ASC leaders are finding physician recruitment more difficult as hospital employment increases, markets become saturated with recruiting facilities and the uncertainties of healthcare reform loom on the horizon. Here Phil Spencer, senior vice president with United Surgical Partners International, shares seven ideas on the trends impacting physician recruitment.
1. Employment is making physician recruitment difficult. Mr. Spencer echoed the woes of many ASC administrators when he said physician employment is trimming the pool of physicians in many areas of the country. "If you talk to almost anybody in the industry, physician employment is the greatest challenge," he says. "It's going to vary by location and by specialty across the country, but the net outcome is that surgeons who might previously have joined an ASC are out of the marketplace now."
He says the trend is particularly pronounced in groups of younger physicians, who are increasingly seeking hospital employment as a way to ensure job security and decrease administrative burdens. As ASCs plan for the future, they must be able to target younger physicians for recruitment to replace older physicians looking to retire.
2. Certain specialties are faring worse than others. Mr. Spencer says several specialties are in shorter supply than others for surgery centers, including orthopedics and gastroenterology. These two specialties have been "picked over" thoroughly in the last 20 years, and many markets have recruited all the eligible physicians to the existing ASCs. He says while orthopedics has been recruited heavily in the past, there may still be an opportunity for surgery centers to enlist orthopedic surgeons who shy away from hospital employment. "Many of these guys are entrepreneurs by nature, but they are still highly sought after by hospitals," he says.
Data from Medscape's Physician Compensation Report 2011 showed that 40 percent of surveyed gastroenterologists are already ASC investors, and 10 percent would consider the investment opportunity in the future. Around 30 percent of orthopedic surgeons are currently ASC investors, compared to 27 percent of ophthalmologists, 19 percent of general surgeons and 11 percent of anesthesiologists.
3. Employment may slow down — but not for a few years. Mr. Spencer predicts physician employment by hospitals will continue to accelerate over the next few years, but the trend may not last. "You have to wonder if over the long term, hospitals will lose money on employment arrangements," he says. "Physician employment goes in cycles. AS in the past, some physicians who become employed decide it is not for them and become independent again. And some health systems who employ physicians find they can't afford it and they unwind the relationships."
4. Physician involvement is essential to recruiting. Mr. Spencer says physician recruitment is still possible if surgery centers involve their physician owners in the process. "Physicians really validate someone's decision to join the center," he says. If your physician owners can talk to potential investors and explain the financial and operational benefits of surgery center investment, providers may be more likely to consider the opportunity seriously. "This can be done through a phone call or a collegial physician discussion after they've been through the decision process," he says.
5. ASC leaders should explain the place of surgery centers in healthcare reform. Physicians considering ASCs may be hesitant because the future of healthcare is uncertain. As providers struggle to handle new regulations from healthcare reform and predict their place in changing payment models, ASCs may seem risky because they lack the clout of a major hospital system. However, Mr. Spencer points out that as a high-quality, cost-effective surgery setting, ASCs are actually well-situated to take advantage of healthcare reform. "ASCs are very cost-efficient, and they're really part of the solution," he says. "I find it difficult to believe they'll be left out of the process."
If your ASC can present a strategic plan to your investors, they will feel more confident in your position in the marketplace. Present your plans for physician recruitment, specialty development and hospital or payor relationships to physicians considering a long-term relationship with your center.
6. New specialties can open up opportunities for recruitment. Surgery centers may have more luck with physician recruitment if they add specialties that have only recently moved into the outpatient setting, Mr. Spencer says. The most commonly referenced of these specialties is spine, which is moving into surgery centers as managed care groups become more comfortable negotiating contracts with ASCs. "If a surgery center is doing a lot of orthopedics, adding a line like spine is attractive," Mr. Spencer says. "Surgery centers that are doing general surgery — or anything minimally invasive — can bring laparascopic surgery or bariatrics into the center."
Of course, surgery centers considering adding a specialty should first look to the marketplace to ensure they can add case volume before investing in equipment and staffing changes.
Related Articles on Surgery Center Physicians:
IPAB and PCORI Must Go: 6 Points From Dr. Scott Glaser on Why Repeal Is Necessary
The Company Model of Anesthesia Services: Will Less Money Lead to Jail Time?
