Losing Your ASC's Volume Leader: 3 Strategies to Survive

It's the news no ASC wants to hear: Your volume leader surgeon is leaving. In a best-case scenario, an ASC will have time to prepare for an attempt to compensate for the loss. In a worst-case scenario, the loss happens suddenly, and the center is left scrambling to try to fill a huge void. 

Either scenario is possible for any ASC, which is why centers should have a plan in place to respond as effectively as possible to the news, advises Brian Brown, regional vice president of operations for ASC management and development company AmSurg Corp.

"The loss of a lead volume or even a heavy volume provider can be a catastrophe," he says. "If you don't have a surgeon who can walk in the door right behind the one who is leaving and replace the volume, you're going to have a lot of work to do. And if you don't know what to do, you may eventually find yourself forced to shut down the ASC."

Brown offers the following three strategies ASCs should follow if they want to weather the storm of losing a volume leader successfully.

1. Adjust your operations. While you may feel like all energy should be devoted to finding and adding new surgeons to replace the volume, that may take a while. In the meantime, modify your operations to reduce costs associated with the work of the departing surgeon.

   "That means examining and probably moderating your supplies and staffing," Brown says. "From a supplies standpoint, if you have custom packs for that surgeon scheduled for delivery on a regular basis, address that immediately. Get on the phone with your vendors and either adjust or stop the orders coming in. If you don't, you will quickly build up inventory on your shelves that you may not be able to get rid. That could prove very costly."

   From a staffing perspective, you may need to scale back your operations, he says. "For your ASC to remain solvent, consider closing certain days of the week or perhaps going from a 40-hour work week to 32 hours to save money as you're working to add volume."

   Brown says communication and transparency with staff are vital if you plan to make schedule changes and reduce hours as decreasing paychecks will affect their livelihood. "In the short term, try to adjust where you can to give yourself time to recover. Hopefully, more volume comes in, and you can return operations to normal, but you must be prepared to make some difficult staffing decisions if the volume is not replaced in the long term."



2. Leverage from within. Hopefully, you will have notice of the high-volume surgeon's departure and can use this individual's connections to replace at least some of the volume, Brown says.

   "When you have advanced knowledge, you can work with the surgeon to see if another surgeon at their practice can bring cases to the ASC," he says. "You might also be able to work with the physician to recruit another physician to their practice who can then bring you volume. This is an optimal scenario as it maintains continuity of business, but it won't always be the case."

   Once you learn of the high-volume surgeon's departure, you should also speak with the remaining surgeons on your medical staff to gauge their interest in bringing more case volume to the ASC to help fill the large open blocks in your surgical schedule.



3. Pursue external opportunities. ASC leaders should maintain a pipeline of physicians with whom they are speaking about the present or possible future opportunities at the ASC, Brown says. "These ongoing efforts can come in very handy when you're faced with a significant opening in your schedule and can plug some holes with new surgeons. This is usually easier to do in a multi-specialty ASC than a single-specialty center as there are likely to be more options for new physicians."

If more direct routes to replacing volume prove unsuccessful or fail to fill enough of the surgical schedule to maintain the business operations your owners desire, examine whether new opportunities are a viable solution.

"This may mean adding a new specialty," Brown says. "Start by assessing the practicality of adding a complimentary specialty to your current offerings, such as pain management and orthopedic surgery, before looking at other specialties."

You will likely need to invest in equipment — and possibly staff — to accommodate any new specialty and its cases, but the expense could be worthwhile if the added cases and their reimbursement make up for most or all the volume lost.

FREE RESOURCES FOR MEMBERS

Guideline Essentials: Improve your ASC’s operations in the event of losing a volume leader surgeon with EBP tools and resources.

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