This Week in Surgery Centers: Lindsay Schulte – Optimizing the Physician Experience: Aligning with Physician Preferences

Lindsay Schulte – Optimizing the Physician Experience: Aligning with Physician Preferences

Here’s what to expect on this week’s episode. 🎙️

Scheduling, block times, equipment, supplies, preference cards, operating room setup – your physicians have preferences. How can you make sure you’re completely aligned?

Lindsay Schulte is the Division Vice President of ASCs at EyeCare Partners, and considering EyeCare Partner has over 300 doctors across their 31 ASCs, Lindsay knows a thing or two about managing the physician experience. Here are some key tips she shared.

📅 Minimize downtime and maximize OR utilization by aligning clinic and surgery schedules, ensuring quick turnover, and offering multiple ORs for efficient surgeons.

💉 Maintain updated equipment and supply options within GPO contracts to meet preferences, avoid delays, and enhance satisfaction.

💰 Update and review preference cards annually (at minimum) to standardize and reduce costs per case and foster collaboration with physicians.

💻 Stay ahead with EMR systems, scheduling tools, and patient tracking technologies to improve both physician and patient experiences.

🤝 Involve physicians early in the planning process to optimize space, equipment decisions, and location, ensuring success from the start.

Episode Transcript

[00:00:00] Welcome to this week in Surgery Centers. If you are in the ASC industry, then you are in the right place every week. We’ll start the episode off by sharing an interesting conversation we had with our featured guest, and then we’ll close the episode by recapping the latest news impacting surgery centers.

We’re excited to share with you what we have, so let’s get started and see what the industry’s been up to.

Hi, everyone. Here’s what you can expect on today’s episode. Last week, we kicked off our Optimizing the Physician Experience series with Dr. Husto, who covered the importance of encouraging your docs to learn new procedures. Today, for part two of the series, we are joined by Lindsay Schultz, who is the Division Vice President of ASCs at iCarePartners.

ICarePartners has over 300 doctors across their 31 ASCs, so Lindsey knows a thing or two about managing the physician [00:01:00] experience. She shares with us today how ASCs can align with physician preferences, including scheduling, equipment, supplies, cards, and more. In our news recap, we’ll cover how data can play a role in securing anesthesia services.

The latest tech trends that are transforming outpatient care, unexpectedly high medical bills, and of course, end the news segment with a positive story about a nurse who adopted her patient’s cat and was able to reunite them 10 years later. Hope everyone enjoys the episode and here’s what’s going on this week in surgery centers.

Lindsay, welcome to the show.

Lindsay: Hi, thanks so much for having me.

Nick: Lindsay, as we jump in here, can you give our listeners a little bit of a quick overview on iCarePartners?

Lindsay: Yeah, absolutely. So to introduce myself, my name is Lindsay Schulte and I’m the division vice president for surgical services [00:02:00] for eye care partners.

Lindsay: I care partners is a clinically integrated brand with both service lines in optometry and ophthalmology. We have a total of 31 surgery centers, mainly servicing ophthalmology. However, we do have some multi specialty sites as well.

Nick: Fantastic. And so the topic at hand for today that we want to dig into is.

Nick: Optimizing the physician experience. And so I wanted to touch on the physician experience and get your perspective across a couple of different, components of the patient lifecycle and thought it’d be good to start with scheduling up front, right? As it relates to scheduling and getting cases on the ASC schedule.

Nick: As you think about that from a physician perspective, what comes to mind is important.

Lindsay: This is a really great question because timing at an ambulatory surgery center is an important factor for its success and physician satisfaction. So [00:03:00] first, we want to minimize downtime in order to capitalize on OR utilization.

Lindsay: And we also want to ensure we’re working efficiently and have quick turnover times to maximize case or block time potential and to create a steady flow. We work very closely with our physicians and our clinic counterparts. to ensure that we have the right mix of clinic versus surgery time and that there’s room for both in their schedules.

