ASC independence has 'seen its better days,' according to one exec

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For some leaders, independence is critical to ASC success — fostering adaptability, innovation and cost containment. For others, independence is unsustainable in the current market. 

Steven Gunderson, MD, is the administrative medical director of Rockford (Ill.) Ambulatory Surgery Center. He spoke with Becker's ASC Review on how ASC independence is no longer feasible in his community.

Question: On a scale of 1-10, how important is it to you that your center is independent? 

Dr. Steven Gunderson: I would give this a 2. My community, like many, has undergone a significant transition from having a majority of surgeons practicing independently to the majority now being employed by one of the three hospital systems in our medical service area. This has resulted in our patient mix changing significantly, as the employed physicians are encouraged to provide surgical services at their respective hospital outpatient department regardless of the financial effects on the patient. 

We have been in business for nearly 30 years and have had the opportunity to observe this transition over the last five to seven years as the younger generation of surgeons replace the old guard. These younger surgeons have large undergraduate and medical school debt and no ambition to become independent entrepreneurs when the hospital systems provide a guaranteed income and minimal responsibility to run a practice. My long term goal is to joint venture or sell to one of the hospital systems so we can expand our capabilities to include spine and orthopedic joint services at a lower cost to our community. 

ASC independence in our community has seen its better days and is slowly being replaced with corporate medicine. Our business will survive to provide lower-cost surgical services, but our independence is questionable.

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