Desert Orthopaedic Center: Michael Pendleton, CEO

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In 1970, two Las Vegas doctors decided to join their efforts and specialize in care for the musculoskeletal system. Since that time, the Desert Orthopaedic Center (DOC) has become the largest group in the area caring for bones, joints, muscles ligaments, tendons and nerves. DOC has 16 partner and 2 associate physicians, as well as about 140 full time employees. Each physician specializes in an area of orthopaedics such as sports medicine, joint replacement, arthroscopic knee and shoulder repair, scoliosis, and foot and ankle reconstruction or repair. The group works out of three Las Vegas area facilities.

Making the DOC Team

DOC physicians are recruited after a high level of scrutiny. It is important to the group that new members emphasize a cost-efficient approach to medicine and lean toward conservative treatment options first rather than pushing each patient immediately towards surgery. The organization maintains a very high retention rate. In the fourteen and a half years that Michael Pendleton, CEO, has been with the organization, only three physicians have left the group, and two of those departed on very amicable terms in order to pursue once-in-a-lifetime opportunities that they were highly passionate about.

Organizational meetings are run so that every doctor has a voice. There is a strong emphasis on good for the group, but the leaders also work to make sure all physicians maintain a feeling of involvement and ownership in the direction being taken. “When it’s all said and done, every physician has had an opportunity to discuss his thoughts and concerns,” says Pendleton. “Over 90% of the time, a decision made is a unanimous one.”

There is longevity in the DOC staff, as well. “Our physicians recognize that each employee is a valuable resource, so they treat the employees very well with a good salary, great benefit programs, and respect in their interactions,” says Pendleton. Not only is it important that each employee be assigned a task, but also they work to make sure each employee is given the tools and equipment necessary to succeed at that task. Whether it is in training, technology, or simply by providing more support, “we emphasize satisfaction on an employee level,” Pendleton says.

State of the Art Imaging

Another attraction for DOC physicians is the medical imaging system, which was upgraded from film to digital imaging in 2005. “It was a huge step ahead for this community at the time we were transitioning to doing computed radiography and PACS,” says DOC’s PACS System Administrator, Brien Vokits. “It’s made a significant impact on where we are going clinically and on our delivery of care.”

“Five years ago I would have said that radiology was a bottleneck within our practice. We’d have the radiology wait room packed and we couldn’t process the films fast enough with the throughput we were being asked to handle,” says Pendleton. DOC physicians now list radiology as one of the best parts of the system. “It has certainly made the physicians more efficient,” he says.

The benefits of the electronic imaging system are above and beyond what the group had anticipated. They have better, more flexible imaging available that can be completed at a more rapid pace than before. “I expected a lot of our physicians to have their staff do [the training to use the new system], but what I found was that our physicians took ownership. They grasped it and had both arms around it and were excited to have that tool in their hands,” says Pendleton.

Once they factored in the cost of the new system versus the cost of maintaining the old film system, convincing the group to spend those capital dollars wasn’t a problem. The old system needed constant maintenance and repair; two of the units needed to be replaced completely. Add to that the continual expense of chemicals and film and the transformation to a computer imaging system was an easy sell.

How about all that space that was being used to process and store films? “We turned it over to revenue generating space,” says Vokits.

Another benefit has become apparent, as well. “When you take into account that one of the top issues for orthopaedics in practice is missed fractures … because of the quality of images they are getting and can manipulate [our physicians] are minimizing their risk on the malpractice side,” says Pendleton. “That was another factor we hadn’t actually put a value on, but in the long run I am convinced it has been a benefit.”

A Culture of Service

From the beginning, DOC physicians have emphasized customer service. No new patient will ever need to wait more than 24 hours. Access to a physician is a priority, and new patients are always seen by medical doctors, though physician assistants do help with follow-up care.

The three DOC facilities, all built within the past six years, were designed with patient comfort and confidentiality in mind. “We spent a lot of money designing an environment that protects our patients’ information,” says Pendleton. Even the workspace for the front desk staff was designed to provide soundproofing ability, so that a patient can share confidential information during registration without everybody in the lobby hearing it.

Computers in the exam rooms allow physicians to pull up PACS, as well as patient information, and each computer terminal was built in to each exam room with security issues in mind. Even the most curious patient or computer savvy child won’t be able gain access to private documents or information stored in the center’s servers.

Serving Cost Conscious Patients

Pendleton says that one of the biggest changes he has seen in the past couple of decades is in the approach of the consumer. “We used to think of orthopaedics or maybe medicine in general, as more or less recession proof,” he says. “But we are seeing a change that is directly related to the economy. There is an overall pessimistic approach and flat-out fear that these people are facing regarding the economy.”

“We have to look at opportunities to control our cost,” says Pendleton. “I would say that it’s a good thing. I think shaking things up a bit is healthy. We’ve always looked at our cost; you can’t work for physicians and not be cost-conscious, but I think this turn in consumer consciousness makes us more aware. As an organization, we have to re-emphasize customer service and make sure that we are giving our patients and our referral sources a good experience.”

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