Dr. Michael Ast: 3 ways orthopedics, ASCs will change in the next 3 years

Michael Ast, MD, an attending orthopedic surgeon at Hospital for Special Surgery and assistant professor of orthopedic surgery at Weill Cornell Medical College in New York City, has focused on outpatient orthopedics throughout his career.

He is excited about the future of orthopedics in ASCs and recently discussed three upcoming shifts in the industry with Becker's.

Note: Responses are lightly edited for style and length.

Question: How do you see orthopedics and ASCs changing in the next three years?

Dr. Michael Ast: There are three things we're looking at over the next three years. The first is we are going to see more alignment between independent centers and someone else, whether that's health systems or ambulatory surgery center management companies. I think you're going to see more alignment because of the need to capitalize to add higher-acuity service lines. When you have a small independent center, and you're trying to do joint replacements, legitimately it's stressful. The logistics and capital that are required pushes beyond what most ASCs are working with.

The other thing we are going to see is that there is going to be more money flowing into orthopedics in general. We've watched private equity starting to make moves into orthopedics. I don't think that's going to slow down. They're not only going to invest in the practice side, but they're going to go into surgery centers as another opportunity to help practices open new centers, expand existing centers and expand the potential service lines at existing centers.

The last interesting thing we'll see moving in the next three years is off-site sterilization. This is a more practical answer than some of the others, but we just saw really the first big move toward that at University of Pennsylvania in Philadelphia, where they created an entire off-site sterilization facility. Sterilization is the most limiting factor for ASCs when they start doing things like joint replacements. You need a lot more trays, and most of these centers don't have the logistical capacity for sterilization there. The sterilization stations are too small, or they don't have enough washers. The options become building a new center, bigger center, or you go into something like off-site sterilization. There has been talk about it in the past, even some industry partners have talked about it, but I think over the next three to five years is when you'll see that applied. That is really exciting and will get rid of one of the big impediments to growing programs.


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