Lindsay: Also, we want to make sure that we’re starting on time to avoid delays throughout the day. And we find that when we have shorter case times and efficient surgeons, we do provide them with an additional OR in order for them to flip between rooms, which saves on downtime as well.

Nick: Fantastic. And you mentioned Hey, we want to minimize downtime, right?

Nick: And obviously physicians like their block time and like having a set standard block time that, that they’re aware of is consistent. [00:04:00] Do those goals of giving the physicians what they want from a block time perspective and minimizing downtime ever conflict with each other?

Lindsay: Depending on the surgical center and how many surgeons you have operating there, it always can be tricky to ensure that everyone has clinic time that is synced up with their OR time, but we are able to manage it with working with those clinic counterparts so that we can jigsaw how we see best.

Lindsay: Block time association with their clinic time.

Nick: Got it. Okay. And you mentioned that timing’s important. Wanted to touch on the equipment and supplies. Aspect of that timing, how does getting supplies right and corresponding with the schedule? How do you guys navigate that?

Lindsay: Yeah, that’s a good question because equipment and supplies can be a high level of physician preference or have a very high level of physician preference.

Lindsay: I [00:05:00] think it’s best to offer options. to your surgeons that are in line with your contracts or your GPOs to ensure the site is getting best pricing and you have allocation, so sourcing availability. From an equipment standpoint, administrators should always want to ensure that all PMs and regular service dates are up to date because that’s You want to have the equipment in working order prior to the case time starting to avoid delays.

Lindsay: Equipment downtime can have a very negative impact on both the patient and the physician satisfaction.

Nick: Got it. You talked about the GPOs and giving physicians options within the GPOs. Do you run into many situations where physicians are requesting or wanting things outside of those GPO?

Nick: Arrangements, or do you find that as long as physicians have options and know what their options are, that typically works well?

Lindsay: [00:06:00] We find they stick pretty close to what their preference or what their options are in terms of what the surgery center has available to offer. If they do change a preference, they’re pretty great about letting us know, and then we can source that product from a GPO standpoint many different vendors to find who’s got the best price point.

Lindsay: point. Another element to consider when we’re talking about supplies and something that we create a high level of transparency is cost per case. Meaning that each physician can see what supplies they use and also what supplies Other surgeons that are performing the same type of case use in order to not only drive down pricing, but create best practice and standardized products so that we’ve got that offering narrowed down.

Nick: And that’s fantastic. And cost per case is something that we hear that folks sometimes struggle with. And ASEs is getting that cost side of the case [00:07:00] consistent nailed down and by specialty and by position. How at iCarePartners have you guys been able to dial that in and do preference cards come into play there?

Lindsay: Preference cards do come into play. So in, in terms of preference cards, we want to make sure that they’re up to date. that we’re meeting the needs of our physicians. When we have new members on board and when we train them, we want them to be highly familiar with those preference cards so that we can continue to consistently meet our physician’s expectations.

Lindsay: We typically post those in a central location so that all team members have easy access to them. And we ask our physicians to review preference cards annually or as needed If they do want to make a change.

Nick: Okay. So that sounds like a good best practice is because we sometimes see. Centers get, get preference cards set up, but then they atrophy or get stale or they [00:08:00] change and they’re, they don’t necessarily maintain them.

Nick: And so it sounds like you’ve got a policy around at least once a year, having the positions update those.

Lindsay: Absolutely. I think that’s also a good time to have an open dialogue with the surgeon. to inform them if there’s new products or more efficient products that they could use. We have a lot of conversations on disposable versus reusable, and then you also want to take into consideration top cost drivers.

Lindsay: So in ophthalmology, we look at some of our larger cost items to ensure that we’re delivering to the surgeon what their preference is, but also introducing other like models.

Nick: So proactively looking at, Hey are there different costs ways to deliver the same service? And just making sure the physician has that information.

Lindsay: Absolutely. I think education and collaboration with that physician is key because there are so many new product offerings. And [00:09:00] it’s hard to keep up to date on what’s new.

