Foundations of Healthcare Management

Short Case 23- A New Look?

Dr. Elinor Cooke is a renowned cosmetic surgeon, highly dedicated to healing and restoring well-being for those who affected by aesthetic issues. She believes that her line of work builds the confidence and self-esteem of those who seek her services. Dr. Cooke received her medical degree from Case Western Reserve University and then completed four years of residency and two additional years of residency in plastic surgery at the Ohio State University Hospitals. Dr. Cooke's current practice, North City Aesthetic and Plastic Surgery, Inc, affiliated with Northside    Community Hospital, is located in a suburb of Cleveland on a beautiful wooded lot next to Lake Erie. In addition to Dr. Cooke, there is one other doctor affiliated with North City, Dr. Ryan Thomas, who specializes in men's reconstructive surgery. The practice also employs two nurses and an office manager. The practice enjoys an excellent reputation and is known for its compassionate approach to care. While North City Aesthetic and Plastic Surgery is considered one of the premier practices in the Midwest market area, Dr. Cooke is concerned about some of the changes she has observed in the field of plastic surgery. When she started her practice in the early 1980s, cosmetic surgery was a relatively new field. Plastic surgery was available for those affected by disfigurement, but not readily available for those who wanted to fix something just because they didn't like their appearance. Over the years, Hollywood, new techniques, and new trends sparked tremendous growth in the cosmetic surgery industry, and with this growth, the profile of a typical cosmetic surgery practice changed. Whereas patients used to be amazed that a tummy tuck, breast augmentation, facelift, or rhinoplasty was possible, now the average patient tends to want more than surgery alone.

Another trend Dr. Cooke has observed is the increasing level of competition for aesthetic surgery services. She is aware of the expanding availability of surgical procedures through ambulatory surgery centers, but a recent invitation to a Botox party event provided evidence of a new competitive threat--even if the quality of care provided might be suspect. Dr. Cooke's North City practice has managed to grow based on patients' word of-mouth recommendations and other physicians' referrals rather than through advertising. Yet given local and regional competition for well-paying patients, Dr. Cooke knows that she must develop her own strategy to ensure that her practice can survive and thrive into the future. The practice's prosperity is important to Dr. Cooke, and she is continually looking for ways to grow her practice's business. Dr. Cooke, who also has a bachelor's degree 1n business, is a problem solver by nature. In considering the new trends in the aesthetic surgery area, Dr. Cooke senses that she has a choice to make. Abdominoplasty (tummy tuck) is the most popular form of surgery that she performs. After surgery, the patient often has trouble with activities Such as moving from a sitting to a standing position, walking, and caring for the postoperative drains. Dr. Cooke has often thought it would be nice to have a 24~hour care alternative for postoperative patients. One particularly intriguing         One particularly intriguing option is to develop a "hideaway" for her aesthetic surgery clients where they can relax and recover after their procedures. She knows that her patients desire complete confidentiality at all times, and that they also want a high degree of professional and personal attention-before, during, and after the procedures. Creating a hideaway would allow Dr. Cooke to provide top-notch medical care in a spalike atmosphere, and enable her staff to offer professional and personal attention to the healing patients during the days following surgery. Further, given her knowledge of the important connections between individuals' minds and their bodies, she is certain that a relaxing atmosphere would enhance the healing process while offering a safe place for her demanding clientele to recover. Moreover, there is no facility in the Cleveland area, and she feels that this would definitely give her practice an edge over other practices. She also feels that her building’s scenic locale would be perfect for this type of postoperative hideaway. While Dr. Cooke suspects that this hideaway concept would have considerable appeal to her well-heeled patients, she knows that potential patients are not the only individuals she would need to consider in developing a new approach for her North City Practice. When she shared her idea with Dr. Thomas, he was less than enthusiastic. Dr. Thomas reminded her that they were surgeons, not innkeepers. He noted that the overhead cost associated with such a practice change would be high, and he was particularly worried about management of the facility. Dr. Thomas also brought up the issue of insurance liability. Then he mentioned that he had heard that St. Clare’s another community hospital, was also looking opening a similar type of facility not too far away. Dr. Cooke, discouraged, yet not defeated, understands Dr. Thomas’s concerns. As the lease is soon up on the building for her current practice, Dr. Cooke knows she will need to make any decision about changing the direction of her practice quickly so that she can take action. The possibility of a facility opening at St. Clare’s motivates Dr. Cooke to further investigate her idea. She believes the wooded lot with lake views that her practice occupies would be an ideal location for a recovery retreat. And she feels that Dr. Thomas’s male patients would also benefit from a discreet hideaway to recover.

Question: Please answer them all.

A. What are the pros and cons of changing the focus of Dr. Cooke’s practice?

B. What would you predict would be the reactions of the various stakeholders to Dr. Cooke’s new business concept (e.g., patients, referring physicians, Northside Community Hospital, her professional colleagues)?

C. What would you recommend for Dr. Cooke?