Satellite clinics in academic ophthalmology programs: An exploratory study of successes and challenges

Background: Major academic ophthalmology departments have been expanding by opening multi-office locations (satellites). This paper offers a first glimpse into satellites of academic ophthalmology departments. Methods. Leaders of seven medium to large, geographically diverse departments agreed to participate. One- to two-hour phone interviews were conducted to assess the features of their satellite practices. Results: Success as clinical entities, profitability, and access to patients were stated goals for most satellites. In approximate descending order, refractive surgery, retina, oculoplastics, and pediatric ophthalmology were the most common subspecialties offered. Faculty staffing ranged from recruitment specifically for satellites to rotation of existing faculty. Except for a department with only one academic track, satellite doctors were a mix of tenure and mostly non-tenure track faculty. According to these department leaders, scholarly productivity of satellite faculty was similar to that of colleagues at the main campus, though research was more community-based and clinical in nature. Fellowship but little resident education occurred at satellites. Though it was agreed that satellite practices were integral to department finances, they accounted for a smaller percentage of revenues than of total departmental visits. Conclusions: Satellite offices have offered access to a better payor mix and have boosted the finances of academic ophthalmology departments. Challenges include maintaining collegiality with referring community physicians, integrating faculty despite geographic distance, preserving the departments academic brand name, and ensuring consistent standards and operating procedures. Satellite clinics will likely help departments meet some of the challenges of health care reform.