A hepatopancreaticobiliary surgery practice at a non-university tertiary care center (NU-TCC)

Abstract

Presenter: Terence Jackson MD | Methodist Richardson Medical Center Background: There is data to suggest that more graduates from Hepatopancreatobiliary (HPB) surgery fellowships go into private practice than anticipated. Fellowships do not prepare them for this environment. In a world where HPB surgery services have typically existed in large academic institutions only, we are also now seeing an increasing number of hybrid models within these institutions. We would like to present a novel way of defining the growth of an HPB practice outside the traditional academic setting. Methods: We examined the nuances of starting and developing a NU-TCC for HPB surgery and present them in a simplified fashion. Not much data is available to guide fellows and young HPB surgeons in this regard and most learn on the job. The information presented here is based on anecdotal data and experiences garnered over several years of running a successful HPB practice. Results: Upon examining the nuances of starting and growing an HPB practice in the private setting the following four pillar of a surgical service were identified – Referral base, Outpatient growth, Practice management and Inpatient growth. The minutia of practice management including finances, billing, coding and staff management, the list of services that need to be secured to provide easy and timely care for our patients in the outpatient setting were identified and detailed. The essentials needed to maintain a certified HPB service include training of nursing and operating room staff, multidisciplinary consulting services and hospitalists. To maintain growth the referral base needs to be continuously maintained and increased. Having a broad based practice, saying “Yes!!” to each problem that is presented, being available/affable/able and being timely in taking care of patients are all crucial aspects. (Image included) Conclusion: With this we hope to provide a road map for our trainees to start their own practices, clear myths and enable them with the tools to venture forth into any scenario knowing the way to succeed.