Staffing overall is “one of the biggest challenges today,” Dr. Ishii said. “The current market is incredibly difficult for hiring, as staffing in general hasn’t recovered from COVID-19. People are having to pay more for their staff than they ever have.”
Explore This Issue
September 2024Location matters, too. “Pick a physical location that meets your needs,” said Dr. Reh. “Select a facility that has the necessary operating and procedure rooms to meet your case volume requirements. It should be designed
for good patient flow, from pre-op to OR and recovery/PACU [post-anesthesia care unit]. It should be geographically located to serve the surgeon’s patient population.”
Ensure the business stays in business, advised Dr. Ishii. “The most important factor is your rates,” she said. “Make sure you can negotiate reasonable payer rates that cover the expense of the procedures. Have your center in a location with a patient base that has a favorable payer mix. Also, make the size of your surgery center [match] what you think your case mix will be made up of.”
As an otolaryngologist, consider whether you will have a single specialty or multispecialty center. “The way you put your case mix together will determine how well you do financially,” she said.
What Are Common Pitfalls?
The flip side of successes can turn into major challenges.
Opening surgical centers “can be financially risky, such as assuming debt to purchase an existing center or to build a new center,” said Dr. Reh. This includes managing the fear of the center failing to avoid financial loss, as well as letting the staff down. Underestimating the overall capital expenditure is an issue, too.
Surgical centers can be time-consuming to run effectively, “which is why having a team that you trust and [who] can competently run the center is essential,” Dr. Reh added. “From experience, staffing is vital. I have worked with staff/administration that did not have the bandwidth to run an efficient center, which makes the risk much more visible.” Having staff who understand the regulations that keep the center in compliance with The Joint Commission standards, and staff—either internal staff or a third party with transparency in billing and collection—who ensure collections are coming in, is crucial, Dr. Thrasher said. “If these things aren’t done well, it could result in your being shut down, either by the state with noncompliance or financially not being able to keep up with others.”
Good administrative partners also negotiate fair contracts with payers and keep track of appropriate supply and staff costs to avoid financial loss.
“Running a surgery center takes real work, effort, and strategy,” said Dr. Zanation. “There has to be a constant evaluation of ways to do things better, more cost-effectively, as well as more efficiently. The best people to do these evaluations are the surgeons who are stakeholders in the company and are direct patient advocates.”
Doing so can help foster a favorable experience for surgeons who want to own or operate an ASC.
“Overall, surgical centers allow physicians to be more efficient and see more patients in their practice,” said Dr. Reh. “Most ambulatory surgical centers, within reason, cater to their physicians and patients to make it a positive experience for everyone involved.”
Cheryl Alkon is a freelance medical writer based in Massachusetts.