Becker's ASC Review

17 THOUGHT LEADERSHIP • Quality of care: ASCs oen achieve high patient satisfaction and safety ratings, bolstering their reputation in the healthcare market. Bruce Feldman. Administrator of Eastern Orange Ambulatory Surgery Center (Cornwall, N.Y.): e continued migration of procedures from the hospital setting to the outpatient arena. Medicare continues to add more procedures each year to the ASC approved procedure list. Additionally, patients and physicians desire more cost-effective and higher quality of care. Michael Foldes. Sales Consultant for MFI Electronics/ Medical (Endwell, N.Y.): ASCs allow management to focus on various areas of healthcare without trying to be all things to all patients. [ey] reduce duplication of services and allow for more convenient local and regional offices with lower building costs and overhead. Leslie Jebson. Administrator, e Orthopedics and Sports Medicine Network at Prisma Health (Greenville, S.C.): Ongoing advancements and innovations in surgical procedure techniques, anesthetic and pain management options, and in next- generation devices and related equipment make for an exciting time in healthcare delivery. e future of quality and affordable healthcare services resides in the ability to provide low-cost, high-quality ambulatory care — whether it be through outpatient clinics or surgical centers. Joe Peluso. Administrator at Aestique Surgical Center (Greensburg, Pa.): What give me hope is the benefits and convenience of ASCs for patients and physicians. Scheduling is more flexible, there is a reduced procedure backlog, less wait time, quicker turnover of cases, personalized care, potential ownership for physicians and approximately 50% cost-savings potenti for procedures compared to the hospital outpatient department. Physicians and staff can perform their work more efficiently, and patients benefit from better patient physician personalized care. Jennifer Robinson, RN. Director of the Center for Special Surgery (Norfolk, Va.): Competitive choice makes me hopeful for the future of ASCs. With the additional approved procedures being added to ASCs, patients now have better opportunities to decide where they want to go for their elective procedures. Typically, ASCs are preferred to hospital-based settings due to a multitude of factors including their size and ease of use. Patients and their families don't want to navigate difficult, large healthcare centers and love an in-and- out setting. I believe the way ASCs are set up, this gives them a significant advantage, coupled with high quality, makes them a recipe for success as we navigate forward. Mitchell Schwarzbach. Healthcare Consultant and Former ASC Director (Bellevue, Colo.): Larger ASCs (more than four operating rooms), due to higher volume of the same types of cases (e.g., total knees), specializing in ongoing standardization of best practices using evidence based care for surgeries. When staff and providers do the same thing over and over again, not only do they get really good at it, but it maximizes great patient outcomes. n 'If you're not good, you sink': Do independent physicians have an edge? By Francesca Mathewes T he number of employed physicians is skyrocketing, and many leaders are concerned about how this workforce evolution will affect care quality. Quentin Durward, MD, a neurosurgeon at the Center for Neurosciences, Orthopaedics, & Spine in Dakota Dunes, S.D., joined Becker's to discuss why he believes private practice physicians are better incentivized to provide quality care. Editor's note: This response was edited lightly for clarity and length. Question: Amid the decline of private practice and the trend toward employed physician models, how is care quality impacted? Dr. Quentin Durward: I have some personal experience with this because the first three and a half years after my residency, I was an employed neurosurgeon at Dartmouth. I was working in the academic model, which is still employment. One of the problems with an employed model — and I can say firsthand because I've seen it and lived in it — is that there are a number of physicians who are highly motivated people and will work hard no matter what, but there are also a number of physicians who will take advantage of an employed model and try and get by with doing sort of a minimal amount of work to get their paycheck. And although many employed models try to offer some incentive- based payment, based on how much the production, etc., rarely is it enough to innovate. There are people who work harder. I personally think that physicians who are employed often do not deliver as much time and effort in patient care as those that are in private practice. In private practice, you have to produce in order to cover your overhead, which is becoming exponentially higher and higher these days. You have to work hard if you're going to have enough income to support the lifestyle you want. Q: Do you think that this will affect patient care in the years to come? QD: You don't survive in private practice without very, very good patient outcomes. You're dependent on your reputation in the community, and you're dependent on doctors referring to you because they know they can trust you, and they've seen your work in their own patients. It's very different when there's an employment model, whether it's a university-based system, a large group practice or hospital-based system, the system is the one that has the reputation. Physicians can coast in a situation like that. They can basically be much less apparent to the doctors referring to the system, or they are guaranteed referrals by doctors who are employed by the system. In my opinion, you need to be as nearly on your toes and maintain the very, very best standard you can if you're in a private practice model vs. an employment model, because if you're not good in a private practice model, you sink. n

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