'Community-Responsive' Practice Building in Plastic Surgery: Implementing Business Development Tools and Outreach

Background: Most inner-city hospitals are isolated from the socioeconomically backward communities that surround them. Other than providing emergent healthcare, they do little to help the community improve. Despite commonly being the respective area's biggest business, our hospitals resemble islands, sequestered from the blight and frankly unaware of their communities' most pressing needs. 

Methods: Using "community-responsiveness" as our chief guiding principle, a new Plastic Surgery practice was created at The Ohio State University- East Hospital, located on the east-side of Columbus, Ohio (demographically >70% black, high rates of disability/unemployment and crime). A 3-step plan was initiated: 1) community-needs assessment, 2) business-level strategic planning, 3) implementation via community-outreach, service alignment and delivery. 

Results: The needs-assessment provided clear understanding of our community's most immediate and unmet clinical needs, market-size, market-segmentation data, sociocultural behavior patterns, and economic descriptors (service-delivery-vehicles, cost-differentiators and scalability). Programs were launched that served as local and regional centers for complex reconstruction of the 3 most common, unmet, clinical problems: hidradenitis suppurativa, traumatic/diabetic limb reconstruction/salvage, and decubitus ulcer management. Services-marketing was implemented via meetings with local providers, hospital-based community healthcare programs, and most importantly, through health-science exhibitions at local schools. Relevant internal service providers were aligned to create comprehensive, multidisciplinary care-teams for effective delivery. New year-to-date and year-year revenues grew by 68%, contribution margin increased by 78%, patient satisfaction scores peaked at 100%, and numbers of new patients increased significantly.

Conclusions: Combining principles of business development with community engagement, one can create a vibrant bond between healthcare providers, their patients, and the surrounding community. Here, we also describe a novel "community-stewardship" practice model that can be implemented by both new trainees and senior surgeons alike.