By Stephen W. Earnhart, MS, CEO
Earnhart & Associates
A couple of months ago, I asked Same-Day Surgery readers to send me a list of their “pet peeves” after I listed mine. I received almost 100 emails from readers listing what irritates them the most. (Several of them listed me!)
I got quite a kick out of them, so I thought I would share those that can be printed.
• From a nurse in Washington State at a not-for-profit hospital. “I am just sick and tired of hearing some of our surgeons talk about how much money they are making in ‘their’ surgery center. It seems like they bring the most difficult, and probably the less profitable — but I can’t prove that — cases to the hospital. I wish someone would let the surgeons know how demoralizing this can be to the staff at the hospital.”
Response: We just did.
• From a scrub tech from a hospital in Los Angeles. “I moonlight at the local hospital from my position in a day surgery center that has all physician owners, and some of these surgeons do cases at the hospital where I work. I am just amazed at the difference in the supplies they use at the hospital! Lots of mesh for hernia cases, almost all endoscopic, and at a much higher cost over the incisional cases they do at the ASC. Robotic surgery for GYN procedures at the hospital, but not at their surgery center. Lots more expensive sutures used at the hospital versus ASC. It just makes me angry, because most of their patients are Medicare or Medicaid, and as a taxpayer, I am paying for this!”
Response: Me too! You didn’t give me any detail on this, but often a patient is too ill to be done in an ASC, and it might be better that they do them in the hospital. Not giving excuses, but that situation is common.
• From a surgeon who “no longer does cases at the local hospital.” “I find it irritating that no one at the hospital I used to do procedures in takes the time for focus on cost control like they do in the surgery center where I do almost all of my cases. If hospitals spent as much time trying to control their costs instead of bad mouthing the surgeons at the ASC I work in now, there probably wouldn’t be as many surgery centers out there!”
Response: Good point. At our surgery centers, we put the price of each item on the surgeon preference cards. They are usually shocked at the costs of items and help us find alternatives.
• From a receptionist at a surgery center in Connecticut. “I worked at the [local hospital] for years before I came over here. This is not really a pet peeve, more like an observation, but it just seems like the patients are friendlier at the ASC than the hospital. Anyway, just thought I would pass that on.”
• From a VP at local hospital. No location given. “Our area is full of surgery centers that are being bailed out (bought out) by the local hospitals. It seems like when the surgeons’ pockets are full, and the effort is too much for them, they look to us to buy them out of their misery. Sadly, we do, and it shouldn’t be right.”
Response: Happens more than you might believe!
• From a surgeon in California. “We have been doing total joints (hips and knees) at our surgery center for years with great results and at a huge savings. Medicare, which make up about 40% of our patients, will not allow them to be performed in our ASC and must be in a hospital, even though it is so much more expensive. I wish the federal government would start listening to surgeons and realize this is a safe procedure that can be done at a much lower cost than in a hospital!”
Response: I think we are going to see total joints added to the Medicare list of procedures approved for an ASC shortly.
• From a staff member. No affiliation listed. “This place makes a lot of money. Be nice if they could at least buy us lunch once in a while!”
• From a staff member at a surgery center in Kansas. “No more cake for staff birthdays anymore. Cheap @#%&!”
Response: I want one too!
• From a surgeon at an Arizona hospital. “Room turnaround time average this month: 68 minutes! Don’t they understand that I don’t get paid for sitting around like they do?”
Response: Well, that’s one of the reasons there are so many ASCs.
• From a biller at a hospital in Texas. “I don’t know if this is what you were looking for, but I hate my stupid computer here at work! Thing crashes all the time, and when I retire next month, I am going to find a way to kill it!”
Response: Get a Mac!
Thanks to all of the Samw-Day Surgery readers who sent in their comments. I’m sorry I could not list them all. [Earnhart & Associates is a consulting firm specializing in outpatient surgery development and management. Contact Earnhart & Associates’ at 5114 Balcones Woods Drive, Suite 307-203, Austin, TX 78759. Telephone: (512) 297.7575. Email: email@example.com. Web: www.earnhart.com.]