Many ASCs are facing a physician recruitment crunch, and some leaders say the hardest part isn’t finding interest in ASCs, but finding partners who can make the economics and efficiency work.
Sixty-one ASCs said recruiting new surgeons is their biggest physician-related risk for 2026, according to a VMG Health survey. This concern is echoed across the physician market. In an August Medscape report, 63% of physicians said they see a shortage of qualified applicants in their local market, compared to 23% who do not and 13% who are unsure.
John Petroni, managing owner of Las Vegas-based Silver State Surgery Centers, told Becker’s that attracting the right physician partners has been difficult, and several factors are complicating recruitment. First, many physicians are resistant to changing established habits and schedules.
“This reluctance can create a barrier to transitioning to a new ASC model,” he said. “We have also had challenges due to specialties that provide a variety of surgical services that are not reimbursed in an ASC environment.”
Additionally, many physicians aren’t fully aware of facility fee reimbursement rates, which can create misconceptions about the financial viability of working in an ASC, Mr. Petroni said. Combined with rising supply costs, staffing expenses and operating room time costs, those misconceptions can erode profitability and deter new ownership opportunities.
“These financial concerns can deter new ownership opportunities for physicians considering a partnership with our ASC,” he said. “Overall, addressing these has required the ownership team to focus on strategic planning, open communication and a commitment to fostering relationships with potential physician partners who are willing to embrace the ASC model they worked so hard to build.”
Some organizations are countering these barriers by emphasizing physician-centered infrastructure and clear pathways to success. Renata Stone, chief marketing officer of Dallas-based Unifeye Vision Partners, told Becker’s her organization’s strategy is rooted in removing “operational friction” that can discourage physicians from joining or staying with a practice.
“By fostering a physician-centric culture, UVP ensures that our doctors feel valued, supported, and equipped with the tools they need to excel in patient care and professional growth,” she said.
Employment models are also reshaping recruitment. Travis Messina, CEO of Regent Surgical Health, told Becker’s that the ASC recruitment landscape today looks nothing like the one the industry was born into decades ago.
Physician employment patterns have shifted from largely independent to predominantly employed. In 2024, 42.2% of physicians were working in private practice, down from 60.1% in 2012, according to a report from the American Medical Association. Private practice now represents less than half of physicians in most specialties, ranging from 30.7% in cardiology to 46.9% in radiology.
According to Mr. Messina, that shift changes how ASCs recruit and engage providers. For younger physicians especially, the challenge is often not a lack of interest, but limited resources and fewer viable ownership pathways.
“Because of the high costs of everything, there’s usually a very significant buy-in required for younger physicians to become partners in private practice,” Shobhit Minhas, MD, orthopedic surgeon at Fox Valley Orthopedics in Geneva, Ill., told Becker’s. “I would also say it’s hard to find physicians now who are willing to take on the burden of ownership, especially younger ones. A lot of independent ASCs have been operating independently for 15 to 20 years, so they’re essentially governed by the older physicians still in practice. Younger physicians today understand the challenges — getting adequate margins, rising healthcare costs, declining revenue, etc. Do they even want to take on the burden or responsibility of ASC ownership, especially with those tight margins?”
To keep candidates engaged, some groups are leaning heavily into tighter hiring and onboarding processes.
Jennifer Pinasco, CEO of Yosemite Pathology in Modesto, Calif., said intentional recruitment design is essential to maintaining momentum in a tight physician market.
“We are very intentional about creating an engaging candidate experience,” she told Becker’s, adding that a seamless, timely and organized hiring and onboarding process helps candidates understand the collaborative environment they’re entering.
Recruitment gaps are already forcing tough decisions for some centers. Myrtletown, Calif.-based North Coast Ophthalmology and Humboldt Physicians Surgery and Laser Center will permanently close in February. Both ophthalmologists are set to retire, and the practice was unable to recruit new physicians despite years of effort.
“We have been actively seeking another physician to join our practice for several years. Despite investing a significant amount of time and resources, our efforts have been fruitless,” according to a letter to patients posted on the practice’s social media.
ASCs will need to adopt creative recruitment models to tackle the shrinking pipeline of independent physicians, rising practice costs and growing uncertainty around ownership willingness.
