As younger physicians weigh the burdens of ownership against the safety of employment, ASCs face a growing challenge: how to sustain physician engagement while maintaining financial stability.
Shobhit Minhas, MD, an orthopedic surgeon at Fox Valley Orthopedics in Geneva, Ill., joined Becker’s to share his perspective on what a best-case ASC ownership model could look like and why legacy approaches may no longer work.
“I would think it would be reducing the buy-in costs into an ASC, whatever that would be,” Dr. Minhas said. “But also, at the end of the day, the ASC has to make money, and that physician needs to bring it in, right?”
In his view, a tiered partnership track, or “super partnership,” offers a compelling structure for both younger physicians and the ASC itself. In this model, physicians don’t become full partners immediately but work toward ownership over time, contingent on performance and financial contribution.
“Most physicians in a private model don’t become partners right away. It’s usually a partnership track,” he said. “If I were the CEO of an independent ASC, I would say: One, the physician has to at least demonstrate that the cases they bring in have a positive revenue margin for the ASC. Otherwise, they’re not making money.”
One way to lower the ownership barrier, he said, is by offering financing support or spreading the buy-in cost over time.
“They either provide a loan or something like that, or a way to finance it — or you pay it in dividends over three to five years,” he said. “There are a lot of different models, but I would probably say even a smaller buy-in — but it may take longer to buy in — because you’d have to demonstrate that you have a robust enough practice with the right payers that allow for relatively high margins.”
Margin awareness is becoming critical as ASCs face tighter reimbursement and more scrutiny, particularly in joint ventures involving hospitals or private equity. While there’s no one-size-fits-all solution, Dr. Minhas emphasized that flexibility and realistic financial entry points will be essential if ASCs want to attract the next generation of physicians.
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.