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release,” says Dr. Caruso. “Administrators should think of the little details such as where visitors can park and how families will find their loved ones.” If patients enjoy their treatment as much as is possible and have their anxieties mitigated, they will return and thus drive profits. 5. Collaborate and expand services. You improve profitability of a spine center by bringing in more cases. If you widen the specialties offered, there will be more reason for more patients to visit. Spine on its own is a profitable venue and according to Dr. Caruso, there will be more shifts pushing spine into outpatient arenas as time goes on. Expanding services and introducing more specialists could capitalize on future trends. While orthopedics and neurosurgeons may compete over spine services, a spine center that expands services to include collaboration between orthopedics and neurosurgery could see increased patient volume and increased profits. “For instance, a great expansion area is neuromuscular care, which inherently combines these great subspecialties” says Dr. Caruso. Look to other spine centers or surgery centers for answers. Dr. Caruso recommends finding examples with similar provider mixes or similar practice dynamics. What have they done, how are they increasing profits? Additionally, look for surgical centers to partner or affiliate with. A spine center can complement larger ASCs or surgery centers. According to Dr. Caruso, spine, orthopedics and neurosurgery need to embrace a collaborative approach because collegial relationships build a competitive advantage and foster cost control. 6. Hire talented administrators and managers. In the face of current healthcare changes, spine centers need sharp administrators who can keep physicians and employees fiscally astute and who understand the bigger picture, says Dr. Caruso. As stated previously, the bigger picture is a focus on the patient and their care experience. “There are a lot of talented individuals available but the key is to get an individual who aligns himself or herself with the business and understands the future of that business,” says Dr. Caruso. “Historically physicians have wanted to make business decisions but they may not have all the information. That is why an administrator or business manager is essential.” Again, hiring a friend is not a best practice. Spine centers need someone with evidence-based experience and knowledge to run the operations and increase profits. “You have to have the right people who understand that right now is truly a unique opportunity to offer high quality care,” says Dr. Caruso. Spine 19 7. Engage in social media. Before social media, health information flow came only from physicians and healthcare groups. Physicians could, to an extent, dictate disease and treatment perceptions, says Dr. Caruso. Social media offers a wide-open arena and it is giving patients a voice in the healthcare information flow — they can engage in a dialogue about their aliments with other patients, with physicians and with healthcare organizations. According to Dr. Caruso, social media will push physicians towards better outcomes and more transparency, not just for the cost but the quality of the care. Additionally, the social media community can help patients assuage their concern about diagnoses. For instance, breast cancer is a diagnosis that has seen a lot of social media activity. Jay Harness, MD, a breast cancer surgeon in California, launched a website to answer questions from breast cancer patients. The website now features over 200 YouTube videos from physicians who answer questions to frequently asked questions as well as questions patients submit online. The website now launches content via YouTube, Facebook, Twitter and Google+. Although different from spine related diagnoses, physicians can still apply some of the techniques. Spine surgeons, neurosurgeons and orthopedic surgeons could maintain a social media presence and answer patient questions. Social media is going to revolutionize how medicine is viewed in the country so spine centers need to be involved, says Dr. Caruso. Both physicians and spine centers should have social media outlets. A spine center will need to hire someone to coordinate the flow of information, says Dr. Caruso. “It is important for physicians to be a part of the information dissemination,” says Dr. Caruso. There are many strategies for improving spine center profitability. Overall, increasing patient flow and reducing costs are pillars in the best practice arena for profitability. Utilizing new technology, embracing different healthcare perspectives and hiring individuals that have the mindset and drive for success among healthcare reform are best practices that may guide a spine center to a better tomorrow. n 2. Relationships with hospitals. Surgery centers often have a love/ hate relationship with hospitals. Many of their physicians need to maintain affiliations with both the hospital and the surgery center. Further, many surgery centers have moved to or investigated joint venturing with hospitals. Even with the joint venture, it remains a love/hate relationship where the surgery center often is not certain if they are getting the benefit from the joint venture that they expected to receive. For example, the hospital may not be able to really help with managed care contracting. Further, the hospital may continue to employ physicians. 3.
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