Case Assignment David Christopher, Orthopedic Surgeon

The current weekly workload of Dr. David Christopher’s practice is a total of 40 hours for two Orthopedic Surgeons over the span of 4 days. Each surgeon’s hours are an even split between surgical procedures and seeing post-operative patients in an office setting. They do this every day by performing surgical procedures in the morning from 07:00 am to 12:00 pm, breaking an hour for lunch, and then returning to see patients in the office from 01:00 pm to 6:00 pm. While they have three days off to attend meetings, conferences, and give guest lectures this schedule is not conducive to covering any emergencies at the local hospital or vacations.

The clinic could easily handle the hiring of one additional surgeon at first with the option of hiring a second if the patient load continues to increase per available surgeon. The first hire would allow more schedule flexibility for each surgeon. Perhaps instead of splitting each day they could so one solid day of surgical procedures with the other three days spent in the office. As well, this operational change could end up reducing the changeover time, as there would be less transition of daily roles. The additional surgeon would allow for vacation times, emergency on-call time, and increased clinic hours thereby increasing work efficiencies as well as revenue.

Other options for this practice could include the hiring of mid-level providers (Nurse Practitioners and Physician’s Assistants) in lieu of additional surgeons to see the post-operative patients in the office leaving the surgeons to perform surgeries and see patients at their initial consultations or for more thorough post-operative follow-ups. Mid-level providers are able to bill in a similar fashion and perform similar services in the office setting. Surgical procedures generate more revenue that outpatient office visits. If the surgeons are able to perform more surgeries their efficiencies will improve, reducing the changeover time allowing for the potential for more procedures without overtaxing the physician.

Final recommendations for Dr. Christopher’s practice would be to hire one surgeon and 2 mid-level providers. An additional surgeon would offer a more flexible schedule for the surgeons and how their time is best spent. Having the mid-level providers cover the bulk of the post-operative office visits will improve patient throughput and is a cost saver as their salaries are less than a surgeon.