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学术眼科项目中的卫星诊所:成功与挑战的探索性研究。

Satellite clinics in academic ophthalmology programs: an exploratory study of successes and challenges.

机构信息

Cornea and Refractive Surgery Services, Wilmer Eye Institute and Wilmer Eye Institute at White Marsh, Department of Ophthalmology, Johns Hopkins University School of Medicine, 4924 Campbell Blvd, #100, Baltimore, MD 21236, USA.

出版信息

BMC Ophthalmol. 2013 Dec 14;13:79. doi: 10.1186/1471-2415-13-79.

Abstract

BACKGROUND

Major academic ophthalmology departments have been expanding by opening multi-office locations ("satellites"). This paper offers a first glimpse into satellites of academic ophthalmology departments.

METHODS

Leaders of seven medium to large, geographically diverse departments agreed to participate. One- to two-hour phone interviews were conducted to assess the features of their satellite practices.

RESULTS

Success as clinical entities, profitability, and access to patients were stated goals for most satellites. In approximate descending order, refractive surgery, retina, oculoplastics, and pediatric ophthalmology were the most common subspecialties offered. Faculty staffing ranged from recruitment specifically for satellites to rotation of existing faculty. Except for a department with only one academic track, satellite doctors were a mix of tenure and mostly non-tenure track faculty. According to these department leaders, scholarly productivity of satellite faculty was similar to that of colleagues at the main campus, though research was more community-based and clinical in nature. Fellowship but little resident education occurred at satellites. Though it was agreed that satellite practices were integral to department finances, they accounted for a smaller percentage of revenues than of total departmental visits.

CONCLUSIONS

Satellite offices have offered access to a better payor mix and have boosted the finances of academic ophthalmology departments. Challenges include maintaining collegiality with referring community physicians, integrating faculty despite geographic distance, preserving the department's academic "brand name," and ensuring consistent standards and operating procedures. Satellite clinics will likely help departments meet some of the challenges of health care reform.

摘要

背景

大型学术眼科部门通过开设多办事处(“卫星”)来扩大规模。本文首次对学术眼科部门的卫星进行了介绍。

方法

七位来自地理位置不同的中大型部门的领导同意参与。通过一到两个小时的电话访谈,评估他们的卫星业务的特点。

结果

作为临床实体、盈利能力和患者获得性,是大多数卫星的目标。按照从高到低的顺序,屈光手术、视网膜、眼整形和小儿眼科是最常见的亚专业。教职员工的配置范围从专门为卫星招聘到现有教职员工的轮换。除了一个只有一个学术轨道的部门外,卫星医生既有终身教职的,也有大部分非终身教职的。根据这些部门领导的说法,卫星教员的学术成果与主校区的同事相似,尽管研究更多地基于社区,性质也更偏向临床。在卫星上很少有住院医生的教育项目,只有 Fellowship。尽管大家一致认为卫星业务对部门财务至关重要,但它们的收入占比小于总部门就诊量。

结论

卫星办公室提供了更好的支付者组合,并促进了学术眼科部门的财务状况。挑战包括与社区医生保持良好的关系,尽管地理位置遥远但要整合教职员工,保持部门的学术“品牌”,并确保一致的标准和操作程序。卫星诊所可能有助于部门应对医疗改革的一些挑战。

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