Same-Day Surgery Manager: Grass is always greener at another surgery program
Grass is always greener at another surgery program
By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
My company is in the unique position of managing freestanding surgery center, hospital outpatient surgical departments, and physician-owned surgical hospitals. This varied clientele helps give us a broad overview of issues related to all entities. It is amazing the commonalities these facilities share.
We often think we are unique, alone in the world of surgical intervention, and that no one else has the issues we must deal with on a daily basis. Not even close. Did you ever buy a car and then notice all the same make and model on the road? It's as if they didn't exist until you bought yours.
For the past month, I polled some of our facilities and some other facilities where I am close with the staff. I came up with a list of issues that plague the centers. See if you can tell which type of facility had these issues. Was it the ambulatory surgery center (ASC), the hospital outpatient department (HOPD), the specialty hospital, or all of them?
- Surgeon utilization. "We have our staff call and meet with the surgeons' staff at least once a month. Nothing we do seems to get them to change their practice patterns and do cases here."
- Staff recruitment." We are having a very difficult time reaching quality individuals. Even with the recession we are having and people looking for positions, it is difficult to find quality nurses and techs."
- Cash flow. "This issue is a big one for us. The insurance companies are slow in paying, and self-pay patients are even worse."
- Back-ordered supplies and missed delivery dates by vendors. "This problem is getting worse. Many of the vendors pass the buck and blame it on the economy."
- Employee retention. "Our staff members keep getting sucked away from us. It seems like we train them, and then they leave for perceived 'greener pastures.'"
- Late surgeons. "We waste more money on tardy surgeons than anything else. It is hurting everyone when cases start late. You would think they would have some interest in controlling costs."
- Management reports. "Our software program is worthless. GIGO [garbage in, garbage out]. We don't trust the management reports we get because they are clearly wrong. We try to trace back the reasons, and it is almost always human input error."
- Demands for profitability. "Demands for cost efficiency and profitability are unrealistic. Every year, we have our budget cut even further. We have staff cutbacks, and that makes it harder to recruit and keep good people."
- Reimbursement. "Reimbursement is not what it used to be. The state is dragging its feet on payments due from Medicaid, and it is impossible to find the right representative [to address reimbursement issues] for our facility."
- Reaccreditation. "Reaccreditation demands do not take into account the cost of the issues they want to make us live up to. It is like these people have all year to come up with items that are now 'required' for licensure, and they just never stop inventing new things to make our lives miserable."
OK, you get the point. Here is the breakdown per question:
- Surgeon utilization. This came from a hospital outpatient department. Hospitals have to deal with retaining and keeping surgeons just as much as other facilities.
- Staff recruitment. This came from our friends at the ASCs. While the lifestyle and glamour of working in a surgery center is important, better health benefits and employer-paid retirement plans are a draw away from ASCs.
- Cash flow. This issue came from the hospital. We often do not think of hospitals dealing with cash flow, but they do.
- Back-ordered supplies. Everyone is having these issues.
- Employee retention. This came from the ASC. It is related to the staff recruitment response.
- Late surgeons. Brought to you by specialty hospitals. Considering the fact that surgeons own these centers, you would think they would be more cost-conscious.
- Software. By far, the hospital industry struggles most with antiquated software and data entry personnel.
- Demands for profitability. Most of you probably guessed right on this: the HOPD.
- Reimbursement. Those having the greatest difficulties right now seem to be the specialty hospitals.
- Reaccreditation. Our ASCs.
I hope this helps when you think you are alone.
(Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Contact Earnhart at 13492 Research Blvd., Suite 120-258, Austin, TX 78750-2254. E-mail: [email protected]. Web: www.earnhart.com.)
My company is in the unique position of managing freestanding surgery center, hospital outpatient surgical departments, and physician-owned surgical hospitals.Subscribe Now for Access
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