6 Steps for Orthopedic Surgeons to Maintain Positive Relationships With Hospitals

Written by Laura Dyrda | May 02, 2011 | Print  |
Once orthopedic surgeons enter into an agreement, alignment or partnership with a hospital, there are a few things they can do to maintain a healthy relationship with the hospital. Surgeons and industry experts discuss six ways surgeons can ensure a good partnership lasts.

1. Approach meetings as partners. "Don't approach the hospital as the enemy from which you need to get as much money as possible, but as a partner," says Rick Wilfong of Rick Wilfong Consulting.

Orthopedic surgeons and hospital executives must have a secure space and trusting relationship so they can talk candidly about what works and what doesn't. "This relationship is important and people have to have a venue where they can trust each other and be frank with each other," says George Rappard, MD, founder and director of the Los Angeles Brain and Spine Institute at Hollywood Presbyterian Medical Center in Los Angeles.

During these meetings, it's important to look at solutions for increasing efficiencies and lowering expenses. You can help the hospital by considering the use of a cheaper devices or implants, working with the hospital to renegotiate current contracts for a better price and being conscious of your payor mix.

2. Address process issues with executives. There can be several issues with the efficiency and efficacy of the different hospital processes, but the executives won't always know there is a problem unless surgeons raise the issue. After developing a good relationship, orthopedic surgeons can maintain that relationship by helping hospitals address nursing issues, scheduling problems and anesthesia needs. Also consider whether there is an effective process in place for efficient transfers, and if not, work with the hospital to create one, says Dr. Rappard.

3. Look for ways you can help the hospital improve. Hospitals are always looking for ways to improve quality, clinical outcomes and budgets. Orthopedic surgeons can become attractive partners to hospitals by intelligently discussing how they can help lower costs and meet guidelines for outstanding clinical care. "What we are seeing a lot of now is service line co-management agreements, which essentially means the hospital and physicians are aligned with the same goals," says Mr. Wilfong. "These agreements incentivize the surgeons to do surgery at the hospital and look for ways to improve clinical outcomes. They also share cost information so they can speak to payors about the total cost of individual procedures."

4. Inquire about how you are doing. Ask the hospital staff members and executives on regular bases how well you are serving the collaboration. Figure out whether there are things you can do to be a better partner with the hospital, which often requires knowing the numbers associated with your cases. Keep track of your case volume and payor mix, and understand how profitable each case is. "You should know the impact of each case on the hospital as well as your own practice," says Mr. Wilfong. "The impact isn't always good for the hospital. Just asking executives about whether you are being a good partner changes the whole dynamic between you."

5. Help executives understand your schedule. Orthopedic surgeons need to maintain an efficient operating room schedule to keep their productivity high, and hospital executives don't always understand how the surgeon's schedule should work. "You can't schedule a meeting at 10 a.m. and another at 2 p.m.," says Andrew Halley, network executive of Halley Consulting Group. "When surgeons get drawn out of the office or the operating room to go to meetings or do non-patient care activities, their production goes down." Private physicians need to maintain patient volume to secure payroll and other expenses at their practice. The hospital also loses money if employed physicians don't see maximum patient volume. If you want to participate in more leadership and administrative roles at the hospital while still being profitable, help the executives understand the benefits of scheduling meetings around cases.

6. Maintain a good relationship with hospital staff. You should make sure you have a good reputation at the hospital, which means fostering a good relationship with the nursing staff, anesthesiologists and other OR professionals. "Developing a good relationship with all these people means there will be a positive messages getting back to the administration," says Randy Shulkin, MBA, FACMPE, principal consultant with Culbert Healthcare Solutions. "The administrators will hear not only are you a good physician technically, but also from a personality perspective, you are a good person to work with. Then you will be at the forefront of their radar."

Read Articles Related to Orthopedic Surgeon-Hospital Relationships:
9 Points for Orthopedic and Spine Surgeons on Forming Positive Relationships With Hospitals

5 Benefits and Challenges of Co-Management Agreements for Orthopedic Surgeons
6 Different Methods for Orthopedic Surgeon-Hospital Alignment

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