BLOG: Measuring cataract surgical density in your practice

Read more blog posts from John B. Pinto

Nearly every cataract surgeon wants to do more surgery and spend less time in the clinic, even in the fast-emerging era in which (absent an owned ASC) profitability per hour of your time can be much higher in the clinic.

Surgical volume is directly linked to your productivity in the clinic: See more patients and you’ll identify more patients to help with surgical care. There are a number of things you can do to increase your surgical yield, but the important starting point is to measure the baseline surgical density of your practice today.

The math is easy. Simply divide your average monthly visits by your average case volumes.

Here’s an example. Imagine a two-surgeon practice with 950 patient visits per month and 60 surgical cases per month. The surgical yield would be 950/60 = 16 patient visits per case, a pretty favorable number. Said another way, these doctors generate a major surgical case for every 16 patient visits.

The upper and lower range for this metric in a general ophthalmology practice is rather wide, from less than five to more than 50 patient visits per surgical case. In the typical private cataract/general practice I consult with, the typical range is narrower, about 15 to 25 patient visits per case. In extremely young practices and in clinically conservative or clinically neglectful settings, the ratio is closer to 50 or more patient visits for every cataract surgical case.

Surgical density can be higher or lower within a practice for a number of other reasons:

In an older, more established practice, the average age of patients is higher, and the cataract yield is often elevated.
Practices that actively market externally generally have a superior surgical density.
Surgeons who co-manage patient care with referring optometrists always have an extremely favorable surgical yield, with as few as three or four patient visits for every surgical case.
Some surgeons, for philosophical reasons or due to a lack of confidence in their operative skills, will only provide surgical care when a patient’s case is well-advanced.
Other surgeons lose cases because their rapport or communication skills with patients is poor or their office is poorly organized. In any competitive environment in which your patients are being actively solicited by other providers, you must have systems in place to transition good clinical candidates who are temporarily fence-sitting into surgical patients.

John B. Pinto, Practice Consultant and OSN Section Editor, focuses his blog on ophthalmic strategic planning, economics and benchmarking, marketing, cost containment, revenue enhancement, physician leadership and personnel/physician career development issues.