Same-Day Surgery Manager: Q&A: Do surgeons have to be credentialed at ASC?
Q&A: Do surgeons have to be credentialed at ASC?
Also: turnaround, preop tests, hoarding supplies
By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX
Question: We have a new surgery center, and I have the job (I am being punished) of taking care of the credentialing of the surgeons. I have a couple of questions. I have been told that if the surgeons have credentials at the local hospital, then they need not be re-credentialed at the surgery center. Further, I have been told that the CRNAs (certified registered nurse anesthetists) do not need to be credentialed since they are "certified." This is actually a great relief to me as several of the surgeons have told me that they would not fill out the paperwork again. I am correct, right?
Answer: I am about to ruin your day. First, your surgeons have credentials at the local hospital, but that has nothing to do with your facility (even if is partly owned by the hospital in a joint venture arrangement). You absolutely, categorically, unequivocally, must credential them at your center. I can certainly understand why they do not want to go through the hassle of the credentialing process again, but they must. It's part of the responsibility of using the facility.
As far as the CRNAs go, just being certified does not exclude them from needing to be credentialed as well. Looks like a bad day for you.
Question: I am a surgeon at the [name withheld] surgery center in Louisiana. I am also an investor in this facility. We have a medical director that is one of the ENT surgeons who started this place about a year ago. I just found out that he is being paid by the surgery center $95,000 for this role. It was my understanding that the medical director of a surgery center gets paid no more than $25,000. Could you please provide me with the literature that states that amount to be paid?
Answer: Actually, there is no such literature. The medical director is paid, essentially, whatever the board of directors says he or she is entitled to receive. There are many medical directors of surgery centers that receive from nothing up to $200,000 (maybe higher) for the service they provide. [Editor's note: For more information on medical director salaries, see the ASC Employee Salary & Benefits Survey report from the Federated Ambulatory Surgery Association (FASA). The cost is $35 for FASA members and $125 for nonmembers. To order the publication, go to www.fasa.org/Publicationsorderform.doc or call FASA at (703) 836-8808.]
Question: What is the average hospital-based ASC [ambulatory surgery center] turnaround time that you are seeing out there?
Answer: For hospital-based ASCs that like to follow procedures, it seems as if the average is about 45 minutes from the time the first patient leaves the room until the next patient goes in. While that number still is high, it is better than it was a couple of years ago.
Question: Our hospital requires extensive pre-op testing for ambulatory patients. I found out this requirement when my relative had surgery here last month. In addition to all the lab and EKG work, he also had to have a chest X-ray even though he is a nonsmoking 28-year-old male. The self-pay part of the bill was more than $350! Why does the hospital require all this expensive testing?
Answer: Actually, the pre-op testing is usually required by the department of anesthesia, not the hospital, so be aware of the culprit. Most facilities have pared back on what is required for essentially healthy individuals requiring surgery. Some stay with the old. It wouldn't hurt to go to your chief and explain to him what you told me. Let me know if you get anywhere.
Question: I understand that you are an RN and past administrator of surgery centers. So let me ask you, why does the staff hoard supplies and implants over and above par inventory levels? Are they really that afraid of the surgeons?
Answer: Shakespeare said, "Cowards die many times before their deaths. The valiant never taste of death but once." Well, I have a string of tombstones as far as the eye can see. I can tell you from experience that none of us want to tell the surgeon who has a sleeping patient on the table that we don't have something they need.
(Editor's note: Earnhart & Associates is an ambulatory surgery consulting firm specializing in all aspects of surgery center development and management. Contact Earnhart at 1000 Westbank Drive, Suite 5B, Austin, TX 78746. E-mail: [email protected]. Web: www.earnhart.com.)
Question: We have a new surgery center, and I have the job (I am being punished) of taking care of the credentialing of the surgeons. I have a couple of questions.Subscribe Now for Access
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