Same-Day Surgery Manager

Get yourself up to date on fun facts and figures

By Stephen W. Earnhart, MS
CEO
Earnhart & Associates
Austin, TX

The kids are back in school (Thank GOD!), the heat is starting to break, the floods are receding, and the fires are burning out.

It was an interesting summer. I spoke at several conferences, and I have to say that the Gulf States ASC Conference & Tradeshow in Biloxi, MS, was one of the best conferences I have had the pleasure of speaking at. The Ambulatory Surgery Center Association conference in Orlando was great too.

These conferences left me with a question: How many of your centers and hospitals are paying someone or some company a management fee? How much? Are you getting ripped off? Well, according to the results of a survey by HealthCare Appraisers in Delray Beach, FL, 56% of centers are paying between 3% and 6% of the net revenue of the center for the pleasure of telling you what to do. For hospitals, the average is about $25,000 per month, not including personnel. Are you in that range? Are you angry? (For information on how to access that report, see note at end of the column.)

A. Here are some questions for you from that survey. See how many you get right.

  1. What, referring to the same survey, is the least desirable specialty in surgery centers (and I am adding hospital outpatient departments as well)?
  2. What is the most desirable specialty?
  3. What percent of surgery center companies were looking to purchase surgery centers last year?

B. Here are some of my questions based upon responses from the conferences I spoke at over the summer (not quite as sophisticated):

  1. What I hate most about working in surgery is ________?
  2. What I like most is _______?
  3. If I could change one thing it would be _________?
  4. The most exciting people in healthcare are _________?
  5. The most entertaining surgeons are ___________?

OK, that was fun. However, on a serious note, most of us are concerned about the future of our industry. But the reality is that we need to focus on what we can do at our own workplace and not worry about the global issues. I will recommend that all of you Google the following words and understand their meaning. These words are going to impact your lives over the next 10 years to a much greater degree than ever. You need to understand them.

         * cash flow;
         * Return on Investment (ROI);
         * Stark law;
         * Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA);
         * breakeven;
         * distributions;
         * economic credentialing;
         * passive investor;
         * one-third one-third regulation;
         * under arrangement.

Most of you know this stuff, but it still is a good exercise.

C. Last question for the ambulatory surgery center group: "Who is the most important person in your facility?"

  1. Surgeon?
  2. Investor surgeon?
  3. Anesthesia (Sorry. Even I had to laugh at that!)
  4. Vendor
  5. Staff

D. Last question for hospital staff: "How many meetings do you attend per week?"

  1. 1-3
  2. 4-7
  3. 8-11
  4. 12-18
  5. More than 20

Answers for questions from group A:

  1. Plastic surgery
  2. Orthopedics
  3. 82%

Answers for questions from group B:

  1. The early start time
  2. The job security
  3. A better retirement plan
  4. Nurses
  5. Orthopedic surgeons

Answer for questions from group C:

  1. The investor surgeon because they bring the patients to the center while being concerned about the running of the center.

Answers for questions from group D:

  1. 12-18 per week. (Oh, come on people!) [To access a copy of the HealthCare Appraisers report, go to http://www.healthcareappraisers.com/ASC_Survey_2010.pdf. Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Contact Earnhart at 13492 Research Blvd., Suite 120-258, Austin, TX 78750-2254. E-mail: searnhart@earnhart.com. Web: www.earnhart.com. Twitter: @SurgeryInc.