Eyeworld

136 Crossing the finish line: Launching your premium technology practice 136 by William B. Trattler, MD Overcoming obstacles to new technology acquisition Strategies for bringing in capital equipment to improve patient care F rom femtosecond lasers to excimer lasers, surgeons want the best premium technologies for their patients. However, young surgeons often encounter what can feel like insurmountable obstacles to access, such as not having enough influence over capital equipment decisions, not having the surgery volume to justify a major acquisi- tion, or simply not having experi- ence with the technology. Thankful- ly, there are ways to overcome each of these obstacles. Expand your influence Even as a minority owner or non- ASC owner, surgeons often have more power than they think. Surgery centers bring in revenues by having a large volume of cases—and they don't want to lose the busi- ness of successful young surgeons. To convince decision makers, be passionate about the impact of a new technology on patient care, and come to the table with ammunition on costs as well as how bringing a specific volume of surgical cases to the ASC will help offset these costs. For example, I'm a 1% owner at my surgery center, but I was able to make the case that a femtosecond laser could attract more surgeons to use the center. With more surgical cases at the center, the costs of the laser would be covered. And in fact, once we brought in the femtosec- ond laser, the additional volume of surgical procedures did help cover the costs of the laser so that we could provide a technology to help improve surgical outcomes for the patients who have surgery at our center (Figure 1). Complacent partners who have no interest in updating clinical technology can be a challenge— one best addressed before joining a practice. Be proactive in finding out what technology is currently in place, what technology acquisition plans have been made, and what the partners' innovation and investment philosophy is. Which comes first—the volume or the purchase? If you don't have the case load to support purchasing a particular new technology right away, consider doing a roll-on roll-off (RORO) ar- rangement, which lets the technolo- gy come to you for as little as 1 day per month. We did this for 6 years with an SLT laser for glaucoma, until we had built up the glaucoma case volume to buy our own laser. Open access centers are an- other good option, even if you are a part-owner in a different center. There is nothing wrong with bring- ing patients to a center that is a little distance away to get access to a technology that will benefit them. Figure 1: Adding a femtosecond laser to our surgery center led to an increase in overall cataract surgery volume by 17% in the first year and 15% in the second, due to strong interest from community physicians to have access to the technology. Young surgeons sometimes feel that they are at a disadvantage com- pared to their more experienced col- leagues, but I would suggest that we are all learning constantly. Much of what I do now I didn't learn in res- idency. Take advantage of mentors in your community and go through manufacturer training and certifica- tion programs so that you are ready to use new technology as soon as you can gain access to it. Online vid- eos and courses are also an excellent resource for staying abreast of new techniques and technology. Finding a way to afford the lat- est devices is always a balancing act, but it's one worth mastering. New technology makes us better surgeons and helps us achieve the best out- comes for patients. Dr. Trattler is director of the Center for Excellence in Eye Care, Miami, and is on the volunteer faculty at the Florida International University Herbert Wertheim College of Medicine, Miami. He can be contacted at 305-598-2020 or wtrattler@gmail.com. 30% 20% 10% 0% Year 1 Year 2 17% 15% Increase in surgical volume after acquiring femto " Finding a way to afford the latest devices is always a balancing act, but it's one worth mastering. " –William B. Trattler, MD William B. Trattler, MD

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