Cardiology is where orthopedics was 15 years ago: a specialty with clear ASC potential, a growing list of eligible procedures and a physician workforce that is largely hospital-employed and watching from the sidelines.
Here are six cardiologists and cardiovascular leaders who are building the specialty’s outpatient model:
1. Darryn Appleton, MD, and John Onufer, MD. Virginia Cardiovascular Specialists (Richmond)
VCS opened its ASC in January 2023, with Dr. Onufer serving as medical director and Dr. Appleton directing the cardiac catheterization lab. The path to operation was longer than anticipated: A number of insurance and other administrative requirements had to be met before the practice was fully operational, Dr. Onufer told Becker’s, underscoring the importance of a solid managerial team in the cardiology ASC space.
What distinguishes VCS is its ownership structure. All shareholders, including physicians, hold equal status in company decision-making.
“The initial founding members of the group made it pretty clear early on that the success of the group would be greatest if all shareholders have equal status,” Dr. Appleton told Becker’s.
2. William Reilly, MD. Founder and President of St. Louis Cardiovascular Institute and St. Louis Specialty Surgery Center
Dr. Reilly is an interventional cardiologist with a history of building medical facilities from the ground up, including cardiac catheterization labs. He founded St. Louis Cardiovascular Institute, an office-based lab, and St. Louis Specialty Surgery Center, an ASC — two entities operating out of the same physical building in St. Louis, with the office-based lab housing eight physician partners.
3. Sandra Roush, BSN, RN. Director of Nursing at Pacific Cardiovascular Surgery Center (Salem, Ore.)
Ms. Roush has been among the clearest voices on what physician-owned cardiac ASCs can offer that hospitals cannot. The center operates in Oregon, one of the states where physician ownership of cardiac ASCs with catheterization capabilities is permitted.
“The biggest opportunities for ASC growth currently are for cardiac clinics,” she told Becker’s. “At Pacific Cardiovascular Surgery Center, we provide surgical procedures such as cardiac catheterization, stent placements and pacemaker implants in a safe environment that is preferred by patients to the large local hospital. Benefits include more personalized nursing care, faster admission and discharge, timely procedures, significant cost savings and great parking.”
4. Amanda Ryan, DO. Interventional Cardiologist, CEO and owner of Advanced Heart and Vascular Center of New Mexico (Carlsbad)
Dr. Ryan is one of the few interventional cardiologists in the country who is simultaneously the physician owner and CEO of a single-specialty rural cardiovascular ASC. Her center is building the cardiology ASC model in one of the country’s most underserved markets. Her patients routinely traveled three to four hours for electrophysiology care before she formed a partnership to bring EP services in house in 2025, targeting atrial fibrillation and heart failure.
Her 2025 focus centered on a dedicated six-month training program to build workflows and staff education around advanced arrhythmia care, which is a model she describes as critical to the mission of providing outstanding cardiovascular care at lower cost and closer to patients.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.