Los Angeles-based Commons Clinic is positioning itself as a physician-led counterweight to healthcare consolidation, backed by investors who believe independent surgeons are essential to the future of surgical care.
For John Loser, founder and general partner of Floating Point, a venture capital firm that led Commons Clinic’s investment round, the model succeeds only if it centers physicians from the ground up.
“I see the physicians as Commons Clinic’s core client,” Mr. Loser told Becker’s. “To build something that can become a credible alternative for surgical care, it starts with the surgeons.”
While many surgeon groups face pressure to either join a large health system or shoulder the administrative burden of running a private practice, Commons Clinic aims to create what Mr. Loser calls a “third way:” a structure that preserves autonomy while removing the operational obstacles that often drive surgeons toward employment.
Creating an alternative to traditional employment vs. solo practice
According to Mr. Loser, most physicians today face a stark choice: remain fully independent and shoulder the time-consuming responsibilities of running a small business, or become employed by increasingly consolidated health systems and trade autonomy for stability.
Commons Clinic was designed to bridge that gap. “What excited us from the start is that Commons offers surgeons the chance to keep that entrepreneurial spirit, the way they want to practice medicine, while taking the operational pieces off their plate,” he said. “They can focus on patients without giving up their autonomy or becoming a cog in a giant machine.”
Mr. Loser described it as “the best of both worlds” for surgeons, especially as more high-acuity procedures transition safely into outpatient settings.
Embedding real physician control Into the model
A key focus for Floating Point was ensuring that Commons’ structure guarantees genuine physician control, not just in branding but in day-to-day practice.
“For a surgeon to be their best, you want to tap into that sense of entrepreneurial agency,” he said. “That feeling of, ‘I have the ability to make decisions based on my own planning and conscience, not the needs of my employer.’”
Ownership of the clinical environment is central to that. “You can’t set surgical schedules if you don’t control the operating theater,” he said. “That’s basic operational reality.”
Commons’ owned-and-operated ASCs enable surgeons and organizational leaders to jointly determine block time, scheduling and workflows without navigating the priorities of a sprawling hospital system.
“Surgeons will still operate in hospitals when clinically appropriate,” he said. “But for the widening set of procedures that belong outside the hospital, having an integrated ASC model allows Commons to collaborate directly with physicians on how surgical time is allocated and how care is delivered.”
Shared ownership as a cultural foundation
Floating Point, primarily a technology investor, viewed Commons through the lens of equity alignment common in the software world. “In tech, shared equity is taken for granted,” Mr. Loser said. “From the CFO down to the receptionist, people receive equity because everyone is building something together.”
Large health systems, he noted, operate differently. “They have employees who earn a paycheck, but they don’t share in the system’s success in any meaningful way,” he said.
Commons intentionally breaks from that model. “Not just physicians but everyone has some equity upside,” he said. “Physicians participate at multiple levels. They truly feel like entrepreneurs.”
The structure resonates with surgeons who have already demonstrated a strong desire for independence. “Choosing private practice today requires real fortitude, it is not the path of least resistance,” he said. “Commons wants to accelerate that entrepreneurial spirit, not replace it.”
Aligning financial and clinical priorities through an ASC-driven model
From Mr. Loser’s perspective, ASCs offer one of the few places in healthcare where financial and clinical incentives naturally align. “In most parts of healthcare, you’re eking out half-percent differences,” he said. “Then you look at ASCs, and they deliver the same procedures, often with better clinical outcomes, at 30 to 50 percent lower cost than legacy hospital systems. That’s rare.”
But for patients, navigating fragmented ASC networks can be confusing. That’s where Commons aims to elevate the model.
“How do you create something that feels like a vertically integrated system, seamless for the patient and streamlined for the physician, while delivering the cost advantages of outpatient surgical care?” he said.
This integrated structure positions Commons for payer partnerships built around value-based arrangements. “You can go to payers and say, ‘We can deliver great patient experience, great clinical outcomes and do it for far less,’” he said. “That opens the door for shared-savings models where everyone wins, the patient, the system and the physicians.”
Scaling a new blueprint for surgical care
While Commons launched with orthopedics, Mr. Loser believes the model has broad applicability. “The movement of high-acuity surgical care from inpatient to outpatient is much bigger than orthopedics,” he said. “It cuts across a huge range of specialties.”
He sees Commons as a blueprint for a new kind of surgical ecosystem. “This is a new way of thinking about what a hospital should be like, what surgical care should look like,” he said. “So many procedures that historically required inpatient settings can be safely done outpatient with better results and much lower cost.”
The long-term vision, he emphasized, is a multispecialty, multi-market platform built around outpatient surgical excellence. “You scale into new specialties and geographies, but keep that core competency, delivering outpatient surgical care as cost-effectively and as high-quality as possible,” he said.
Despite his enthusiasm, Mr. Loser is quick to redirect credit. “I always feel like as an investor, I get to pretend to take credit for things I had nothing to do with,” he said. “At the end of the day, it’s the team — the founder, and the surgical leaders who took a leap of faith and believed there could be a better way. We provide the capital. That’s the easiest part of the job.”
