Future Growth of ASCs – The Paradigm Shift in Physician Recruitment
The last and final installment of our series on the Future Growth of ASCs deals with the shift in the paradigm of physician recruitment tactics and models.
The different avenues that are available to those seeking to recruit physicians have been changing, with some becoming more favorable and successful than others. Taking on a “physician recruitment mindset,” so to speak, is proving a necessary step on the road to success.
Physician Recruitment, Then and Now
“Physician recruitment is the process by which we recruit physicians who will do procedures in our surgery centers,” explains Blayne Rush, President of Ambulatory Alliances, LLC. “When we refer to physician recruitment, we are not recruiting physicians to invest in the surgery center — at least not until we have established a substantial relationship with them. We want them to use the surgery center for their cases.”
There are different roads by which physician recruitment has been done over the years. These can be broken down into three main channels, according to the CEO at University General Hospital in Houston, TX, Rob Turner.
“Channel number one is a straight employment agreement when a physician comes out of medical school looking for a job or got tired of running a practice, or for whatever reason, and shows up one day and seeks out a position,” he explains. “It’s a standard employment contract. Route two would involve a headhunter or outside agency that would seek out physicians and then bring them to the hospital or center. The third caveat happens when a physician practice is acquired.”
Turner noted that this third channel is less popular at the present time and is not as widely used as it was in the past.
“We were all in a frenzy buying physician practices about a year ago, and now it’s coming down to more of recruiting the physician and building the practice, as opposed to going out and buying the practice,” Turner said. “That’s not to say it doesn’t happen, but it’s definitely less of the model than it was two or three years ago.”
The physician recruitment process as a whole up until now has more or less been viewed one way, according to Rush. However, those who wish to be successful should consider a new perspective.
“ASCs sometimes look at physician recruitment as a one-time ‘event,’ carried out at some stage in the development which can later be forgotten about during the center’s day-to-day operation,” Rush said. “The most successful surgery centers understand and make recruitment an ongoing process. For some centers, this will be a paradigm shift and one that they will need to make. The market is changing, and those centers that do not adapt will not survive.”
New Strategies, New Success
The first channel of physician recruitment, as described by Turner, involves a number of physicians either coming out of medical school or stepping away from a practice for some reason or other. But what happens when that pool begins to shrink?
New strategies must be adopted by owners to proactively seek out physicians. Strategic alliances between ASC and the referring primary care physicians must be developed. Furthermore, a great amount of time must be dedicated to a consistent recruiting effort.
“A large part of your administrator’s job needs to be ongoing physician recruitment,” explains Rush. “I would say at least 20 percent of their time needs to be in the field meeting and recruiting new physicians; this is in addition to the physician partners recruiting as well. There should not be anything going on as far as which physician is doing his/her cases where in the market that the administrator does not know about. But that takes commitment and a lot of work.”
One area that is worth exploring is that of data analysis, according to Turner. He has devoted time and resources to figuring out ways of mapping such data that most ASC operators go without through a software called “Patch”.
“Most doctors, for whatever reason, have no idea where their business comes from and goes to,” Turner said. “I’d argue that most ASCs, short of seeing the case flow, don’t really know where the patient came from. Being able to look up the stream of the doctor and seeing who is referring is what I’m working with a group on right now on the big data analytics side. We can literally map out where business comes from for an ASC. We can see everything that goes to, from, in, and around an ASC.”
The methods by which this should be gone about involve a new paradigm for physician recruitment. Information is readily available now that hasn’t been so in the past. This information has to do with where referrals are coming from, what physicians are receiving them, what the case load volume is for a physician and what types of procedures are being done by that physician.
The value of this information lies in the ability of a recruiter to build relationships with the physicians with the right case load and surgical discipline. However, what happens if that physician is already married to a practice and in unavailable for recruitment?
According to Rush, the knowledge of where that physician’s referrals come from can bring about success regardless of whether or not that doctor can be recruited.
Discovering which primary care physicians are feeding referrals presents an opportunity for an ASC to develop a strategic alliance with that primary care doctor. Understanding why this doctor refers to specific surgeons or specialists opens the door for an ASC owner to have some of those referrals directed toward his or her own center.
According to Turner, this whole process can be broken down with the aid of Patch. The information can come with other advantages as well.
“We start by identification, then we group by specialty, then we group by volume, then we group by type of procedure, and then the next level of analysis to that is to discern the physician’s primary care feed,” he explains. “A user of the software can integrate a physician that I am trying to recruit to be a part of my ASC either in an employment model, a physician practice alignment model, if I’m trying to grow a group of specialty surgeons, and/or I can dissect the referral stream into that physician practice to help them increase their business.”
This work should include active research efforts on certain reports and statistics that apply to physician activity within your area.
“Gather current case load statistics, such as utilization reports, volume projections and actual cases and current schedules,” Rush advises. “Get familiar with other metrics, like turnover time, that you think make you stand out in a positive way. Collect the equipment list that will allow you to know what cases you can support now.”
Perhaps the most important point is that this data can help owners interpret the referral base for specific procedures and case types. It can allow for understanding who and what other centers and/or doctors are “feeding” a surgeon cases.
Other information that is accessible to recruiting owners comes in the form of physician profiles. In reference to the second channel of recruiting, that of a third party headhunter or agency seeking out doctors, information on and interaction with potential candidates is crucial. These efforts all tie into what should be the goal of ASC owners: developing strategic relationships with physicians, both referring and otherwise.
Suffice it to say that when it comes to physician recruitment changes have occurred and will continue to do so. It’s important to place consistent emphasis on this area of growing your practice.
“If you are not at 100 percent utilization and your goal is to grow the center, you should always be recruiting,” Rush said. “Each dollar of revenue — once you are at breakeven point — can add up to between $.65 and $.80 of profit to the bottom line. Successful recruitment campaigns are as, if not more important to the success of your ASC than strong payor contracts and business best practices.”
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