At the 19th Annual Ambulatory Surgery Centers Conference in Chicago on Oct. 26, Scott Becker, JD, CPA, partner at McGuireWoods moderated a panel, which discussed key issues for orthopedics, spine and paint management in ambulatory surgery centers. Michael R. Redler, MD, of The OSM Center; Sev Hrywnak, DPM, MD, CEO of AASC, Inc.; and Yousuf Sayeed, MD, of The Spine Center of DuPage Medical Group sat on the panel.
Due to the unique physician group that Dr. Sayeed is a part of, Mr. Becker began by asking him to explain the process behind his affiliation with DuPage Medical Group.
"First, I was in an anesthesia-based pain practice, doing both anesthesia and pain management at the same time. That is hard to do because those two specialties are distinctly different with different cultures. I eventually separated from that practice into a freestanding pain practice. I was there for a while until DuPage Medical Group approached the practice with an offer to join their large physician group. They had no pain physicians and were building a surgery center. If the practice did not join, DuPage would get other pain physicians and the area may have been saturated," said Dr. Sayeed.
Dr. Sayeed's situation is unique because DuPage Medical Group is dominant in its market. It has become an alternative to hospital employment for physicians because it is a marquee group in the greater Chicago area, said Mr. Becker. However, usually the potential for hospital employment is a threat for physician groups or surgery centers that would like to recruit physicians. It is a big issue for the specialties of orthopedics, spine and pain management in the ASC setting.
Option of hospital employment
"We are always concerned [about the threat of hospital offers]. We hear every week from a big primary care group: 'Join us or lose referrals.' From a hospital we hear: 'Join us or we will hire other surgeons,'" said Dr. Redler.
Dr. Hrywnak has also seen a lot of pressure stemming from hospitals luring physicians into employment. "We have been successful in that we've had orthopedic groups join [our ASC]. However, the primary care [physicians] are screaming, 'If you are not with us, you are against us,' as they are forming or joining accountable care organizations in the area and grabbing subspecialists to grow a referral base. However, I am a big believer in independence," said Dr. Hrywnak.
Joint ventures
Along with hospital employment, the option to partner with hospitals is a big issue in the industry. However, many physicians prefer the independence an ASC offers.
According to Dr. Redler, his ASC hears from a hospital every month about a joint venture. "We have been successful in a our volume, quality of care and finances. At one time we were in significant negotiations with a large health system, but their surgical center was run very inefficiently. They wanted to work with us but be the managing partner. That element of the joint venture ended the discussions quickly," said Dr. Redler. "As a surgical center, we have our systems in place. Every case is optimized. WE know how much every case cots for every physician. We do it better than the hospital. We were not going to go into collaboration where a hospital needs to be the managing partner,: added Dr. Redler.
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Due to the unique physician group that Dr. Sayeed is a part of, Mr. Becker began by asking him to explain the process behind his affiliation with DuPage Medical Group.
"First, I was in an anesthesia-based pain practice, doing both anesthesia and pain management at the same time. That is hard to do because those two specialties are distinctly different with different cultures. I eventually separated from that practice into a freestanding pain practice. I was there for a while until DuPage Medical Group approached the practice with an offer to join their large physician group. They had no pain physicians and were building a surgery center. If the practice did not join, DuPage would get other pain physicians and the area may have been saturated," said Dr. Sayeed.
Dr. Sayeed's situation is unique because DuPage Medical Group is dominant in its market. It has become an alternative to hospital employment for physicians because it is a marquee group in the greater Chicago area, said Mr. Becker. However, usually the potential for hospital employment is a threat for physician groups or surgery centers that would like to recruit physicians. It is a big issue for the specialties of orthopedics, spine and pain management in the ASC setting.
Option of hospital employment
"We are always concerned [about the threat of hospital offers]. We hear every week from a big primary care group: 'Join us or lose referrals.' From a hospital we hear: 'Join us or we will hire other surgeons,'" said Dr. Redler.
Dr. Hrywnak has also seen a lot of pressure stemming from hospitals luring physicians into employment. "We have been successful in that we've had orthopedic groups join [our ASC]. However, the primary care [physicians] are screaming, 'If you are not with us, you are against us,' as they are forming or joining accountable care organizations in the area and grabbing subspecialists to grow a referral base. However, I am a big believer in independence," said Dr. Hrywnak.
Joint ventures
Along with hospital employment, the option to partner with hospitals is a big issue in the industry. However, many physicians prefer the independence an ASC offers.
According to Dr. Redler, his ASC hears from a hospital every month about a joint venture. "We have been successful in a our volume, quality of care and finances. At one time we were in significant negotiations with a large health system, but their surgical center was run very inefficiently. They wanted to work with us but be the managing partner. That element of the joint venture ended the discussions quickly," said Dr. Redler. "As a surgical center, we have our systems in place. Every case is optimized. WE know how much every case cots for every physician. We do it better than the hospital. We were not going to go into collaboration where a hospital needs to be the managing partner,: added Dr. Redler.
More Articles on Key Issues for ASCs:
10 Steps to Attract Orthopedic & Spine Surgeons During RecruitmentOrthopedics and Spine: The Best Opportunities and Biggest Threats
Moving Spine Procedures to ASCs — Key Business and Clinical Issues