Brilliant Concepts That Fail
Two months ago, if a patient needed general anaesthesia, I could have booked a session with Day Surgery International at Paragon, called my anaesthetist and had the surgery completed without much waiting. Besides that, the facility fees at the day surgery centre were much lower than that at the hospitals. Surgeons and patients could have benefited from the lower costs and convenience. For a moment, it seemed that the couple who came up with the brilliant concept were on their way to buying up their very own private island in the Bahamas. Except that business wasn’t brisk for almost 2 years.
Late last month, it was reported in the news that the day surgery centre at Paragon has folded along with the other centre at Camden. The failure of the centres was attributed to high operating costs, slow business and the relative novelty of facilities devoted to day surgery. Most of the procedures the centres offered are normally handled in hospitals and doctors were slow to refer patients. Even good ideas may not work out when put into practice. Why? Let’s begin with me.
I have my own clinic and I’m already paying rental for it. If I have a surgery, I would certainly prefer to do it under sedation in my own clinic. In the case of children who must undergo general anaesthesia, I may have no choice but to use the day surgery. Apart from these rare cases, I wouldn’t need the facilities at the day surgery.
What about surgeons who routinely operate with their patients under GA? For the minor surgeries, they can certainly consider using the day surgery centre, but many patients who need surgery under GA happen to be cases serious enough to require hospitalisation post-op. The day surgery would not be suitable in these cases. If we trim all these cases down, the percentage of each surgeon’s patients suitable for treatment at the day surgery centre may actually be quite low. What seemed like a good idea initially turns out to be not so hot when one goes into the details.
I remember that not too long ago, another doctor has the brilliant idea of bringing medical specialists into the heartlands for the convenience of heartlanders. A polyclinic of sorts was set up. Instead of GPs, specialists like endocrinologists, cardiologists, ENT surgeons, onchologists, orthopaedic surgeons …. waited to see patients who not only knew exactly what was wrong with them but also knew which specialist they ought to see. It was like a consortium of medical specialists sitting in a neighbourhood mall, waiting for patients who knew who to see to pop in.
The originator of this concept assumed that heartlanders are well-educated enough to be able to walk directly into the correct specialist’s office and get treated. The centre recruited an impressive “menu” of specialists. Many people who passed by the neighbourhood mall and read the menu were very impressed. They were equally lost.
“Got stomachache see who huh?”
The receptionists may be able to get him into the right consultation room, but can the ailment not be easily and quickly treated at the much more user-friendly GP clinic downstairs? Traditionally, specialists get their cases through GP referrals. Successful specialists often have a very good rapport with GPs. Yet recently, more and more specialists have been trying to get walk-in patients direct from the streets. Some have been very successful. Apparently some wannabe thought of skipping the “middleman” too. Sounds good to the specialists, sounds good to the patient, but when the latter needs a doctor, he is almost certain to start off with a primary healthcare provider. The only exceptions could be gynaecologists and paediatricians.
Not surprisingly, that consortium of specialists failed miserably. There are many lessons to be learnt from others’ mistakes. It’s better than to make them yourself. In these difficult times, I need to keep reminding myself not to get too ambitious and carried away by another “brilliant concept”. Between success and failure, it’s not too bad to just stay put until the storm is over and directions are clearer.
