According to a study published by the US National Library of Medicine and National Institutes of Health, the quality of acute surgical care in the US remains threatened by a shortage of surgeons performing emergency procedures because of rising costs of uncompensated care, liability concerns, declining reimbursement, retiring surgeons and lifestyle considerations.
"Our thought process when we started in 2006 was that our surgicalist model could improve timeliness of care, physician satisfaction, emergency surgery scheduling, continuity of care, patient satisfaction and revenue increases," Desai said.
The US National Library of Medicine study's results stated three surgicalists cared for 853 patients during 1 year. Patients ranged from 17 to 100 years of age and presented with abdominal pain (66%), infection (18%), malignancy (6%), hernia (4%), and trauma (3%). Fifty-seven percent of consults originated from the ED; 8% came from other surgeons. Mean time to consult was 20 minutes. A survey of ED physicians reported shorter ED length of stay, better patient satisfaction, improved professionalism and resident supervision, and better overall quality of care. Average waiting time for patients with acute appendicitis to undergo operation was reduced from 16 +/- 10 hours to 8 +/- 4 hours (p < 0.05). Forty-two percent of consults resulted in an operative procedure, and revenue increased as the number of billable consults rose by 190%.
The study's conclusion was fairly straightforward: The surgicalist model provides a more effective way for general surgeons to provide timely and high-quality emergency surgical care and enhance patient and referring provider satisfaction.
The benefits of the model extend beyond fewer complications, shorter wait time and reduced length of stay statistics; a five year study of acute care patients at a community hospital published in the Journal of the American College of Surgeons highlighted improved cost outcomes as an additional advantage. For the surgical cases studied, hospital costs decreased by 31% under the model, with the most notable reduction for appendectomies (37% cost reduction).
Shalin Shah, COO at Regional Medical Center Bayonet Point in Hudson, Florida who has experienced the benefits of the Surgicalist Model said, "We got to a point where three of our surgeons were on staff more than 15 years, a milestone that allows them to be off emergency calls. This created an uncovered gap of about 15 days for us; not a good thing. We reached out to our sister hospital in Trinity and they had success with The Surgicalist Group, founded by Dr. Mit Desai. Upon initial onboarding, we had some initial hesitation from our surgeons with regard to the protection of their practices; however, the surgicalist model gives us access to quality emergency surgeons with no interest in an active practice. They are purely geared toward filling our emergency surgery calls. It's worked out rather well for us."
According to Desai, another large factor that is making the Surgicalist Model more attractive is lifestyle. Most surgeons are drawn to the career shift after practicing under the traditional elective/on-call combined model for years. They are acutely aware of the costs associated with pursuing this schedule long-term, but they do not want to give up practicing surgery. When it becomes clear that the surgicalist schedule allows for every other week off, with only 26 weeks a year committed to being on call, many surgeons are more than willing to give up their elective practice to have better work, life balance. In addition, next generation surgeons still in medical school tend to look at surgical careers and wonder how an adequate lifestyle balance might work in the traditional old-school setting; the surgicalist model creates a new balance for that dilemma.
"I was recently on a plane and happened to be seated next to a medical student considering a career as a surgeon; however, as our conversation continued his fears and anxieties were not about the work but more of the work and life balance. As fate would have it, this is one of the reasons I started our Surgicalist Group back in 2006. The concept includes a set schedule for surgeons, one week on/one week off, focusing on acute cases only, rather than balancing elective and on-call duties. This is very important to not only young medical students of a new generation but also for that senior surgeon who isn't ready to retire yet but has earned that non-emergency call status," Desai said.
The Surgicalist Group states the competitive compensation and benefits packages ultimately make the decision that much easier. Finally, after becoming a surgicalist and practicing under this innovative model, many surgeons find they actually enjoy the daily realities of the position. Surgicalists are able to dedicate their time to patients in need, and spend energy on improving their hospital community in a way that is frequently difficult when juggling the responsibilities of elective practice and call schedules. Surgicalists are not only able to be invested in their community with newly found free time, but they become invested members of their hospital team, improving the quality of their workplace through leadership pursuits and professional development.
Paul M. Phillips, former UnitedHealthcare Executive said, "For health insurance plans, ensuring that a hospital is staffed with surgeons highly experienced and specializing in acute care can mean the difference between a short hospital stay or one with more complications and a higher chance of readmission. The surgicalist model is a way that hospitals and health plans can both lower costs and improve quality of care."
Hospital executives are forced to make difficult decisions every day. The intent of sharing these findings is to make one decision easier. The ED can often be a source of some of the longest wait times in hospital systems, staining the reputation of an otherwise efficient institution. Staffing troubles in the emergency surgical department can similarly be a serious headache to not only administrators, but the surgeons themselves. More hospitals are increasingly adopting the surgicalist model, and preliminary findings indicate there may be very good reasons for more to follow suit. The Surgicalist model represents the future of emergency surgical departments, and it is essential for hospitals to quickly begin leveraging the model for the benefits it yields to patients and bottom lines, alike.
For more information on the Surgicalist Model, call 888-510-1325 or visit www.thesurgicalist.com.
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SOURCE The Surgicalist Group