Adaptability is how small practices can succeed, says Texas surgeon

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With the ongoing trend of small ASCs being bought up by larger groups, some see the consolidation as detrimental to the market, including President Joe Biden, who issued an executive order on July 9 to crack down on anticompetitive acquisitions.

"In many industries, consolidation is greater now than it was even just 20 years ago," Associate Attorney General Vanita Gupta said at the 15th annual Global Antitrust Enforcement Symposium at Georgetown Law School Sept. 14. "For example, today, dominant health systems can approach 50 percent control of a relevant local or regional market. This kind of consolidation can be detrimental to our economy."

Carey Windler, MD, an orthopedic surgeon with Austin (Texas) Sports Medicine, told Becker's ASC Review that smaller practices like his have some key advantages that make them valuable to the market.

Note: this is an edited excerpt. Download the full podcast episode here.

Question: Looking at some of the big market trends in healthcare today, do you think smaller physician groups will be able to succeed in the future, or do you see all the consolidation and private equity investment being a vehicle that will be necessary for growth in the future? 

Dr. Carey Windler: I think that there is definitely going to be a role for smaller groups [like] our group of eight, and we're strategically growing as we fill needs in our practice. But we've looked at those other opportunities — larger groups, consolidation, private equity — and for us, we felt like because of the efficiency of our practice and the growth of our practice that we didn't need to go in that direction. … We never closed the door on that, but again, I think there is going to be and will continue to be a role for smaller groups anywhere from six to 15 doctors, rather than the super groups of over 100. 

I think partly that's based on when we've looked at those options, we just feel like we can adapt and change to market demands and market trends very nimbly. I think the larger a group becomes, the more difficult it is to do that, and you're certainly giving up a lot of autonomy. There may be a time in the future where the advantages change, but for the time being, we feel like we're in a much better position than the groups that have merged into super groups of 50 to 100 doctors.

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