A Look Behind the Scenes
Presearch Management Profile
We begin each assignment with a thorough pre-search review. In this process, which can take from one to four days, we interview a cross section of the organization, including managers, staff, and line personnel through its various levels. The results of these interviews are summed up in a 10- to 25-page Presearch Management Profile that enables us to learn about your organization, its culture, and its goals, and provides you with a candid snapshot of your organization that provides you with valuable insights on it. This Profile, a unique part of our search process, allows us to identify candidates who not only have the proper experience for the position, but also are good fits on a personal basis for your organization.
Presearch Management Profile (Excerpt)
Medical staff needs enhancement, as key procedures are outmigrating. A number of the referring physicians question the experience of your medical staff specialists, and are referring their patients to other hospitals located as far as 75 miles away.Your research indicates that over 50% of inpatient surgical procedures are being completed out-of-town.The surgical staff is older; many are closing in on retirement. The referring physicians are significantly younger than the surgeons and other specialists, and this has created a degree of disconnection between these two groups. Your immediate need is to add two general surgeons, with one of the two having some thoracic capability.
An increase in the acuity of surgical offerings is needed. Because of the recent capital investments you have made, your operating rooms are operating at 72% of capacity. The resources are clearly available for you to add additional services. A review of your surgical records indicates that your surgeons are not operating at the cutting edge; laparascopic procedures are outmigrating, as current surgeons are not well-trained in these procedures. Adding high-acuity surgical services will enable you to serve most of the patients in your catchment area.
Comments from the Administrative, Clinical and Medical Staff at the Hospital:
“From 1995 to 1998, we had serious discussions regarding mergers with two area hospitals. During that period, we didn’t spend much time or money on either capital improvements or physician development. There was some degree of turmoil during these years, and when we finally came out of that process, it took a while for reality to set in.”
“We have made significant investments in our hospitals. We have seven brand new operating rooms. We have a new on-site MRI. We have a new interventional unit. We have a new dialysis facility (the only one in the county). We have a new pain management center. We also have a women’s health center under construction.”
“In recent years, our outpatient revenues have gone up 34%. Our inpatient revenues are only up 3%, however. We keep asking ourselves, ‘Where are these procedures going?'”
“We have pretty low vacancies among our nursing staff. We do have a few in ICU and E.R. There is no agency nurse problem here.”
“The pace here is more relaxed than in New York City. I get to go to all of my kids’ sporting events, for example.”
Surgery at our Hospital
“Our research indicates that 54% of the surgical procedures performed on patients in this county take place elsewhere. They are often driving 50 to 75 miles for surgery. Our patients frequently give us the names of out-of-town surgeons they would like to see.”
“As we move to more complex surgical procedures, we will also have to be aware of the increased need for the development and training of our nursing staff regarding these new procedures.”
“Elective cases aren’t bumped here, as they are in New York City. You can be more productive in the operating room.”
“Currently, we have one 71-year-old General Surgeon, a 70-year-old General Surgeon who works half time, and a 63-year-old General Surgeon. We also have a group of four General Surgeons. One is age 65, one is in her early forties and concentrates on breast surgery, and one concentrates on vascular surgery. Their other member is a half-time administrator and a half-time surgeon.”
“That group doesn’t do a lot of high end work. They do a little laparoscopic work, plus a lot of breast surgery and vascular surgery. They don’t do any oncological surgery, thoracic surgery or video-assisted procedures.”
“Most of our older general surgeons are not comfortable with laparoscopic surgery.”
“Half of this new general surgeon’s work could be thoracic surgery. Our current thoracic surgeon is brilliant, but he is 70 years old and picks his cases.”
“Ideally, we could use one general surgeon who works above the diaphragm and one who works below the diaphragm. Thoracic surgery would be important, but this person will not do aortic aneurysms or related procedures. Lobectomies will also be part of his work.”
“The General Surgeon will need good laparoscopic skills, and also needs to be able to work in the biliary track.”
“Ideally, this person will probably need to do vascular surgery, general surgery and laparoscopic surgery to be successful. We are losing a number of patients to other facilities for these procedures.”
“We have no one who can do a mediastinoscopy here, and that infuriates the primary care staff.”