Here's what to expect when replacing an ASC volume leader — 5 challenges

If a surgeon retires or suddenly departs due to death, illness, relocation or hospital employment, ASC administrators can find themselves scrambling to recoup the case volume loss.

Here are five barriers to successful recruitment of new surgeons, according to Surgical Information Systems Clinical Solutions Specialist Daren Smith

1. Equipment, staffing and training. A new surgeon may bring in new procedures and require different equipment than the previous surgeon. Before bringing a surgeon onboard, learn the candidate's needs and whether you can afford the expenses required to address those needs. Clinical staff should be trained on how to support any new procedures and business staff should be trained on how to code and bill for them in advance.

2. Share Price. The ability of a physician to buy into the ASC is a common obstacle to recruitment. Work to keep the ownership share price at a reasonable figure so it doesn't deter new physicians from joining. ASC owners can also secure financing options stipulating the bank will give new physicians a preferred rate or overlook financial issues if the owners decide to sell shares down the road.

3. Existing Shareholders. Current ASC owners may oppose the idea of offering additional shares without creating more shares, which can dilute their holdings.

4. Hospital Employment. Some hospital employment agreements bar physicians from owning shares in an independent ASC. If your ASC partners with a hospital, avoid these kinds of provisions.

5. Operating Agreement. During an the development phase, owners may fail to include language concerning the new investor process in the original operating agreement. If the ASC eventually decides to add physicians, revising the agreement to allow recruitment could be difficult — especially if any existing owners are opposed to adding new physician owners.

"When creating or updating an operating agreement, consider the future needs of your ASC," Mr. Smith said.

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