3 experts tackle 2 questions: Is it harder to recruit surgeons to ASCs today? Why do physicians take cases elsewhere?

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Three leaders in the ASC industry weighed in on two important business questions at the Becker's ASC 23rd Annual Meeting: The Business and Operations of ASCs in Chicago on Oct. 27.

Jeffrey Peo, chief development officer with Hanover, Mass.-based Ambulatory Surgical Centers of America; Amanda Sosnosky, administrator with Green Bay, Wis.-based Bellin Orthopedic Surgery Center; and Stephen Rosenbaum, CEO of Atlanta-based Interventional Management Services, shared their insights and observations on strategies for ASCs to add surgeons and cases.

Holly Carnell, attorney with McGuireWoods, moderated the discussion and posed two questions specifically to the panel: Is surgeon recruitment tougher today and why do physicians often take cases away from a center? Read on to see what the experts had to say.

Is it harder today than it has been historically to recruit good surgeons to ASCs?

"We're getting to a saturation point right now with ASCs where a lot of free surgeons in the community are tied up with surgery centers," said Mr. Peo. "You can have surgeons with multiple centers, but you'll find that whittles their value to you."

A few factors are contributing to this competitive environment, including high-deductible health plans. This type of plan drives physicians' volumes down, since more people put off elective surgeries. As the pool of eligible surgeons tightens, Mr. Peo said more centers now offer ownership opportunities to young physicians at an earlier time than in the past. "Before, [ASCs used to] wait to see their volume and for physicians to show they could do cases," he said.

Ms. Sosnosky faces her own recruitment challenges in Green Bay. "The single specialty orthopedic practice is a joint venture with Green Bay-based Bellin Health System and an independent orthopedic practice. "One of our challenges is our doctors all have to travel rurally," she said. "They are expected to travel 30-50 miles from the main surgery center base, and we have surgeons approaching 3 to 4 hours of travel daily in the Upper Peninsula. That's a recruitment issue for us."

Why do physicians take cases elsewhere?

"The reason for cases going out of your center is pretty simple: The doctor is unhappy," said Mr. Rosenbaum. "What's another center doing for them that you're not? What happened in your center to cause them to grow unhappy and take cases to another place?"

Mr. Peo pointed to a few likely reasons for an exodus of cases. Your center may lack the convenience, staff or equipment the physician needs to complete a certain procedure. Or, the physician may have ownership somewhere else. Rather than trying to pinpoint the reason based on your observations, have a candid discussion about the change in cases.

"It's very important that you have open and honest dialogue with your physicians, especially physician owners," said Mr. Peo. "With owners, by them not bringing those cases, that's dollars in their pocket they are potentially giving up. Have an open dialogue so they can come to you and say, 'I'm going to start taking these cases somewhere else for this reason.'"

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