8 Points on Physician Engagement in an ASC

Here are eight points on physician engagement in ambulatory surgery centers from Interventional Management Services, Ambulatory Alliances, Pinnacle III and Health Inventures.

1. Physicians doing mostly outpatient procedures prefer ASCs. Allen Hord, MD, of West Paces ASC in Atlanta, an Interventional Management Services partner center, says medical specialists and surgeons who do mostly inpatient procedures often become hospital employees. "However, I do not believe that pain specialists or surgeons who do mostly outpatient procedures will follow this trend," he says. "These specialists are generally fiercely independent and tend to want more control than is possible as a hospital employee."

2. Physicians like controlling the revenue stream. Dr. Hord says surgery center physicians have often shied away from hospital relationships because of the level of control the hospital expects over revenue issues. "In two previous experience in hospital-contracted (although not employed) groups, I found that hospitals rarely acted in the economic best interests of their doctors," he says. "They want to control the revenue stream and reap all the benefits. However, I do believe that there will be a trend toward hospital/physician joint ventures, where doctors maintain control of the surgery center."

3. Physician engagement is key to an ASC's success. The ownership mix and percentage of ownership available to each physician is critical to the success and longevity of an ASC partnership, says Kenny Spitler, chief development officer, Interventional Management Services. In addition to making sure each current owner has a significant enough stake to create an incentive for high performance, additional physician partners should be recruited and syndicated.

4. Owning a majority of the center can maintain physician engagement. When physician-owners sell a minority share of a center to a management company, they are able to maintain control of the center. Stephen Rosenbaum, CEO, Interventional Management Services, says this also allows for more physician-owners to join the center. "At the end of the day, the physician-partners need to own enough to influence their environment," he says. "If the management company owns too much and the hospital too little then there is risk the physicians will become disengaged."

5. Recruitment is an important part of physician engagement. Blayne Rush, MHP, MBA, president of Ambulatory Alliances, says although physicians are busy, reaching out to other physicians as potential recruits is important to a center's profitability and success. "One of the greatest assets in recruiting new physicians is the support of the current physician base," he says. "This support can take form in a variety of ways, including speaking with new recruits, giving tours, attending new recruit open houses, making phones calls and agreeing to write letters to potential utilizers. The role of individual current owners will depend on their personalities and comfort level, but nonetheless, all owners should accept, as part of their ownership mindset, the responsibility to be part of the recruitment process."

6. Provide educational materials. Chuck Brown, administrator of Bidwell Surgery Center, a Health Inventures ASC in Middletown, Ohio, says his ASC is working to keep physicians "abreast of the constant updates and possible regulatory changes and their impact on the healthcare environment via newsletters, email updates and locker room discussions."

7. Ensure convenience. Mr. Brown says he and the Bidwell Surgery Center staff members will continue to work to make the surgery center as convenient as possible for them. "The intent is [to] be an extension of their office practice," he says. "We keep in constant contact with their schedulers, managers, etc., to foster a relationship and help in any way we legally can."

8. Make sure new physician-investors share the same vision. Any new physicians brought into the ASC should have philosophies that align with the philosophies embodied by the center's current physicians and any outside investors, such as a hospital or management company, says Robert Carrera, president of Pinnacle III. This will not only ensure a stable working environment for physicians but also the center's future success. "It's not inexpensive to bring people into the partnership," he says. "Significant levels of both financial and human resources are put out there to get them into the partnership. If you didn't do your due diligence, you may find yourself actively working on removing or trying to remove a newly recruited physician, which is going to create additional expenses."

Related Articles on Physician Engagement:
7 Points on Improving ASC Physician Productivity Through Data Analysis
5 Ways to Recruit More Quality ASC Physicians This Year
5 FAQs on ASC Physician Recruitment With Sean Baker of Stealth Executive Search

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