Noninvasive vascular diagnostic testing is efficient and cost-effective, and it is an integral part of vascular surgery practice. Integration of the laboratory into the practice can add significant ...income to a practice as well as increase the quality of the patient's experience. Maintaining a successful vascular laboratory is a key component of the practice's remaining competitive in an ever-changing health care system. Attention must be paid to staffing, operations, financial performance, revenue cycle, and patient and referring physician satisfaction to grow the business.
Objective To survey the Society for Vascular Surgery (SVS) membership with regard to practice trends related to work effort, employment status, practice ownership, endovascular cases, and anticipated ...changes in practice in the near future. Methods A survey questionnaire was developed to gather information about member demographics and practice, hours worked, full-time (FT) or part-time status, employment status, practice ownership, competition for referrals, proportion of endovascular vs open procedures, and anticipated changes in practice in the next 3 years. We used SurveyMonkey and distributed the survey to all active vascular surgeon (VS) members of the SVS. Results The response rate was 207 of 2230 (10.7%). Two thirds were in private practice, and 21% were in solo practice. Twenty-four percent were employed by hospitals/health systems. Those VS under the age of 50 years were more likely to exclusively practice vascular surgery compared with VS over the age of 50 years ( P = .0003). Sixty-eight of the physicians (32.7%) were between 50 and 59 years old, 186 (90.3%) were men, 192 (92.8%) worked FT (>36 hours of patient care per week), and almost two thirds worked >60 hours per week. Those in physician-owned practices worked >40 hours of patient care per week more often than did FT employed VS ( P = .012). Younger VS (age <50 years) more frequently reported >50% of their workload being endovascular compared with older VS (age ≥50 years; P < .001). Eighty percent of FT VS planned to continue their current practice over the next 3 years. Of the 43.6% indicating loss of referrals, 82% pointed to cardiologists as the competition. Conclusions The current workforce is predominately male and works FT; one-third is between the ages of 50 and 59 years. Younger VS (age <50 years) are more likely to exclusively practice VS and have a higher caseload of endovascular procedures. Those in physician-owned practices are more likely to put in >40 hours of patient care per week than are FT employed VS. Longitudinal surveys of SVS members are imperative to help tailor educational, training, and practice management offerings, guide governmental activities, advocate for issues important to members, improve branding initiatives, and sponsor workforce analyses.
To report the consequence of missed appointments ("no-shows") in the noninvasive vascular laboratory of a large teaching hospital and evaluate the effect of one potential solution.
The financial ...effect of missed appointments by outpatients during a 9-month period was calculated on the basis of weighted average reimbursement rates for the technical component of a bilateral venous duplex examination. In addition, the effect of an automated telephone reminder system on the no-show rate was studied over a subsequent 17-month period.
The overall no-show rate for outpatients in the vascular laboratory was 12%, with an average of 7.6 missed appointments per week. This translated to a gross annual revenue loss of $89,107 assuming a per-appointment revenue equal to the 2005 technical component of the reimbursement rate for outpatient bilateral duplex venous ultrasound studies. Of the 8,766 patients offered automated reminder calls, 4,648 (53%) agreed to receive the calls. The no-show rate was significantly greater for those patients who chose to receive automated reminder calls (8.9% vs 5.9%, P < .0001).
A 12% no-show rate offers an opportunity for significant cost savings and improved efficiency in the vascular laboratory. Automated reminder systems did not appear to significantly reduce the no-show rate. Various strategies are outlined to achieve the goal of a 5% no-show rate, including methods of scheduling, pre-examination notification, and advanced overbooking techniques. Further investigation into these strategies to reduce the no-show rate is needed.
Changing practice paradigms: Negotiating your future Satiani, Bhagwan B., MD, MBA; Motew, Stephen J., MD; Darling, R. Clem, MD ...
Journal of vascular surgery,
04/2012, Letnik:
55, Številka:
4
Journal Article
Recenzirano
Odprti dostop
There are many recent and ongoing changes in the practice of medicine from a business standpoint as well as in overall practice management. Economic and lifestyle desires have pushed many physicians ...to a decision point of whether or not to join a large multispecialty group or to sell their practice and become an employee of a hospital system. There are advantages and disadvantages to both options; however, deciding on the most appropriate path for each individual can be a daunting task. At our recent breakfast session at the vascular annual meeting in Chicago, Illinois, in June 2011, we brought to light these topics to try and help enlighten physicians on which option may be right for them. There is no single answer/option that will fit every practice, but discussion for various practice management designs are outlined and critiqued. This article cannot fully discuss each view in the allotted space, but it is designed to encourage thought and discussion among the vascular surgical community as a whole.
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