Well, we all do it. Some more than others; some do it all the time, others, just a few times per month. After awhile, you want to do it all the time – and that is when you open yourself up for disappointment.

Times were when you first outsourced it was probably housekeeping, laundry, maybe Human Resource or some other essential service that you just didn’t want to deal with internally or it was too expensive to do it yourself.

Now? What don’t you outsource?

Billing, management, IT, contracting, credentialing, patient registration, web-site, social media, forms, anesthesia, medical records consultant, pharmacy, EMR, staffing, linen, gas sterilization, infection control consultants, housekeeping, custom packs, and many others are doing the job most of us used to do internally. Is it getting that complicated? I don’t know. Everything lately seems to take too long or cost too much or just plain not available.

Should you bring all these services back “In-house” again? Billing seems way too complex now – I know many facilities that do it in house but they seem to struggle with it. Anesthesia is practically impossible to make a profit or even break by hiring your own staff. Who wants the smell of detergent in the place or wants to spend valuable staff time reviewing medical records?

We have become so addicted to others doing what we cannot or don’t want to do it might be tough bringing it back in-house. But what does all this cost? What are we paying to have someone check a patients insurance deductible and out of pocket obligation.

Earnhart & Associates is a consulting firm specializing in all aspects of outpatient surgery development and management.