Nick: Sure. Okay. And you mentioned that those preference cards help with cost per case and be able to compare that, to deliver that from a reporting perspective and show your physicians the differences in cost per case.

Nick: Have you? Have you seen that lead to any behavior changes or different decisions that are made within your surgery centers?

Lindsay: Absolutely. We break our cost per case down by CPT code and that helps with the variation. Understandably different products are used for different type of cases, but if you’re able to narrow down per CPT code, per physician, what current state is and compare that among other surgeons that have quality outcomes.

Lindsay: There’s an opportunity to present an example of how a case could become more efficient.

Nick: Yeah, that’s great. [00:10:00] Okay. Shifting gears a little bit from a technology perspective, Lindsay, are you seeing any newer technologies that your physicians are trying or asking about or interested in?

Lindsay: Absolutely. There are technologies not only within the EMR space, which some surgery centers have in some surgery centers are still on paper.

Lindsay: I think you see some variation there. However, there are additional scheduling tools, front end tools that are coming out also. Patient tracking tools, which can be very important to patient satisfaction, and therefore the physician and the patient both have a more positive experience.

Nick: Sure. Okay. What about new ASCs, right?

Nick: We have listeners and customers that build DeNovo. And are considering building DeNovo’s in the early phases of thinking through that. For ASC operators that have the benefit of [00:11:00] starting from scratch, are there physician experience things they should keep in mind from the beginning as they build out their centers?

Lindsay: Yes. If you’re going to build a new ASC, I would recommend bringing the physicians into the conversation early in the process. The physicians can be a great ally when making decisions. such as equipment or location and even space planning. We want to ensure that they can be successful as a key stakeholder.

Lindsay: It’s also important to consider ASC placement or location with the respect to the corresponding clinics. If an ASC is co located with a clinic, it can potentially reduce drive time. For our surgeons on days where they have both clinic and OR time. Also planning is extremely important to ensure you’re on time with all milestones, such as accreditation and credentialing.

Lindsay: When you’re thinking about building a new ASC.

Nick: Great [00:12:00] final question for you, Lindsay, and we do this each week with all of our guests. What’s one thing our listeners can do this week to improve their surgery centers?

Lindsay: Yep. Great question. With the ever changing landscape of the ambulatory space. You have to be really sharp on operational efficiencies.

Lindsay: So that would be my recommendation is to always be thinking about optimizing operational efficiencies. You’ll see that in labor when you can cross train or stagger staff. And then also, like we talked about earlier, leveraging technology can save both time and resources.

Nick: Fantastic. Thanks so much for joining us today.

Lindsay: Thanks again.

Erica: As always, it has been a busy week in healthcare, so let’s jump right in. If you are in the same boat as a lot of ASCs right now, securing reliable and affordable anesthesia services can be tricky. There have even been some really sad reports of ASCs [00:13:00] Having to close simply because they could not find an anesthesia provider.

Erica: But Karen Fink, the director of ASC clinical operations at Saxony Surgery Center and Riley Outpatient Surgery Center, both in Indiana, believes that the problem could potentially be fixed by leaning into data. In Fink’s experience, anesthesia providers are looking to understand the financial situation of an ASC to ensure they will profit before agreeing to partner with one.

Erica: So in that case, they will come looking for lots of financial data to review before signing a contract. Brian Brown, who has more than 20 years of ASC operations experience, shared a similar sentiment. He said, and I quote, anesthesia providers are in high demand, so they have greater control over where they work.

Erica: They are looking for facilities that can show they have the ability to meet the provider’s clinical and financial needs, with the financial component taking on greater importance in recent years. [00:14:00] Since expenses for anesthesia providers have risen while their reimbursement has tightened, they have come looking for stipends, which is typical in a hospital setting, but has not been typical in an ASC setting until recently.

Erica: ASCs will have leverage to negotiate that stipend if they can prove financial soundness through their data. So what data are they looking for? Fink and Brown suggested case volume, case mix, payer mix, net income per case, quality metrics, infection prevention, and insurance. Case start and stop times and operating and procedure room turnover times as well.

