Becker's ASC Review

8 ASC MANAGEMENT How the primary care shortage is spilling over into ASCs By Paige Haeffele T here are many systemic issues that all healthcare professionals are forced to grapple with, including staffing shortages, rising practice costs and decreasing reimbursement. Becker's connected with Agnes Hurtuk, MD, assistant professor and ambulatory medical director of ENT at Loyola Medicine in Chicago to elaborate on the biggest issues in the industry. Note: is response has been edited lightly for length and clarity. Question: What is the most insidious issue in healthcare? Dr. Agnes Hurtuk: e growing national shortage of physicians and its impact on healthcare delivery and quality of care is one of the most insidious issues in healthcare. Over the last several years, I have had an increasing number of patients that I see in my otolaryngology practice ask me to refill their blood pressure medications or an inhaler for their asthma because their primary care physician has le the state, retired, is no longer accepting their insurance, or is booked for a long period of time and unable to see them in a reasonable amount of time. Patients are having increased difficulty establishing care with primary care physicians, and as we all know, the pathway to good health starts with a good relationship with a primary care physician. In order to address this issue, it is first important to quantify and understand the current physician supply, areas in need, capacity of current practicing physicians, and how long they plan to practice. In addition to understanding the current physician pool, it is also important to understand who will replace or help these physicians when they leave practice, retire, or reach volume where they need help from another physician with the patient load. Currently, there are no reliable answers to these questions. One estimate states that approximately 83 million people in the U.S. currently live in areas with limited access to primary care physicians. As the U.S. strives to provide a more equitable and affordable healthcare system, there needs to be a better understanding of the supply of physicians and demand to achieve adequate access and maintain the high-quality care for which the U.S. healthcare system is known worldwide. It is important to understand the possible etiologies behind the current and anticipated physician shortages to address them. While this may not apply to all specialties, there are several factors that can be looked at to improve workflows for physicians, such as decreasing unnecessary administrative burdens, capacity enabling technologies such as telemedicine or virtual or digital charting support and investigating other factors to improve physician job satisfaction. Once these etiologies are better defined and quantified, these issues can be effectively addressed, and this, in turn, will continue to attract the best and the brightest candidates to medicine to move U.S. healthcare forward with research and innovation to provide the highest quality care to our patients and communities. n 5 things to consider when opening an orthopedic ASC By Claire Wallace A s several different physician specialties, including orthopedics, continue to move to the ASC setting, there are several considerations that executives and physicians need to make when deciding whether or not to open an ASC, according to an April 16 article published in Outpatient Surgery Magazine. Here are five key things to consider when opening a new orthopedic ASC: 1. Just because you build an ASC does not mean patients will automatically show up at the door. ASC owners need to reach out to payers and make sure to have strong relationships and data. Crunch the numbers to make sure operating an ASC makes financial sense in the area. 2. Assemble appropriate staff members who have experience in, or knowledge of, the ASC setting and its differences. ASCs need staffers who are cross-trained and familiar with different areas of the practice, as they are often smaller and have fewer hands on deck. There are fewer silos within ASCs, so hire employees who know that. 3. Equipment is changing rapidly in healthcare. It is important to build strong partnerships to acquire top- of-the-line tech. Additionally, some equipment for orthopedic ORs can be rather large, so ASC builders need to account for the footprint of equipment in the design of a new center. 4. Decide if an ASC should be built from scratch or renovated from an existing facility. When building an ASC from the ground up, it is a good idea to include enough extra space for future expansion. 5. ASCs can grow rapidly, and many owners report feeling that there is "never enough space." Keep in mind that as orthopedic demand grows, it is important to have the room to grow. n

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