Same-Day Surgery Manager

What can you reform in your program?

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

Interesting things going on out there, aren't they? Town meeting riots, "death panels," trillion-dollar budgets, "evil businesses." As a clinician, a business owner, and a health care consumer (I broke my foot skydiving a few weeks ago), I've got to tell you: I am OK with the system as it is . . . almost.

I do think we need to change it around a bit. Tort reform is necessary to eliminate much of the unnecessary testing. It would be a start to make catastrophic coverage more affordable, to price coverage per pound and by cigarettes consumed per day, and to not mandate that businesses foot the bill. I think Americans simply are tired of paying for others' indulgences. The system is not broken as some believe, but it could stand some scrutiny. Consider these suggestions:

Revenue enhancement.

I speak a lot about revenue in my column because it is revenue, not expenses, that drive a successful business. I rely greatly upon growing a business by bringing in new surgeons and procedures. I rely upon others to deal with the appropriateness of the expenses of the venture.

Toward that end, there is a company named MediGain USA in Dallas ( that I consider to be one of the top full-service accounts receivable management companies with a unique service model. It has increased revenues an average of 24% and increased payment time by 30% for their clients. It runs its operations using metrics and analytics, as Fortune 500 companies do in other industries, that provide more visibility into your operations to manage it better. I like MediGain because it offers you a free analysis of where you are and where you could be. You can contact MediGain for more information at (877) 237-9539 or

You already have hustled to bring in the business to your department or surgery center. You now need to maximize those efforts.

Online patient registration.

Are you allowing your patients to preregister online? If no, why not? It is fast, simple, and a growing extension of your operation. It is also a great way to obtain patient satisfaction input. Make your web site as interactive as possible not only for your patients but for your staff. I promise you that members of your staff (or their kids) can do it for you.

Pictures in the waiting room.

Do something inexpensive to set yourself apart: Put a picture of your staff members in your waiting room. The cost is less than $3 per picture, and that includes the frame! We receive such positive feedback from patients at our centers about this simple consumer service feature. Pay the kid who is doing your web site to post them there as well.

If you have the money . . .

If you can afford it — and most of you can — put a flat screen in your waiting room that gives the progress of the patient's movement through the facility. It makes it easy for family members to track their loved ones. Each patient has an identifier that shows if he or she is in pre-op, the operating room, recovery, or step-down unit.

This saves your receptionist from calling back all the time asking if the patients still are in surgery and how they are doing. It also makes your facility look high-tech and gives the waiting room visitors something to do.

Validate parking.

Come on! Making surgical patients pay to park is like putting in a toll booth at the drive-thru window at McDonald's. And your patients aren't "lovin' it." Keep in mind that the Office of Inspector General says that freebies for Medicare beneficiaries should be limited to a $10 value, and no more than $50 annually. (Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management. Contact Earnhart at 1000 Westbank Drive, Suite 5B, Austin, TX 78750-2254. E-mail: Web: