ring provider about a patient who'd come in with a cut on his thumb,"
says Mr. Bullock. "They said we think it's a tendon, not just a normal
cut. He sends him over, the hand doctor looks at it and says, absolutely,
we need to go in and fix it. And he adds it on at 4 that afternoon. So all
within one day, the guy saw his primary care, got referred to the ortho
doc, got surgery and was back home."
Although the vast majority of Mr. Bullock's nearly 9,000 outpatient
cases per year are elective orthopedic procedures, a typical week is
likely to include at least a couple of patients who've fallen off ladders,
fractured an arm playing basketball or slipped on some ice, and who
need attention immediately, he says.
To make it work, "you've got to be flexible in terms of staffing," says
Mr. Bullock. "Most ASCs don't have on-call or late teams. You have to
have staff that are will-
ing to flex. Adding a
case at the end of the
day might turn an
8-hour day into a 10-
hour day, and we
accommodate for that.
We have 10-hour
shifts."
That goes for ven-
dors, too. "You never
know what type of
implant you're going to
need," says Mr.
Bullock. "If a fracture
comes in and needs a
plate, you've either got
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