Physicians are concerned about the erosion of autonomy amid accelerating industry consolidation and migration to employed models.
In 2022, just 44% of physicians owned their practice, compared with 76% in the early 1980s, according to a report from the American Medical Association.
However, some surgeons are choosing to leave employed models to regain control.
Benjamin Stein, MD, is an independent orthopedic surgeon who co-founded and is chairman of ASC development group Capital Surgical Solutions. He joined Becker's to discuss the success of his physician-owned company and the importance of independent models.
He was propelled toward independence after witnessing the changes at a former employer when the organization was bought out by a larger company.
"It was an instant ignition for me," Dr. Stein told Becker's. "I knew it wasn’t good, and I knew other people felt the same way. So, I wanted to create a system that addressed those issues."
The acceleration of facility acquisition, particularly in musculoskeletal care, has resulted in "a lot of mid-career physicians who are unhappy with their current situation," he said.
Following the acquisition, he told Becker's he saw "a noticeable shift in the culture among the staff and the surgeons," which he said can spill over to patient experience.
His company's first ASC, the Capital Orthopedic Surgery Center in Germantown, Md., has seen immense success after opening more than four years ago. With 12 "independent, busy, value-oriented orthopedic surgeons and a strong focus on joint replacements," Capital Surgical Solutions continues to see positive results.
"It has outperformed the rest of the region in terms of quality — whether you look at satisfaction, patient outcomes, or complications," he said.
Staff retention has been near perfect, he added, which is unique for his market.
"I believe our staff value how we prioritize listening to our teams, ensuring that management decisions, such as clinical services and operating times, are made in partnership with our doctors and staff," he said. "We're committed to providing competitive compensation that reflects the exceptional talent we seek to attract and retain. While we manage our labor effectively, we never compromise on quality."
His team also fosters collaboration among sister facilities to mitigate burnout by sharing best practices in areas like supply chain, business office and sterile processing.
The holistic approach to staff management "translates directly to the level of patient satisfaction," Dr. Stein said. The Capital Orthopaedic Surgery Center has earned more than 300 5-star Google reviews.
"The patients value the caliber of surgeons at our facilities in addition to the boutique and truly customized patient experience that they receive," he said. "We perform more than 1,000 joint replacements per year at COSC and have done so with unparallelled outcomes in our region. Over time that reputation takes hold and patients notice."
The second facility, District Surgery Center, opened in January and is still in its early stages, but Dr. Stein said he's seeing the same positive trends there.
"It has a big spine footprint, which is a key area moving toward surgical centers, and the feedback has been great so far," he said.