Compensating Physicians in Surgery Center Administrative Roles: Q&A With Ben Ulrich of VMG Health
1. Employment is making physician recruitment difficult. Mr. Spencer echoed the woes of many ASC administrators when he said physician employment is trimming the pool of physicians in many areas of the country. "If you talk to almost anybody in the industry, physician employment is the greatest challenge," he says. "It's going to vary by location and by specialty across the country, but the net outcome is that surgeons who might previously have joined an ASC are out of the marketplace now."
He says the trend is particularly pronounced in groups of younger physicians, who are increasingly seeking hospital employment as a way to ensure job security and decrease administrative burdens. As ASCs plan for the future, they must be able to target younger physicians for recruitment to replace older physicians looking to retire.
2. Certain specialties are faring worse than others. Mr. Spencer says several specialties are in shorter supply than others for surgery centers, including orthopedics and gastroenterology. These two specialties have been "picked over" thoroughly in the last 20 years, and many markets have recruited all the eligible physicians to the existing ASCs. He says while orthopedics has been recruited heavily in the past, there may still be an opportunity for surgery centers to enlist orthopedic surgeons who shy away from hospital employment. "Many of these guys are entrepreneurs by nature, but they are still highly sought after by hospitals," he says.
Data from Medscape's Physician Compensation Report 2011 showed that 40 percent of surveyed gastroenterologists are already ASC investors, and 10 percent would consider the investment opportunity in the future. Around 30 percent of orthopedic surgeons are currently ASC investors, compared to 27 percent of ophthalmologists, 19 percent of general surgeons and 11 percent of anesthesiologists.
3. Employment may slow down — but not for a few years. Mr. Spencer predicts physician employment by hospitals will continue to accelerate over the next few years, but the trend may not last. "You have to wonder if over the long term, hospitals will lose money on employment arrangements," he says. "Physician employment goes in cycles. AS in the past, some physicians who become employed decide it is not for them and become independent again. And some health systems who employ physicians find they can't afford it and they unwind the relationships."
4. Physician involvement is essential to recruiting. Mr. Spencer says physician recruitment is still possible if surgery centers involve their physician owners in the process. "Physicians really validate someone's decision to join the center," he says. If your physician owners can talk to potential investors and explain the financial and operational benefits of surgery center investment, providers may be more likely to consider the opportunity seriously. "This can be done through a phone call or a collegial physician discussion after they've been through the decision process," he says.
5. ASC leaders should explain the place of surgery centers in healthcare reform. Physicians considering ASCs may be hesitant because the future of healthcare is uncertain. As providers struggle to handle new regulations from healthcare reform and predict their place in changing payment models, ASCs may seem risky because they lack the clout of a major hospital system. However, Mr. Spencer points out that as a high-quality, cost-effective surgery setting, ASCs are actually well-situated to take advantage of healthcare reform. "ASCs are very cost-efficient, and they're really part of the solution," he says. "I find it difficult to believe they'll be left out of the process."
If your ASC can present a strategic plan to your investors, they will feel more confident in your position in the marketplace. Present your plans for physician recruitment, specialty development and hospital or payor relationships to physicians considering a long-term relationship with your center.
6. New specialties can open up opportunities for recruitment. Surgery centers may have more luck with physician recruitment if they add specialties that have only recently moved into the outpatient setting, Mr. Spencer says. The most commonly referenced of these specialties is spine, which is moving into surgery centers as managed care groups become more comfortable negotiating contracts with ASCs. "If a surgery center is doing a lot of orthopedics, adding a line like spine is attractive," Mr. Spencer says. "Surgery centers that are doing general surgery — or anything minimally invasive — can bring laparascopic surgery or bariatrics into the center."
Of course, surgery centers considering adding a specialty should first look to the marketplace to ensure they can add case volume before investing in equipment and staffing changes.
Related Articles on Surgery Center Physicians:
IPAB and PCORI Must Go: 6 Points From Dr. Scott Glaser on Why Repeal Is Necessary
The Company Model of Anesthesia Services: Will Less Money Lead to Jail Time?
Compensating Physicians in Surgery Center Administrative Roles: Q&A With Ben Ulrich of VMG Health