Adding Cases & Recruiting Surgeons at Surgery Centers

At the 19th Annual Ambulatory Surgery Centers Conference in Chicago on October 25, Vice President of Development and Acquisitions Brandon Frazier and Vice President of Acquisitions and Development Jeff Peo, of Ambulatory Surgical Centers of America, gave presentation titled “Adding Cases and Recruiting Doctors.”

When adding surgeons and cases to the ASC, make sure existing partners follow a few key rules to recruit their colleagues:

·    Do not offer less or more shares of a higher or lower price based on the value or volume of referrals
·    Never focus on individual distributions being tied to the number of referrals
·    Avoid providing physicians with estimates as to the amount of revenue that will be generated from their referrals

If the partners don’t want to bring on a new partner and dilute their shares, figure out how to maximize case volume from current partners. If you are able to show them how much revenue increases by bringing in more cases, they may be more willing to consider new partners in the future.

“I showed them that if they brought every case to their center possible what their anticipated distributions would be,” says Mr. Frazier. “I had to create a desire among the physician group to increase the number of cases that were coming in. The scheduler becomes the boss and tells them where their cases go. We need some change to occur here and make sure surgeons become involved with schedulers to bring every case possible to the ASC.”

Administrators should put together a pro forma that includes a financial analysis to paint a picture with the numbers before changes can be made. Even a player who has 5 percent ownership, bringing more cases will mean a significant increase. Make sure the surgeons know you are monitoring their scheduling to make sure all possible cases are going into the ASC and being as efficient as possible.

“The fact that you are being watched makes you improve your outcomes,” says Mr. Frazier. “Everyone has to be motivated to do work. The physicians have to have enough equity to make it worth their while; if they don’t have substantial distribution checks, everything is harder.”

Bringing all cases in possible is important before recruiting new physicians, because new physicians won’t be willing to bring cases if the original partners don’t either. “Why would they want to join when current owners aren’t committed?” asked Mr. Peo. “Also have a good anesthesia situation that can handle the new specialty. You should recruit people within the community that fits with your specialty mix.”

Mr. Peo suggests making sure the recruits “feel special” throughout the process. “Help them feel and understand that they are important and they will want to do cases there,” said Mr. Peo. “Be prepared to meet with the recruits and know what you want to talk about. Have answers to any questions they might have and speak enthusiastically about your center.”

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