the greatest number of patients. Hospital administrators who acknowledge the demands on their medical staff and take steps to partner with physicians can see not only increased physician retention. but increased patient volumes and healthier bottom lines.
"The health care landscape is changing, but there is still incredible potential for growth — and, more important, improved patient care — for hospitals that choose to partner with their physicians.
