6 Big Questions to Ask Before Pushing Forward With a Comprehensive Orthopedic or Spine Center

Practice Management

Kim Pensenstadler, director of business development at Chapman Medical Center in Orange, Calif., spearheaded efforts to open the Chapman Neurosurgical Spine Institute. She discusses six questions to consider before pushing forward with forming a comprehensive orthopedic or spine center.

1. What is the community need within your market?
"Look at the demographics in your area to determine whether there is a community need or a shortage of specialists in that particular specialty," says Ms. Pensenstadler. "In the case of a comprehensive orthopedic facility, you need to consider if there are enough orthopedic surgeons available to support the needs of the community? If there are a lot of families with young children in the community, the bulk of your patients will most likely arrive at the center with sports- or activity-related injuries. Your next question: Is there access to a board-certified sports medicine specialist and orthopedic surgeon? If the community has a large retired population, patients will be more likely to seek joint replacements or back pain therapies. Do they have access to a board certified orthopedic joint replacement specialist?  In the initial planning stages for developing a center, identifying local specialists with these skill sets will be a great resource pool to consider as potential partners."

2. Do you need to bring new physicians to the community?
"There are a lot of regulatory guidelines that you must understand and follow when recruiting physicians," she says. "Be certain to have a fair market community needs assessment of the number of orthopedic specialists in the area, so that you can meet any regulatory guidelines when considering recruiting a physician." If there are highly sub-specialized orthopedic surgeons already practicing in the community, consider seeking a potential partnership with them. If and when there is a lack of specialists in a targeted area, consider recruiting new surgeons into the community making certain they have extensive experience in the field.

When building a comprehensive orthopedic center, it's important for all affiliated surgeons to have the appropriate board certification and fellowship training in order to effectively deliver a high-quality, full service program that specializes in hand, foot and ankle, shoulder, knee, hip, and spine procedures. "Patients will want to know how well-trained and experienced the surgeons are and what their outcomes are before deciding to have them performing their surgery," says Ms. Pensenstadler.

3. What other types of specialists do you need to include?
Solid comprehensive orthopedic programs will include support services such as physical therapy, pain management, radiologists, vascular surgeons, anesthesiologists, pulmonologists, internal medicine, physician assistants, chiropractic care, and other specialists who provide support services for orthopedic patients.

"One goal of comprehensive orthopedic centers is to have access to all the different services and treatments a patient may need, whether it is surgical or conservative intervention," says Ms. Pensenstadler. "Following surgery, you want to ensure that patients have access to quality internists and physical therapists so they may have excellent rehabilitation experiences and obtain the best possible functional outcome."

4. Are we able to acquire the right staff and equipment for all services? Having the appropriate surgical equipment and staff for orthopedic, spine and pain management procedures is a necessary component at comprehensive centers. Be certain to take inventory of the necessary equipment and staff needed for the orthopedic program. This might include a 360 degrees rotating Jackson table for spine procedures or robotic technology for joint surgeries.

"You also have to consider whether your surgical technicians and nursing staff are up to speed on the latest advances in the field," says Ms. Pensenstadler. "Coordinated care is critical in today's healthcare and it is imperative to ensure that there is strong communication between the staff members and surgeons. The nurses should also be trained on knowing what conditions to look for postoperatively and when to notify a surgeon when problems arise."

5. Do you have physician buy-in? Having support for the common goals of the group from all physicians is paramount to the success of a comprehensive center. "It is important to evaluate the physicians' concerns and understand their perspective when working with them," says Ms. Pensenstadler. "It will make the group far more cohesive if everyone agrees to the same goals of providing the highest quality care possible."

When forming her center, she worked closely with the spine surgeons and neurosurgeons to discuss the community needs and outlined specific actions they would take to meet their goals. The administrators worked with surgeons to train the support staff and acquire the necessary equipment to meet the goals of the program, a process that continues today.

6. How will you ensure the quality of your outcomes? Building a great comprehensive orthopedic program is one thing, but ensuring a high level of care is another. Constantly evaluate surgical outcomes and patient satisfaction to ensure patients are satisfied with their healthcare experience. Word-of-mouth is one of the most common ways patients will be referred to orthopedic providers, which means the patients' experience is incredibly important. Patient evaluations can come from patient satisfaction surveys or internal questioning about the potential for improvement in specific areas of care.

Learn more about Chapman Neurosurgical Spine Institute.



Related Articles on Large Orthopedic Groups:

6 Best Practices for Effectively Managing Large Orthopedic Practices

5 Factors for Long-Term Stability and Growth of Orthopedic Practices

Palos SurgiCenter: 7 Points on Significantly Increasing Orthopedic Case Volume



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