David Mittleman, MD's practice has been at the forefront of technology and patient care for 26 years. He recognized early on that ophthalmic office-based surgery (OBS) was the answer to his frustrations with the ASC where there was a complicated scheduling process that often caused patients to forego surgery altogether. He had no flexibility or control over his surgical practice, leading to the implementation of two iOR Suites in 2021. Now he can increase patient volume without restrictions, and he gives all the credit to OBS.  

Ophthalmic Office-Based Surgery Has Changed My Experience Dramatically 

I wasn’t in control of my schedule or surgical volume at the hospital or ASC. With my OBS, we operate Monday through Thursday, and usually see 30 patients per day in two surgical suites. I’m no longer dealing with eight other surgeons from eight other offices vying for time and equipment in the ASC. With OBS, I get to decide whether I want a ZEISS microscope or an Alcon lens. There are no committees making those decisions for me, and no waiting for equipment months on end. Instead, I choose my own equipment and work with my staff who is trained to my standards. And since there’s no traveling to the ASC, I can see other patients after surgery.  

The Efficiency of Office-Based Surgery Increases Surgical Volume and Revenue 

Hugh Glatts, Mittleman Eye CEO, says, “The math was simple when we were considering OBS. If you’re seeing more patients and performing more surgeries, you’ll obviously increase volume and surgical revenue. I always thought the practice was limited by the number of patients needing cataract surgery, when in fact it was limited by the capacity the ASC had available. What’s more, our healthy patients often had to have bloodwork, chest x-rays, and EKGs for a simple seven-minute procedure.” 

“Within a month of launch, we were performing significantly more surgeries than we ever did in the ASC and all reimbursements were staying in the practice. I study every surgery every day for efficiency purposes, and because OBS utilizes oral sedation, surgery is more efficient, and recovery time is faster.” 

Ophthalmic Office-Based Surgery Has Changed My Staff’s Experience Dramatically  

We have a tremendous team, and OBS has given them all a chance to shine. OBS has unlocked their full potential, and in doing so, they’ve become more valuable to the practice. They’re more engaged with the patients and eager to take on additional responsibilities. They help make critical decisions to improve surgery and efficiency, and their income potential and career advancement has increased. It’s a win/win for me and my staff. 

When there are communication barriers, my staff arranges to have a translator in the operating room. Oftentimes it’s a family member. You simply can’t do that in the ASC. It makes the patient less anxious, and we’re able to accommodate a much broader patient population. 

Our Experience with iOR Partners Made Such a Dramatic Difference 

iOR has set the industry standard for OBS, and it’s a high bar. They helped us plan and redesign our existing space to accommodate two surgical suites, then trained our staff, provided billing support, scheduling expertise, patient prep, and equipment trouble shooting. We would have fumbled with those things. They simply aren’t our expertise.  

With iOR by our side, we didn’t have to worry about accreditation or compliance either. And on the backend, they took care of pre-verification for every surgery to determine in-network benefits vs. out-of-network benefits. That said, the out-of-network benefits we’ve received have greatly exceeded our expectations. What’s more, they automated our billing process so that all medical records and op reports are totally digital. The entire process was seamless start to launch.  

Now that we’ve launched, they manage inventory and supplies too. We’ve never been surprised that something is missing during surgery. iOR’s just-in-time inventory system sends us everything we need exactly when we need it.  

To summarize, OBS is good for patients, good for surgeons, good for staff, and good for business. We’ve performed over 3,700 in-office surgeries with no complications. In that time, I’ve found OBS to be as safe or safer than surgery in the ASC.  

We’ve also increased surgical volume and revenue markedly, and we’re certain that trend will continue. Working alongside our own clinical staff is so rewarding, and the scheduling experience for surgeons and patients is so much less complicated than the ASC. I give OBS a huge thumbs up. It’s changed the direction of my practice for the best, and I’d encourage other ophthalmologists to take the leap now. When you own the OR, you own your experience and the patient experience. You can’t ask for anything more than that.