Janet Carlson, RN, spent years watching surgeons struggle, not with patient care, but with everything around it.
“I saw incredibly talented surgeons weighed down by operational inefficiencies, regulatory hurdles, staffing issues and financial blind spots,” Ms. Carlson, a veteran registered nurse and former executive director of Commonwealth Pain and Spine, told Becker’s. “These were solvable problems. But they were costing physicians their time, revenue and autonomy.”
That observation spurred the founding of Vertex Surgical Solutions. Vertex is a consulting and advisory firm launched to help ASCs and physician-owned practices strengthen their operations, accelerate development timelines and build financially resilient surgical enterprises, without giving up equity or control to a health system or outside management company.
“As an RN who grew into ASC leadership, I realized I could have a far greater impact by stepping outside a single facility and helping physicians across the country build stronger, smarter, more sustainable surgical centers,” Ms. Carlson said. “Vertex was created to remove friction, elevate performance and give physicians the operational and financial clarity they deserve.”
That independence piece is central to Vertex’s pitch. Ms. Carlson said too many physicians don’t fully appreciate what’s lost when they align with a larger entity and give up ownership shares in the process.
“When you do that, those shares — I consider those dead shares, meaning you can’t use them to incent and recruit new surgeon partners if you don’t have them available,” she said. “I’m talking to people constantly about the fact that they really want to have their own place, or be part of a partnership where they can have guaranteed block time and also get paid for their work appropriately.”
Although the ASC market remains largely independent, consolidation is still underway. Nearly 2,000 ASCs are now affiliated with a national chain. Chain operators now control about 33.5% of freestanding ASCs, with the remaining 66.5% still held by independents.
Most physicians, she said, also underestimate how much of their daily frustration stems from systems outside their control — scheduling, staffing, supply chain, payer contracts and capital planning.
“When you own the environment, you own the outcomes,” she said.
Vertex works with physicians across each stage of that process. The company helps them understand the business of surgery, build out ASCs with optimization from the start, avoid costly mistakes and delays, improve margins through case costing and operational discipline, and create scalable, physician-aligned models built for long-term autonomy.
“Independence doesn’t mean doing everything alone — it means having control,” she said. “Vertex gives you the structure, expertise and data discipline to build an ASC that reflects your values, your workflow and your long-term goals.”
One of the biggest surprises since launching, Ms. Carlson said, has been just how hungry physicians are for that clarity. Many she’s spoken with have spent years frustrated by systems beyond their control, without realizing how much better things could be with the right infrastructure in place.
The results, she said, tend to show up quickly. Once disciplined workflows, case costing and scheduling optimization are in place, physicians often notice the shift almost immediately.
“Physicians often tell me, ‘I didn’t know it could be this smooth,'” she said. “That’s incredibly rewarding.”
The regulatory environment remains one of the steeper climbs. Ms. Carlson said many physicians underestimate the planning and documentation required, and that the landscape continues to shift rapidly. But that’s precisely the burden Vertex is designed to absorb.
“My pitch is simple,” she said. “You focus on the patient and clinical excellence, and we build the operational and financial engine that lets you practice at the top of your license.”
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
