How to improve profitability of the OR

Ever wonder why it is so easy to make fun of everybody else’s business? We have no problem picking on the phone company, the hardware chain store, and the airlines. Do you suppose those people do the same thing when it comes to healthcare?

The airlines make it quite easy for us to pick on them. After all, nobody knows what it costs to fly from Philadelphia to Atlanta on different airlines. Heck, nobody who works for the airline or even the people on the same flight can tell you what it costs. There is probably a higher likelihood that you and the person in the seat next to you have the same birthday than there is that you paid the same price to fly to the same place.

How far away is elective healthcare from adopting the airline’s business practices? In many offices, we already have built-in delays, just like on flights.

I am thinking it would work something like this. I call the hospital to schedule to have my ACL repaired.

The scheduler asks me when I would like to have the procedure, telling me the possible dates. “If you book it on-line, I can offer you a five percent discount. Two weeks in advance takes off another ten percent. There is a ten percent surcharge for Mondays and Wednesdays, and it is twenty percent more if you request a surgeon with more than ten years experience. Surgeons from Ivy League schools are an additional three percent provided they graduated in the top fifty percent of their class.”

“If you have been cut on by us before, your hospital points may entitle you to free cable television or a fruit cup with your breakfast.”

“You should be aware that this is a very popular operation, so we may over schedule the OR—that means you may be bumped. However, we also have had a number of no-shows which is why we require payment at the time you book the procedure. Of course, that is not refundable. Alternatively, there are other less popular procedures you may wish to consider.”

“Come again?” I asked.

“Something like a face lift, appendectomy.”

“But I don’t need an appendectomy.”

“That is a person problem, Mr. Roemer. We are not permitted to discuss that with our patients.”

“What will this cost?”

“I can’t tell you.”

“Is this like I can’t tell you or I will have to kill you, or is it, ‘I can’t tell you?’”

“I can’t tell you.”

Paul M. Roemer
Chief Imaginist, Healthcare IT Strategy