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

Irene C Kuo

doi:10.1186/1471-2415-13-79

Abstract

BackgroundMajor academic ophthalmology departments have been expanding by opening multi-office locations (“satellites”). This paper offers a first glimpse into satellites of academic ophthalmology departments.MethodsLeaders 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.ResultsSuccess 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.ConclusionsSatellite 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.

Highlights

Major academic ophthalmology departments have been expanding by opening multi-office locations (“satellites”)
Bentley et al provided a nondepartment specific description of the modern academic medical center: “Satellite centers, which offer a variety of primary and specialty care serves, are being established to increase patient referrals to the main campus, as service areas are expanded beyond historical boundaries” [2]. Do these findings apply to ophthalmology departments? The purpose of this survey was to offer an exploratory, descriptive first glimpse into satellite practices of academic ophthalmology departments by ascertaining the views of department leaders–to discern common themes of successful satellite practices at various programs and common programmatic issues that need to be addressed. As this project was a pilot study of satellite clinics of major academic ophthalmology programs, interviews of department leaders were deemed a first step to uncover common themes
The author conducted phone interviews with chairs, except when they recommended a vice-chair or chief executive officer; questions were not provided in advance, anonymity was promised, and interviews lasted 1–2 hours long

Summary

Introduction

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. There is little peer-review literature on satellite offices in academic medical departments in general, [1,2] let alone in ophthalmology. This paper offers a first glimpse into these practices. Ophthalmology departments were in expansion mode in the 1970s and 1980s. Under the auspices of a very young National Eye Institute, the first comprehensive assessment of major needs and opportunities in vision research in the United States was published [3]. One result was that academic ophthalmology departments began to expand beyond their typical urban settings

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