Three spine surgeons discuss strategies they have implemented to reduce costs at their medical practices.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses. Next week's question: What’s the most important professional lesson you learned over the course of your career?
Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, Aug. 27, at 5 p.m. CST.
Question: What are some cost-cutting initiatives you have implemented at your practice?
Brian R. Gantwerker, MD, The Craniospinal Center of Los Angeles: We have cut costs through cross-training employees on each other's jobs, digital fax services and encouraging same-day appointments to fill up and utilize space and time more effectively.
Douglas Won, MD, Founder & Director of SpineCARE and CMO of Star Medical Center, Irving, Texas: We've implemented several cost-cutting initiatives at SpineCARE, such as using multiple supply vendors to ensure the best pricing; no overtime policy; combining jobs and centralization to cross utilize staff; staying in touch with the market rates to ensure we're not overpaying our staff; streamlining patient flow to maximize staff/space utilization; shopping our benefits and insurance packages to get the best rates; Sam's club for supplies instead of using expensive vendors; just-in-time inventory of supplies and drugs to avoid waste and stock piles of items; developing vendor relationships and constant renegotiation of rates on highly used items as well as buying used or refurbished equipment instead of new [equipment].
Ara Deukmedjian, MD, CEO, Medical Director, Deuk Spine Institute, Melbourne, Fla.: Deuk Spine Institute has focused more attention on increasing revenue rather than decreasing overhead cost. We are developing stronger patient education and marketing efforts to capture more patient encounters. Our biggest draw has always been our excellent outcomes treating chronic back and neck pain. Saving money by lowering costs sounds good but is very difficult to achieve in the real world.
The biggest expense for any medical practice will be the salaries of its employees. Reducing wages is not possible unless positions are eliminated or the surgeon is willing to take a pay cut. Getting your employees to take a pay cut is a very unlikely proposition. Electronic medical records were supposed to save money by lowering costs associated with paper charts but the opposite is happening, practices are spending much more money on the establishment and maintenance of EMRs. I can tell you firsthand that the cost of equipment, medication and supplies has not significantly declined over the years.
Looking at all the facts, how are medical practices to reduce costs? They cannot without significantly reducing quality of care. High-quality medical care is expensive and will remain so as long as the equipment, staffing, administrative, liability and real estate costs remain high as all of these are out of the control of the surgeon. If the government wants to reduce the cost of medicine they need to regulate the health insurance companies and the medical suppliers, not the providers.
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