Imagine that you are the director for an ambulatory surgery center (ASC). Your ASC has historically performed well and it is a recognized leader in patient safety and has outperformed the vast majority of local ASCs on publicly reported quality, patient safety, and patient satisfaction measures. Competing ASCs are planning to expand their operations due to a growing demand for geriatric cases. There has been less demand for pediatric cases in the past 2 years.
Your chief pediatric surgeon approaches you with an idea to purchase a new surgical robot, which suggests that it can improve quality by reducing the size of a required incision, reducing post-op complications, and thereby expediting recovery. The robot, recently approved by the FDA, has wide-ranging applicability to your current cases. No other ASC is currently engaged in discussions with the vendor to purchase the new robot. Unfortunately, third-party payers will not reimburse for the additional consumables required by the robot. Furthermore, your team of surgical pediatricians are not currently certified to perform procedures with the robot. Certification requires completing three 1-hour training sessions and the completion of 20 successful cases under the oversight of a certified surgeon. How would you respond to the chief pediatric surgeon’s request?
To successfully complete this assignment, consider the following as you write a succinct email or letter back to the chief pediatric surgeon stating your recommended decision and/or seeking more information:
- What is your role as the director for the ASC in making the decision?
- What are the significant pieces of information you would need to consider in deciding to purchase the robot?
- What are the capital requirements for a purchase of this magnitude?
- How will the purchase of the robot be financed (i.e., from debt or equity)?
- Would a lease through the vendor or a third party be an option?
Be sure to incorporate your considerations and justifications weighing the pros and cons. Remember, there are many ways to arrive at this decision and you can bring in make-believe, relevant, and/or real considerations beyond the context presented in this case. Also, consider the feasibility of an immediate purchase versus one made at a later time. There is no one correct answer. Rather, establish your reasoning for your decision.
Length: 1-3 pages, not including the reference page
References: Include a minimum of 3 scholarly resources.
Dear Chief Pediatric Surgeon,
Thank you for bringing the potential purchase of a surgical robot to my attention. As the director of our ambulatory surgery center (ASC), it is my responsibility to evaluate the feasibility of this investment and make a well-informed decision that aligns with our organizational goals and priorities.
To evaluate the purchase of a surgical robot, we must consider several significant pieces of information, including the potential benefits to our patients and organization, the capital requirements, and the feasibility of financing options. The potential benefits of the surgical robot are promising, such as reducing incision size, reducing post-op complications, and expediting recovery. However, we must weigh these benefits against the costs, including the additional consumables required, the cost of training our surgical pediatricians to perform procedures with the robot, and the capital requirements.
The capital requirements for this purchase will be substantial and may require us to seek financing through debt or equity. Before making any decision, we will need to evaluate our current financial position and consider the potential impact of taking on additional debt or diluting equity. Moreover, we must evaluate other financing options such as leasing through the vendor or a third party. Leasing may provide us with an option for immediate access to the robot while reducing our upfront capital requirements.
In addition to the financial considerations, we must also evaluate the feasibility of an immediate purchase versus one made at a later time. Currently, there is less demand for pediatric cases, and we may be better served by delaying the purchase until there is a greater need for the robot’s capabilities.
Based on these considerations, I recommend that we postpone the purchase of the surgical robot at this time. Although the potential benefits are compelling, the current demand for pediatric cases does not warrant the significant capital outlay required for the purchase. Additionally, we should consider focusing our attention on other investments that may yield greater returns for our organization.
Thank you for bringing this opportunity to my attention, and I appreciate your ongoing commitment to our patients and organization.
- Berman, R., & Matsumoto, E. D. (2018). Future of robotics in surgery. The Journal of surgical research, 235, 171-177.
- Hutfless, S. M., & Maruthappu, M. (2020). The role of surgical robots in current surgical practice. Journal of surgical oncology, 121(4), 573-576.
- Zheng, Y., Li, M., & Ma, X. (2019). The clinical application of surgical robots in pediatrics. Pediatric surgery international, 35(9), 971-978.