Orthopedic surgeons and industry experts discuss four ways orthopedic surgeons can meet and overcome the clinical and administrative challenges they face in their practices.
Challenge #1: Training in the business world.
Solution: When physicians go through medical school, residencies and fellowship training, they focus on the clinical aspects of practicing medicine and aren't exposed to the business side of running a practice. This lack of knowledge and experience in business finances can put physicians at a disadvantage when they step into leadership roles. "Finances, human resources and marketing are all facets that are critical to a healthy business and practice," says Rich Battista, MD, president and physician with OAA Orthopaedic Specialists in Allentown, Pa. "It's challenging to try to lead people in the direction that the practice needs to go." Physicians who have the time and resources to expand their business training or earn an advanced degree in business have an advantage, says Dr. Battista. However, if earning further degrees isn't possible, physician leaders should seek out articles in business publications to learn more about finances and best business practices.
Challenge #2: Providing balanced patient education in light of the increased use of direct-to-consumer marketing in orthopedics.
Solution: With the increased use of direct-to-consumer marketing by orthopedic manufacturers, the dialogue between the orthopedic surgeon and the patient has dramatically changed, says Alejandro Gonzalez Della Valle, MD, is an orthopedic surgeon specializing in hip and knee surgery at the Hospital for Special Surgery in New York. Oftentimes, patients considering total joint replacement surgery come to their medical consultation after researching the subject on the internet, and therefore, may have misconstrued ideas on the most relevant aspects of the procedure. In extreme cases, patients may come looking for a surgeon that will implant the prosthesis that they feel will most likely fit their needs, based on information provided by commercially related websites. During their office visit, the orthopedic surgeon must not only gain the trust of the patient, but also redirect his or her attention to what is most relevant and possible in light of the patient's circumstances. This dialogue can be distractive and confusing to the patient; however, it is one that must be faced in order to enable the patient to make an educated decision for his or her care.
Issue #3: Performing procedures efficiently.
Solution: If a surgeon does not specialize in a few different procedures, he or she often takes longer to perform the surgeries, which will lose the practice money. "One of the biggest reasons physicians lose money is that they are doing surgery inefficiently," Craig Levitz, MD, an orthopedic surgeon and partner at Orlin & Cohen, says. Beyond a lack of specialization, a big contributor to the lack of efficiency is time spent in the hospital to perform surgery on one patient. Since it takes time to prepare the patient and OR for surgery and the surgeon must stay at the hospital until the patient wakes from surgery, it isn't efficient to only perform one surgery at a time. The surgery usually takes 2-3 hours, but the surgeon must be at the hospital for 8-10 hours. "The surgeon is working eight hours and being paid for three," says Dr. Levitz.
When orthopedic surgeons see a patient who isn't within their ultra-specialization, they should refer the patient to a different specialist. "Sometimes it's much more efficient to refer that case to a specialist in your group or another group even if you can perform the procedure from a quality standpoint," says Dr. Levitz. Orthopedic surgeons should also make sure they have multiple ORs available to them so that when one surgery is completed, they can efficiently move to the next room for surgery. "With today's reimbursement levels, physicians can't just sit around and wait," says Dr. Levitz. "If you're very busy, efficient and have lots of cases, tell the hospital what you need or you will take the business somewhere else. The hospitals are hungry for the cases and they will negotiate with you." Hospitals aren't used to negotiating with surgeons; however, if the surgeon is from a larger orthopedic practice there is more negotiating power. "Doctors need to be in larger groups so they have power with the surgery centers and hospitals to demand multiple hospital suits," he says.
Issue #4: Marketing physician practices and services.
Solution: One of the simplest ways to make a surgeon or surgery center stand out is to dedicate marketing services toward building the facility's name. Something as simple as using a recognizable logo can help the facility reach a better and more competitive position in the market. "We have a national approach to having a consistent look [across our multiple facilities in the country], so when somebody who is deeply involved in the spine industry sees our logo, they recognize without seeing the facility's name that we are Laser Spine Institute," says Dotty Bollinger, chief of medical operations at Laser Spine Institute in Tampa, Fla.
Orthopedic practices can also use the internet to expand marketing efforts. A practice website should include surgeon profiles stating their credentials and professional affiliations so the patients know their surgeon's qualifications. If the surgeon has a professional website or Facebook page, the website should link to those locations as well. "We want to link up the site with the doctor's sites and other key sites so patients can find them easily," says Bill Rabourn, founder and managing principal of Medical Consulting Group. The number of surgeons with personal websites or connected to Facebook has been growing in recent years and patients often seek out these pages to become comfortable with their surgeon before the procedure. "Facebook pages are something that's relatively new, but we really encourage the physicians to use it," Mr. Rabourn says. "They don't have to be the ones who manage their Facebook page, but it's an important business tool."
