To cut costs and maintain good patient services, Czajkowski said, his practice recently eliminated corneal transplants because reimbursement is below costs.
"We have to make patients feel you are spending more than adequate time with them, but we have relegated some of the dialogue to assistants," he said.
Over the next several years, Edwards said, the decline in professional fees for physicians will result in consolidation of some surgery centers.
"Our department has been growing, and more private doctors will join ambulatory care centers as a way to cover their overhead and pay for the new technology that is coming out every year, (much) of which is not being covered by insurance," Edwards said. "We have to be as efficient as we can to keep our costs down for patients."
At the Livonia Outpatient Surgery Center, Nate Kleinfeldt, M.D., co-owner with Saad Ahmad, M.D., said business is booming in cataract surgery because of the aging senior population.
Kleinfeldt also owns the Coburn-Kleinfeldt Eye Clinic, which has offices in Livonia and Dearborn and the recently opened a Warren clinic. The practice has six ophthalmologists and conducts about 2,600 cataract surgeries a year.
While reimbursement has declined the past several years, Kleinfeldt said his clinic has increased patient volume an average of 10 percent from referrals.
"All we do every day is eyes," he said. "It takes us 10 minutes to do a core cataract. Any hospital, in general, takes 20 minutes."
Kleinfeldt said patients can expect to have their cataract operations completed in less than an hour, compared with three hours at a typical hospital.
"We have a surgery center not to just do surgeries faster, but better," he said.