SUCCESS IN THE ASC

PART 1 IN A SERIES

It has been almost 20 years since Larry Patterson, MD, established the ambulatory surgery center (ASC) that complements Eye Centers of Tennessee (ECOTN)—an eight-location practice in predominantly rural Southern Tennessee—the eyecare practice he founded in 1988. Along the way, Dr. Patterson and his team—including his son, Michael Patterson, DO—have learned a thing or two about building a successful ASC.

On Purchasing Technology To wit: Their surgery center’s success arises from as much as what they don’t do as much as from what they do. Take, for example, their philosophy on new technology, which Dr. Michael Patterson whittles down to a single declarative sentence: “We don’t buy everything, period.”

Indeed, while the Pattersons and their team attend the major conferences, where new technologies are often showcased, they are careful not to get too caught up in all the hype typically surrounding the “latest and greatest.” Instead, they focus on those tools they believe will truly add tangible value to the ASC or their patient care.

“So many people want to be on the cutting edge of everything, but the problem is that the cutting edge might not really be giving you an advantage,” Dr. Michael Patterson says. “If it doesn’t benefit our practice or patients, then we don’t invest in it. We don’t buy stuff just because it’s ‘cool.’”

Purchasing technology just because it’s new is “a real recipe for becoming a completely non-profitable surgery center,” he says. “You may look good on paper, but you’re not really doing anything for your patients.”

Word-of-Mouth Marketing

Another practice the Pattersons and their team don’t devote much time or resources to—which may or may not be surprising—is marketing.

“First of all, I don’t really believe that marketing in any rural setting makes a big difference,” Dr. Michael Patterson says. “We’re a word-of-mouth type of community, and we do no marketing for the surgery center.”

In addition, while ECOTN does have a website and Facebook, Twitter, and LinkedIn accounts, Dr. Michael Patterson says those avenues are rarely used to market the practice. They also rarely, if ever, leverage billboards, direct mail, or even discounted products and services, which historically have delivered little return on investment.

“Marketing doesn’t work well in our area,” says Dr. Michael Patterson. “That’s not why people come to us. They come to us because we have the best, most efficient practice, and we have found that spending a lot of money on marketing has very little benefit for our company.”

Invest in Quality Staff

What does work for ECOTN and its ASC, says Dr. Michael Patterson, is investing in the ASC staff and their patients.

“Staff’s always going to be number one for us,” he says, also stressing the importance of stability and low turnover. With the exception of contracted anesthesiologists, ECOTN operates entirely on the efforts of full-time physicians and support staff.

“Personally, I think too many surgery centers have staff that are just PRN,” he says. “For us, even though it costs a bit more money, it’s a better investment to have full-time people who know everything about us.”

He and his supervisors also strive to promote teamwork, accompanied by their belief that every staff member is equally important—including physicians.

“I’m the director of nursing, but I try to step in and help all my staff when it’s needed, whether it’s the front desk or the nurses out in the PACU,” says Cammie Henry, RN. “No one’s invested in just doing their own job. If anyone needs help, we’re always there.”

“I think the biggest reason that ASCs don’t get the best out of their staff is that their doctors think they’re more important and that their staff is there to serve them,” Dr. Michael Patterson explains. “The doctors are no more important than the janitor. The janitor is no less important than the nurse. Every person has an equally integral part, because we can’t operate without a clean OR, without good nurses, without good CRNAs, and without good front desk staff.”

Make Patient Care a Top Priority

That same prioritization of people applies to patient care, says Megan Flatt, Dr. Michael Patterson’s executive assistant and one of his surgical coordinators at the ASC, who says that she strives to view all patients as though “it’s my mom walking in that door.”

“We know that patients are nervous, and we try to help ease that every step of the way,” Flatt says. “When they leave, we even give them a bouquet of flowers. They are very appreciative of that.”

Availability is another key ingredient of the ASC team’s philosophy. All surgical patients, for example, are provided with a nurse’s cell phone number in the event a postsurgical complication or other related issue arises after they arrive home. “Surgery can be very nerve-wracking for a patient. It could be a weekend, it could be a night call—we make ourselves available 24/7,” she says.

Don’t Go It Alone

These are just a few of the “keys to success” the Pattersons and their team have learned since the ASC was established in 2002. Dr. Larry Patterson remembers those early days as going very smoothly, primarily because he had previously operated a multispecialty ASC, and also because he enlisted the help of an expert consultant in establishing ECOTN’s surgery center.

“That’s probably the most important thing,” he says about launching an ophthalmic ASC. “If you’re thinking about opening a surgery center, don’t do it on your own. Pay someone who has experience setting up surgery centers and who knows what he’s doing. The consultant shouldn’t be someone who’s running his own ASC, but a consulting firm that specializes in launching ASCs.”

Have a Backup Plan

Dr. Larry Patterson also learned the vital importance of having a “deep bench” of employees to draw on when the unexpected happens. When a director of nursing left the ASC some years back, for example, he recalled not being prepared with someone else who could quickly step into the role.

“But more recently, another director of nursing left, and we had Cammie. We were kind of grooming her as the assistant director of nursing, so that when that director left it wasn’t such a big deal to move on,” he says.

The concept of having extra hands on deck extends to all positions within the ASC.

“I think at times we ran a little bit too lean, and if someone got sick, we were really in trouble,” he admits. “We now tend to have at least one person more than we really need, and that goes a long way, especially in these times of COVID-19 when you never know when somebody’s going to be exposed and they’ve got to drop out for a while.”

It All Comes Back to Staff

Asked to sum up the ASC’s record of success, Dr. Michael Patterson reiterates the efforts of the people who work at ECOTN’s surgery center.

“It’s just the people. You’ve got to have people who are committed to and believe in what they’re doing,” he says. “If you don’t feel that you’re changing lives, you’re not going to love this. But the people in our surgery center know they are.” ■