As the economic atmosphere rapidly changes in healthcare, a major challenge facing leaders is how to preserve an academic mission while maintaining financial stability. Becker’s previously reported that leaders at other top-ranked neurosurgery programs are watching reimbursement and affordability pressures squeeze even the most prestigious academic centers.
To navigate this tension, John Golfinos, MD, chair of New York City-based NYU Langone Health’s neurosurgery department — the nation’s No. 1 neurosurgery program according to U.S. News & World Report — has spent time building a relationship with the hospital’s administration. He said his positive relationship with administrators is one factor in his department’s success.
“You’ve got to have the administration’s support,” Dr. Golfinos said.
He said relationship building allows administrators to better understand why long-term financial success is not possible without creating a robust avenue for academic research, innovation and subspecialties.
“Being good means you also support the research and the team because all that comes together at the end,” he said, referring to the connection between hiring specialists, supporting research and achieving quality outcomes.
That case is not always easy to make, Dr. Golfinos said. Convincing a group focused on a health system’s financial welfare to value investments with no direct fiscal return requires proper framing.
“So how do you get them to support that?” Dr. Golfinos said. “How do you convey that to the administration? You’ve got to show them the big picture.”
Part of that picture, he said, is refusing to let lower-volume specialties be treated as expendable simply because they do not generate the same revenue as higher-volume care.
“We need people who love doing pediatric neurosurgery to do pediatric neurosurgery, and we can’t treat them as second-class citizens,” Dr. Golfinos said. “We need people who love research to be able to research.”
The same logic applies to how the department is measured overall. Dr. Golfinos said administrators should accept that raw case volume is a poor stand-in for performance and that chasing numbers without regard for outcomes ultimately costs more than it earns.
“It’s got to be quality in the face of quantity,” Dr. Golfinos said. “The administration has to understand that pure quantity doesn’t mean anything and leads to worse outcomes. And the problem with worse outcomes is they’re expensive.”
He said his team’s work shows that administrative support for academic investments improves the overall quality and financial health of a department.
“The proof of the pudding: In the end, they see how well we are doing, and it’s because it’s all tied together,” Dr. Golfinos said.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
