Impact of Satellite Practices on Academic Ophthalmology Departments
15 September 2016
27 March 2017
16 May 2017 (online)
Background A recent small study described how “satellite” clinics (off-site and strategically situated) associated with six academic ophthalmology departments provided expansion opportunities, and also created unique challenges.
Objectives The aim of this study was to gather a wider viewpoint by surveying chairpersons about their opinions of satellite practices, and how these relate to their departmental mission.
Research Design Online survey.
Subjects Chairperson members of the Association of University Professors of Ophthalmology.
Results More than 60% of respondents had satellite practices affiliated with their departments. Most departments had two to five satellite practices; 33% had satellites that were located further than 50 miles away from the main hospital. On average, satellites accounted for 25 to 30% of total patient visits for the department. Departments whose satellites accounted for 50% or more of total patient visits to the department were those with the largest clinical volumes (>100,000 annual patient visits). Comprehensive ophthalmology was the most common service offered at satellites. All Chairs believed satellite practices had at least maintained, if not improved, their departments' reputation. Seventy percent were concerned about perceived competition with referring community doctors. Research endeavors and trainee education were not considered to be priorities of satellite practices.
Conclusion Overall, chairpersons in the United States believed that satellite practices had strengthened their departments. The geographical expansion of departments, particularly with comprehensive ophthalmology (inclusive of optometric services), has implications for relations with the referral base in the surrounding communities. Thoughtful management of these practices, with attention paid to both meeting financial goals as well as fulfilling the academic mission, is necessary to ensure that the advantages outweigh the drawbacks.
- 1 Kuo IC. Satellite clinics in academic ophthalmology programs: an exploratory study of successes and challenges. BMC Ophthalmol 2013; 13: 79
- 2 Helzner J. Major eye centers in expansion mode: should independent practices in their orbit be concerned? Ophthalmology Management. February 2011:55–58. Available at: http://www.ophmanagement.com/article.aspx?article=105236 . Accessed October 21, 2011
- 3 Bentley JD, Chusid J, D'Antuono GR, Kelly JV, Tower DB. Faculty practice plans: the organization and characteristics of academic medical practice. Acad Med 1991; 66 (08) 433-439
- 4 Hamm J, Hilliard L, Howard T, Lebensburger J. Maintaining high level of care at satellite sickle cell clinics. J Health Care Poor Underserved 2016; 27 (01) 280-292
- 5 Ecklund K, Share JC. Extension of academic pediatric radiology to the community setting: experience in two sites. Pediatr Radiol 2000; 30 (01) 3-6
- 6 Coran AG, Blackman PM, Sikina C. , et al. Specialty networking in pediatric surgery: a paradigm for the future of academic surgery. Ann Surg 1999; 230 (03) 331-337 , discussion 337–339
- 7 Stein D, Chen C, Ackerly DC. Disruptive innovation in academic medical centers: balancing accountable and academic care. Acad Med 2015; 90 (05) 594-598
- 8 Berkowitz SA, Miller ED. Accountable care at academic medical centers--lessons from Johns Hopkins. N Engl J Med 2011; 364 (07) e12
- 9 Barzansky B, Kenagy G. The full-time clinical faculty: what goes around, comes around. Acad Med 2010; 85 (02) 260-265
- 10 Bucklin BA, Valley M, Welch C, Tran ZV, Lowenstein SR. Predictors of early faculty attrition at one Academic Medical Center. BMC Med Educ 2014; 14 (01) 27
- 11 Thomas PA, Diener-West M, Canto MI, Martin DR, Post WS, Streiff MB. Results of an academic promotion and career path survey of faculty at the Johns Hopkins University School of Medicine. Acad Med 2004; 79 (03) 258-264
- 12 Durso SC, Christmas C, Kravet SJ, Parsons G, Wright SM. Implications of academic medicine's failure to recognize clinical excellence. Clin Med Res 2009; 7 (04) 127-133
- 13 Fox BI, McDonough SL, McConatha BJ, Marlowe KF. Establishing and maintaining a satellite campus connected by synchronous video conferencing. Am J Pharm Educ 2011; 75 (05) 91
- 14 Flint L, Flint CB. Academic surgical group practices at the dawn of health reform. Ann Surg 1994; 220 (03) 374-378 , discussion 378–381
- 15 Bloom M, Markovitz S, Silverman S, Yost C. Ten trends transforming cancer care and their effects on space planning for academic medical centers. HERD 2015; 8 (02) 85-94
- 16 DiSesa VJ, Kaiser LR. What's in a name? The necessary transformation of the academic medical center in the era of population health and accountable care. Acad Med 2015; 90 (07) 842-845
- 17 Kahn MJ, Maurer R, Wartman SA, Sachs BP. A case for change: disruption in academic medicine. Acad Med 2014; 89 (09) 1216-1219
- 18 Wartman SA. Toward a virtuous cycle: the changing face of academic health centers. Acad Med 2008; 83 (09) 797-799
- 19 Huddle TS, Heudebert GR. Internal medicine training in the 21st century. Acad Med 2008; 83 (10) 910-915
- 20 Arora V, Guardiano S, Donaldson D, Storch I, Hemstreet P. Closing the gap between internal medicine training and practice: Recommendations from recent graduates. Am J Med 2005; 118 (06) 680-685 , discussion 685–687
- 21 Whitcomb ME, Cohen JJ. The future of primary care medicine. N Engl J Med 2004; 351 (07) 710-712
- 22 Gruppen LD, Wisdom K, Anderson DS, Woolliscroft JO. Assessing the consistency and educational benefits of students' clinical experiences during an ambulatory care internal medicine rotation. Acad Med 1993; 68 (09) 674-680
- 23 Mandel HG. ; The National Caucus of Basic Biomedical Science Chairs. Downsizing of basic science departments in U. S. medical schools: perceptions of their chairs. Acad Med 1997; 72 (10) 894-900
- 24 Souba W, Notestine M, Way D, Lucey C, Yu L, Sedmak D. Do deans and teaching hospital CEOs agree on what it takes to be a successful clinical department chair?. Acad Med 2011; 86 (08) 974-981
- 25 Peterson LE, Blackburn B, Phillips Jr RL, Mainous III AG. Family medicine department Chairs' opinions regarding scope of practice. Acad Med 2015; 90 (12) 1691-1697
- 26 Hemmer PA, Alper EJ, Wong RY. Participation of internal medicine department chairs in the internal medicine clerkship--results of a national survey. Acad Med 2005; 80 (05) 479-483