Hospital Employment of Key ASC Specialists: Where the Trend is Going

Laura Dyrda -

At the 18th Annual Ambulatory Surgery Centers Conference in Chicago, a panel including Vice President of Strategy at Surgical Care Affiliates Brian Mathis, CEO of Surgical Management Professionals Mike Lipomi and Strategic Advisor to Laser Spine Institute Jimmy St. Louis, spoke about the trend of hospital employment of key specialists to the ASC.

The panel was moderated by Amber McGraw Walsh, a partner at McGuireWoods. While physician employment of specialists at hospitals is trending up, many specialists are still looking for alternatives to employment such as joint ventures, co-management arrangements and medical directorships to align with hospitals. Eventual employment by hospitals may be attractive to some physicians because they have security, salary and a 9am-5pm job instead of the constant work associated with maintaining a private practice and ASC. However, the trend toward hospital employment could shift the other way.

"Doctors are attracted to the hospital environment and both parties eventually find it an uncomfortable relationship," says Mr. Lipomi. "Hospitals might not see the profits they thought they would see from employing physicians and when they don't see the profits, they ratchet down benefits and salary. In this situation, doctors go out the door. When doctors are swinging out of the hospitals, they are going to come back to the ASC."

Panel members stressed that focusing on profitable physicians who are bringing several cases to the center per month is more important than focusing on a certain specialty or subspecialty within an ASC. "For these physicians, get a close look to really understand the physician's practice fits within the surgery center," says Mr. Mathis. "Enable independence of the physicians and connect them with the right vendors, help them with marketing and provide them with EMR so they aren't scared of things hospitals hold over them."

Another emphasis of the discussion was providing quality services along with quality outcomes for patients. Some surgery centers are looking at ways to accommodate patients where hospitals do not. "You can't just do customer services as a piece of the business, it has to be part of the culture," says Mr. St. Louis. "Start with engaging physicians and work your way down with the medical professionals and staff members."

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