Erica: So the advice here is to take time to regularly review your ASC’s data with your anesthesia providers if you currently have any and make it a true partnership. And that’s it. You can’t perform procedures without them and they can’t make money without you. So by leaning in and analyzing the data together and being transparent, you’ll not only improve their loyalty, but you’ll also [00:15:00] likely come up with some great ideas along the way as to how you can both financially profit and keep outcomes high.

Erica: And I know. If you listen to the podcast often, I am always on my high horse about the importance of data. This is no different. The more you can prove the success of your surgery center with data, the more likely that these partners are gonna come calling. Alright, next up, again, I’m always going on about the importance of technology, and today will be no different.

Erica: Thanks to Outpatient Surgery Magazine, we are looking at five key tech advancements that are transforming how outpatient care is delivered right now. So first up are custom and smart implants. Thanks to 3D printing, implants can now be tailored to fit patients that have unique anatomical needs, which will ultimately improve outcomes significantly.

Erica: These custom implants, often used in joint replacements, can be a real game changer for patients who couldn’t find a fit with off the shelf [00:16:00] options. And with smart implants, which come equipped with sensors, doctors can track recovery data such as step count and movement as well. Next is AI, yet again. AI and gastroenterology is helping doctors spot polyps during colonoscopies that might otherwise be missed.

Erica: These AI tools highlight potential problem areas on the screen, boosting detection rates and improving outcomes. And my usual reminder when I talk about AI, this is a tool that enhances the physician’s skill and certainly does not replace it. But we have seen a ton of studies like this where AI is helping supplement some things that the human eye just would naturally miss.

Erica: Next up is superior visualization, particularly in the field of endoscopic spine surgery. The shift to 4K imaging systems is allowing these procedures to move into outpatient settings, thanks to the clear high [00:17:00] definition views that these cameras provide.

Erica: Fourth, handheld ultrasound devices are revolutionizing how nerve blocks are administered. These portable devices, costing between 2, 000 and 9, 000, make precise anesthesia more accessible, especially for facilities operating on tight margins, and we all have heard how these nerve blocks can be better than just general anesthesia.

Erica: They obviously help with recovery times, OR turnover times, and patient outcomes as well. And finally, patient communication apps are making the surgical experience smoother. So these apps handle everything from appointment reminders to post op instructions, reducing confusion and improving compliance.

Erica: And despite concerns about patients being resistant to tech, most patients are embracing these tools because they just make the whole process easier. Everyone’s comfortable texting. Everyone has a smartphone. And if you’re in the market for a two way texting solution, have a look [00:18:00] at HST patient engagement.

Erica: Our clients have had great success improving patient communication and reducing cancellation rates thanks to software like this. Now, I really liked this roundup because these innovations, to me, don’t feel like just these flashy new gadgets that are going to come and go. They’re really about improving care and making life easier for both patients and the providers and providers.

Erica: Your staff as well. And I’m sure you’re thinking that is cute advice, Erica, but these things cost money. And you are totally right. You will definitely want to evaluate these vendors. First, look at costs, expected ROI, talk with your peers who might be using similar tech or are already working with these vendors.

Erica: All of that will be super important before you make any investments. All right. In our third story, let’s talk about something that’s all too common in the unexpectedly high medical bills. It’s a huge problem with around one in five [00:19:00] Americans dealing with medical debt, totaling a staggering 88 billion with a B.

Erica: So the focus of this article is mainly sharing tips for individuals with incredibly high medical debt. So post procedure, post service, you’re hit with this bill, what do you do? They suggest options such as charity care, If it’s a hospital, you could try to appeal to their financial assistance department.

Erica: You can reach out to nonprofits such as dollar four who will retroactively try to support people who have been hit with these crazy bills. While the system is undoubtedly complicated with a bunch of persistence and a little creativity, it is possible for patients to get crazy high medical bills waived.

