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Enhancing Eye Care in a Rural Community

The Eye Care Center’s Journey to Office-Based Surgery

Since 1973, The Eye Care Center has provided rewarding, convenient, and stress-free eye care. Office-based surgery is a natural fit for their philosophy. The center is located in Canandaigua, NY, and provides accessible eye care in a rural community. The surgical team at The Eye Care Center includes Holly Hindman, MD, and Sungjun Hwang, MD, cataract surgeons; Anna Rothstein MD, oculoplastic surgeon; and Heidi Piper, MD; who performs cataract and retinal surgeries.

Transition to Office-Based Surgery

The Eye Care Center transitioned from the local hospital outpatient surgery department (HOPD) to office-based surgery (OBS) in March 2022. Several factors motivated this transition, including greater access to care, enhanced patient experience, increased efficiency, and more surgeon control. Find out their results and why Dr. Hindman believes this shift was the most impactful change in her career.

Improved Access in a Rural Community

Canandaigua is a small city with surrounding rural areas in upstate New York. There is more limited access to ambulatory surgery centers (ASCs) and HOPDs. The neighboring HOPD performed cataract and oculoplastic cases before transitioning to OBS. This hospital had a staff shortage that limited surgery opportunities. Patients were sometimes traveling upwards of two hours in each direction to have surgery in another city. Since launching their iOR Suite, the surgeons have complete control over their schedule and can provide more access and convenience to their patients.

Enhanced Patient Experience

The familiarity of the office setting provides a seamless and relaxed surgical experience for patients. They have already established a relationship with the practice staff and feel more at ease on surgery day. Compared to the HOPD, patients benefit from shorter surgical time (1 hour vs. 3 hours), reduced anxiety, and lower costs.

The Eye Care Center uses oral anesthesia instead of IV sedation. This is in comparison to the hospital’s use of IV sedation. Patients prefer lower anesthesia and compare it to the level experienced at a dental office. This also results in a shorter recovery time and does not require fasting before surgery.

Physician-Run & Controlled

Being physician-run and controlled was identified as a critical benefit of OBS, allowing The Eye Care Center to have complete autonomy over their surgical practice, financially and operationally.

  • Financial – OBS provides an additional revenue stream. Physicians are reimbursed for practice expenses. In addition, physicians can choose the supplies and equipment that make them more efficient and reduce the cost-per-case.
  • Culture – With the OBS environment, the physician team has created a culture of positivity, empowerment, and efficiency. Integrating clinic and surgery offers them the flexibility for a four-day workweek, with an extra day to tie up loose ends before the weekend. If a surgeon is out sick, a physician partner can help instead of canceling appointments. In addition, their clinic staff has developed a new skill set with more growth opportunities. These staff members have a sense of ownership over the process and greater job satisfaction.
  • Continuity of Care – the OBS model enabled the surgeons to be involved in the entire surgical process, facilitating continuous quality improvement in workflows and outcomes. “We’re closer to the work and the patient experiences so that we can provide continuous quality improvement to workflows and outcomes. There is no administrative layering. Our patients, or staff, and our surgeons directly experience the benefits of this practice model,” said Dr. Hindman.

Making the Transition with Logical Ease

The Eye Care Center worked with iOR Partners to ensure a seamless transition to office-based surgery-from build-out and staff training to accreditation, materials management, and billing support.The surgeons were surprised at how quickly they improved efficiency in their OBS as compared to an outpatient facility.

“iOR was extremely helpful with building out the space, providing instruments and equipment, sharing training details, and getting everything up and running. We can’t imagine doing all that ourselves, especially the accreditation component,” said Dr. Rothstein.

“Converting to OBS was surprisingly easier than we thought. iOR provided all the guardrails and structure we needed to make the transition successfully, and they were available to answer our questions along every step of the journey. We were a little nervous through our third patient case, but after that, there was no looking back,” said Dr. Hindman.


The Eye Care Center’s transition to office-based surgery has yielded numerous benefits for surgeons, staff, and patients. The OBS model has provided greater control over the surgical schedule, improved access to surgeries in rural areas, enhanced the surgical experience for patients, and empowered surgeons with autonomy and flexibility. With ongoing support from iOR Partners, The Eye Care Center successfully navigated the transition and now enjoys the advantages of an efficient and patient-centered office-based surgical suite. Please contact us if your rural community could benefit from office-based surgery.