Ophthalmic Consultants of Boston and Dr. Bradford J. Shingleton (2004)
Dr. Bradford Shingleton has developed some of the highest quality eye surgery techniques in the industry. He involves his nurses and technicians in creating a surgical service that is constantly improving. The case has many details about how Dr. Shingleton works with his staff and patients, and how the provider team focuses on patient care. A key measure of productivity for the surgery center is the time required in the operating room. Shingleton's numbers are impressive as they decrease each year. The business context relates to the particular patients, mostly require cataract or glaucoma surgery and the payer is Medicare/Medicaid, which regulates the price. Yearly decreasing prices make it more difficult for doctors to earn a good income unless they improve their productivity. Other surgeons in the practice do not copy Dr. Shingleton's practices nor use his trained surgical team. The dilemma relates to why his methods do not spread to other doctors and other clinics.