Erica: Now, after reading this article, I took a moment to think, what does this mean for surgery centers? Considering 1 out of every 5 Americans have medical debt, that means 20 percent of your potential patients or current patients are already [00:20:00] scarred and jaded thanks to our healthcare system. So that means they will be reluctant to move forward if they don’t understand their financial responsibility down to the pennies.

Erica: So you really have to go out of your way to help them understand exactly who owes what, by when, and why. Here are a few tips. So you always want to provide patients with an accurate estimate as soon as you can. You want to make sure that whatever tool you’re using to generate that estimate integrates with all the clearinghouses so that it’s accurate.

Erica: HSC actually offers a great solution called HSC Clarity if you’re interested in learning more about software that can help you do that. You also want to make sure That the estimate you’re sending to your patients is itemized and free of as much medical jargon as possible. So that itemized invoice should have, what procedures with the CPT codes, adjustments, payer responsibility, the co [00:21:00] pay that the patient owes to the patient.

Erica: deductibles, and so on. And whether you outsource this part or have someone do it in house, you must offer a financial counselor where patients can feel free to ask every question they have. Safe space, no dumb questions, hash it all out. This will undoubtedly build that trust and make them feel more comfortable knowing that they can pick up the phone and call someone if they need to.

Erica: You also want to make sure that you offer customizable payment plans and the ability to pay via credit card online. Most patients are willing to pay for the services they receive. They just may need a monthly payment plan in order to do it could be as simple as that. And then thinking even further, you can also offer charity care programs for uninsured and underinsured patients who don’t qualify for other government based medical programs.

Erica: Or you can partner with programs such as Access Now or Crossover Healthcare [00:22:00] Ministry, that’s one in Virginia, that will pay a portion of a patient’s responsibility if they qualify. These programs exist for a reason, so leaning into programs like that will just benefit both you and your patient population.

Erica: Now I would be remiss if I covered medical billing without talking about the No Surprises Act. is obviously intended to protect patients from being blindsided by out of network charges. And you bet over the next few years, patients are going to become more and more savvy about what their rights are, especially since it involves money.

Erica: So in order to maintain federal compliance, keep your patients happy and continue to get paid for the services you provide, make sure you’re being as transparent as possible when it comes to patient responsibility. And again, this article from us news was all was Targeted towards patients to help them understand how they can get relief from unexpectedly high medical bills and as soon as I saw it, I was like, this is, just the tip of the iceberg.

Erica: [00:23:00] NPR has a whole series on high medical bills and helping people overcome them, understand them, get them waived. There’s just more and more talk about making sure that there are no surprises and you don’t want your surgery center to get swept up in a PR nightmare just because of, one patient who maybe didn’t understand what they owed or weren’t, they weren’t shared what they owed far enough in advance.

Erica: And to end our new segment on a positive note, 10 years ago, a patient was faced with a heart wrenching decision about their beloved cat, Papa bear. In a moment of compassion, the patient’s nurse, Ariana Graziaday, stepped in and offered to adopt the cat from her patient.

Erica: When the patient’s partner returned to the hospital last week, so 10 years later, the same nurse was there and she recognized the cat. the name. The nurse walked into the patient’s room and she recognized both the women and she asked, do you remember me? The [00:24:00] women said yes and shared that they miss their beloved Papa bear.

Erica: So the nurse contacted her husband and asked him to bring the cat to the hospital. She surprised both women by bringing the cat into the room and both women, as you can imagine, were crying tears of joy. Papa Bear is now 17 years old and the cat sat down immediately on Margaret’s lap and started wagging his tail and purring, clearly remembering his former owners, even though it had been 10 years.

Erica: Grazia Day’s thoughtful gesture of not only adopting the cat in the first place, but also now reuniting Papa Bear with his original family showcases once again the profound impact nurses have on their patients lives. And that officially wraps up this week’s podcast. Thank you as always for spending a few minutes of your week with us.

Erica: Make sure to subscribe or leave a review on whichever platform you’re listening from. I hope you have a great day and we will see you again next [00:25:00] week.