Table 2.

Summary of similarities and differences amongst six ophthalmology departments with satellite offices (number of departments)

Similarities amongst majority of programs	Differences amongst programs
Suburban location of satellites (6)	Number of satellites relative to size of the department (as measured by clinical encounters)
“Patients do not want to travel as far as they used to in order to see their doctor at the medical center.”
Lease rather than purchase space for satellite offices (6)	Satellites developed de novo vs. acquired (e.g., department buys community practices)
Satellites led by clinician or clinician-educator (5):	Type of doctors at satellites:
“Time carved out for administration detracts from research and clinic”	- hiring specifically for satellites (doctors with “private practitioner” mentality) vs.
“We need people who can build a practice, clinicians who can provide good consultations”	- rotating existing faculty members vs.
“They have to be responsive to referring doctors’ needs”	- hiring by a subspecialty division then rotating faculty to satellites
Satellites staffed predominantly by junior faculty (5)	Senior doctors at satellites closer to medical center
	Academic rank of faculty members at satellites
Type of specialties offered in approximate descending order (6): refractive surgery, retina, oculoplastics, pediatric ophthalmology, cornea, glaucoma	Decision to offer comprehensive ophthalmology at satellites; to have optometrists at satellites
Revenue/visit is less at satellites than for over all department (5)	Some departments have “hub and spoke” model (surgical and/or more difficult cases are shunted from satellite to main medical center)
Better payor mix at satellites (6)
Concern about integrating faculty members, maintaining cohesive group of faculty (4)	Concern about mentorship
Perceived strain with community ophthalmologists (4)	Providing consultation to community doctors vs. competing directly with them (by offering “general ophthalmology” at satellites, for example)
Lower staff/patient ratio at satellites compared to main medical center (4)
Teaching of fellows, not residents, at satellites; no resident clinic at satellites (5)	Types of research/scholarly pursuits
	-success in “clinical research and community-based research projects.”
	-“Research coordinators can conduct clinical trials. We want to make [satellite doctors and staff] part of the overall academic mission.”
	-“Every faculty member has to be plugged into teaching.” Even full-time satellite faculty have to teach at the main hospital
Financial potential or constraints are most important determinants in opening or closing a satellite; financial benchmarks (6):	Concern about preserving academic “brand” as open more satellites
	Patient satisfaction, physician/staff performance, infection control, tracking surgical complications
“A satellite is a total business decision”
Increase in number of visits to eye department at main hospital as a result of satellites (3)