Same Day Surgery Vol.28, No 3 March 2012
Can you believe that 2012 is almost 25% over! It just started, for heaven’s sake! Myself, I’m still struggling with issues from 2011.
One of the great things I enjoy about writing this column is the wonderful feedback I get after each column. I received quite a bit of feedback from the January 2012 column on revamping surgery in the outpatient area. I think I hit a nerve. If you didn’t get a chance to read it, go back and grab your issue. I had comments from several hospital CEOs and owners of GI and pain centers, as well as staff members who work with them. They already are noticing the trend. For help in this area, read on.
Question: We are a GI center only, and while we have had some decline in the volume of cases over the past year and a half, we are financially struggling with volume that we used to flourish with. Our center is up for sale by our owners. How can that happen, and so quickly? We don’t see the “numbers” (as the docs call them), but we feel the void and the insecurity.
Answer: Surprisingly, with a number of single-specialty facilities at the tipping point (an event of a previously rare phenomenon becoming rapidly and dramatically more common), it comes on quickly with the decline in even a small reduction in cases being performed. The reason those decreased cases are so dramatic is that those last few hundred cases per year are the ones that generate the profit and lead to financial success.
Question: I have heard that there are opportunities for recruiting cash-paying patients from other countries to hospitals and even surgery centers in the United States. Is that true, and is that an option for our hospital?
Answer: Yes, and many hospitals and surgery centers are doing just that. You need to stand out, however, to be successful. You need to have a unique procedure that you perform, such as bariatric procedures, penile implants, cardiac, transplants, etc., to be attractive to international patient will to travel to the United States for surgery that is technically difficult or unavailable in their country. These patients want state-of-the-art facilities and first class service when they arrive. The vast majority of hospitals and surgery centers cannot live up to those standards.
Question: Our hospital has never laid off staff before. In the last few months, they have started aggressively reducing personnel. Is this just the beginning?
Answer: Unfortunately, it is just the beginning. I have spoken about and written about so often over the past few years the need for individual growth and achievement within your respective organization. You need to stand out in the crowd, or you will stand out with the crowd.
Question: Our surgery center has started “flexing” (rolling reduction in hours for staff) staff this year. We have never done this before, and it is demoralizing to us all and, quite honestly, scary. Have you heard of others doing this, or are we the only ones?
Answer: First, you and everyone reading this need to get out and interact with your peers, either online or through local and national conferences, so you will not feel so isolated. Yes, it is going on in many facilities, including hospital surgical departments, and it is everywhere. In a way, it is not such a bad thing, unless you need every one of those 40 hours per week. It allows the facility to reduce everyone’s hours just a bit during slow periods to avoid terminating staff.
While it is troublesome to all, it is better than a reduction in staff. I always tell “flexed staff” that this is the perfect time to take courses at your local college to perfect your skills and desirability to your employer. As nurses and techs, we have always been (or felt) we were a protected class. Not anymore. You need to look sharp and be sharp.
Question: Several of our surgeons have become employees of the hospital. I didn’t know that could even happen, but obviously it does. They no longer do late elective cases or seem to “bust our butts” on turnaround times and starting on time. It doesn’t seem like this is the way to be more productive. Is it just me?
Answer: No, not just you. We see it too. Hospitals’ physician employment jumped 32% from 2,000 previously to roughly 212,000 physicians in 2010, according to the AHA Hospital Statistics, 2012 Edition. That number means hospitals employ almost 20% of all physicians, notes a Hospitals & Health Networks Daily article. That trend is going to continue, and I predict that we will continue to see a reduction in productivity that you so accurately described.
So, with all the above going on, I have a motto on my web site and all of my e-mails that says: “Audentes Fortuna luvat.” (“Fortune favors the brave.”) Consider it.