Challenge #1: Training in the business world.
Solution: When physicians go through medical school, residencies and fellowship training, they focus on the clinical aspects of practicing medicine and aren't exposed to the business side of running a practice. This lack of knowledge and experience in business finances can put physicians at a disadvantage when they step into leadership roles. "Finances, human resources and marketing are all facets that are critical to a healthy business and practice," says Rich Battista, MD, president and physician with OAA Orthopaedic Specialists in Allentown, Pa. "It's challenging to try to lead people in the direction that the practice needs to go." Physicians who have the time and resources to expand their business training or earn an advanced degree in business have an advantage, says Dr. Battista. However, if earning further degrees isn't possible, physician leaders should seek out articles in business publications to learn more about finances and best business practices.
Challenge #2: Providing balanced patient education in light of the increased use of direct-to-consumer marketing in orthopedics.
Solution: With the increased use of direct-to-consumer marketing by orthopedic manufacturers, the dialogue between the orthopedic surgeon and the patient has dramatically changed, says Alejandro Gonzalez Della Valle, MD, is an orthopedic surgeon specializing in hip and knee surgery at the Hospital for Special Surgery in New York. Oftentimes, patients considering total joint replacement surgery come to their medical consultation after researching the subject on the internet, and therefore, may have misconstrued ideas on the most relevant aspects of the procedure. In extreme cases, patients may come looking for a surgeon that will implant the prosthesis that they feel will most likely fit their needs, based on information provided by commercially related websites. During their office visit, the orthopedic surgeon must not only gain the trust of the patient, but also redirect his or her attention to what is most relevant and possible in light of the patient's circumstances. This dialogue can be distractive and confusing to the patient; however, it is one that must be faced in order to enable the patient to make an educated decision for his or her care.
Issue #3: Performing procedures efficiently.
Solution: If a surgeon does not specialize in a few different procedures, he or she often takes longer to perform the surgeries, which will lose the practice money. "One of the biggest reasons physicians lose money is that they are doing surgery inefficiently," Craig Levitz, MD, an orthopedic surgeon and partner at Orlin & Cohen, says. Beyond a lack of specialization, a big contributor to the lack of efficiency is time spent in the hospital to perform surgery on one patient. Since it takes time to prepare the patient and OR for surgery and the surgeon must stay at the hospital until the patient wakes from surgery, it isn't efficient to only perform one surgery at a time. The surgery usually takes 2-3 hours, but the surgeon must be at the hospital for 8-10 hours. "The surgeon is working eight hours and being paid for three," says Dr. Levitz.
When orthopedic surgeons see a patient who isn't within their ultra-specialization, they should refer the patient to a different specialist. "Sometimes it's much more efficient to refer that case to a specialist in your group or another group even if you can perform the procedure from a quality standpoint," says Dr. Levitz. Orthopedic surgeons should also make sure they have multiple ORs available to them so that when one surgery is completed, they can efficiently move to the next room for surgery. "With today's reimbursement levels, physicians can't just sit around and wait," says Dr. Levitz. "If you're very busy, efficient and have lots of cases, tell the hospital what you need or you will take the business somewhere else. The hospitals are hungry for the cases and they will negotiate with you." Hospitals aren't used to negotiating with surgeons; however, if the surgeon is from a larger orthopedic practice there is more negotiating power. "Doctors need to be in larger groups so they have power with the surgery centers and hospitals to demand multiple hospital suits," he says.
Issue #4: Marketing physician practices and services.
Solution: One of the simplest ways to make a surgeon or surgery center stand out is to dedicate marketing services toward building the facility's name. Something as simple as using a recognizable logo can help the facility reach a better and more competitive position in the market. "We have a national approach to having a consistent look [across our multiple facilities in the country], so when somebody who is deeply involved in the spine industry sees our logo, they recognize without seeing the facility's name that we are Laser Spine Institute," says Dotty Bollinger, chief of medical operations at Laser Spine Institute in Tampa, Fla.
Orthopedic practices can also use the internet to expand marketing efforts. A practice website should include surgeon profiles stating their credentials and professional affiliations so the patients know their surgeon's qualifications. If the surgeon has a professional website or Facebook page, the website should link to those locations as well. "We want to link up the site with the doctor's sites and other key sites so patients can find them easily," says Bill Rabourn, founder and managing principal of Medical Consulting Group. The number of surgeons with personal websites or connected to Facebook has been growing in recent years and patients often seek out these pages to become comfortable with their surgeon before the procedure. "Facebook pages are something that's relatively new, but we really encourage the physicians to use it," Mr. Rabourn says. "They don't have to be the ones who manage their Facebook page, but it's an important business tool."