Maximizing Surgical Outcomes with Practice Management Principles

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I am Bella Pandit. I am board certified by the American Board of Foot and Ankle Surgeons. I am the current chair of the Practice Management Committee for access for the last two years, and I practice in the Chicagoland area in Illinois.
 
What practice management challenges to you feel surgeons in particular experience?
 
I think the biggest challenge is I think we do great work. I think whether you are hospital-based or in private practice, we get called into so many immediate life-threatening type of things. We do the good work or we just do even amazing elective work and we're just not getting reimbursed or insurance is holding back from us, but we've done the work and we improve someone's life usually and we're not getting reimbursed for, and I think that's very frustrating.

In your experience, how can surgeons leverage practice management to improve surgical outcomes?

I think especially in the world of practice management, we have protocols for so many ways that we treat people on a daily basis and we should implement protocols for our surgeries as well. So verifying insurance before you do an elective procedure with every possible code you might use, because as you know, things change when you open up somebody and maybe you have to do something else. What you don't want is to do that good work and you didn't get that code approved and you're not getting paid for all that great work that you did. I think you should have protocols of a timeline of when you should actually do surgery on a patient. A lot of people come in and they're like, I want my bunion done tomorrow. I mean, we cannot do that. And every other surgical practice in the world, particularly like plastic surgeons, you're getting paid tons to do all this work, and they have a wait list of a year, so you shouldn't feel bullied because someone comes in and that's all they want to do. You should definitely do those protocols of conservative care, document it, and then book your case that you want to do.

What one change or process can surgeons implement in their practices today to have a positive impact?
 
I think the biggest thing we could do is really stick to your personal protocol for every single case. So someone comes in, it's a routine type elective case. You have to document and try whatever your protocol is for conservative care. It'll help you in a legal situation because you never know when that can come and bite you that you actually didn't have them change shoes and shoes from your office, or orthotics from your office or strappings or whatever they may need to do.

Have the patient sign off and also have a deep conversation with you with their expectations, but most importantly, your expectations of after the surgery. This is what's going to happen. You need to be in orthotics, you need to have physical therapy, and you cannot deviate from that. They're not willing to do that. They're not the right fit for you.