Adding a Total Joint Program to a Surgery Center: Q&A With John Brock of NorthStar Surgical Center

NorthStar Surgical Center in Lubbock, Texas, began offering total knee, uni-knee, total ankle and total shoulder procedures at the beginning of the year. The ambulatory surgery center has performed approximately 10 of the procedures so far. John D. Brock, administrator for the ASC, discusses his surgery center's new program and why it was the right time for the facility to expand its offerings.

Q: What led NorthStar to consider expanding your services to offer total joint replacement?


John Brock: Several of our physician-partners expressed a desire to provide this service to their patients in an outpatient setting. The mindset is that the physicians wanted to provide the appropriate patient seeking this procedure with the same access to outpatient care as the more conventional orthopedic patient. The patient benefits not only from going home much sooner than in the past, but we can perform the procedure for a significantly lower cost. Currently we have two physicians that perform the total knee, three that perform the uni-knee, three that perform the total ankle and one that performs the total shoulder.


Q: Describe the process your ASC went through which confirmed expanding was the right decision and that the time to expand was now.


JB: Our physicians determined that the procedures are now more advanced, less invasive and patient pain is easier to control. Also, our physicians had a significant increase in demand for these procedures in an outpatient setting, which led to us working under the direction of our physicians to structure a program to meet this demand. We also met with the medical supply vendors to facilitate providing these procedures in a cost-effective manner.

Q: Why expand to offer total joint replacement rather than expand in a different direction?


JB: NorthStar Surgical Center is the premier orthopedic facility in this market. We provide sports medicine services to Texas Tech University athletes. We have nine orthopedic physician partners. On staff we have three hand fellows, three foot and ankle fellows and three sports medicine fellows. Expanding in this direction was a natural move.

Q: How have your payors responded to this expansion? What feedback have you received from patients?


JB: The payors where the procedures are allowable have responded favorably. The fact that we're able to perform these procedures at a savings to them is certainly a positive. The patients have responded favorably as well.

Q: What role do you envision your total joint program playing in the long-term financial success and sustainability of your ASC?


JB: It can only help from a multitude of reasons. First, we have found orthopedic procedures to be a great service line for us here at NorthStar. And by growing orthopedics, it can only result in sustaining the financial health of the facility. Finally, there is a halo-effect associated with high-tech procedures of this nature, which I would expect to positively impact other service lines as a result.

Q: For ASCs considering expanding into total joint replacement surgeries, what advice would you offer? For ASCs considering any type of expansion, is there other advice you would offer?


JB: Whether it's expanding into total joints or other service lines, I think the advice would be the same and that's to do your due diligence. In the case of total joints, I would first recommend that the physicians be the drivers of the process. Without their commitment, you're doomed to mediocrity. I would also recommend visiting and consulting other facilities that have successfully implemented the program — this would include learning about their policies, processes and protocols and their relationships with home health agencies for aftercare.


Learn more about NorthStar Surgical Center.

Related Articles on Total Joint Replacement:

10 Steps to Add Total Joint Replacements to a Surgery Center

Biologic Joint Replacement: The Future of Joint Replacement Surgery

8 Ways to Reduce Surgical Site Infections for Total Joint Replacement Patients With Comorbidities

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