By operating in ASCs instead of hospitals, physicians gain increased control over their surgical practices. In the ASC setting, physicians are able to schedule procedures more conveniently, assemble teams of specially trained and highly skilled staff, ensure that the equipment and supplies being used are best suited to their techniques, and design facilities tailored to their specialties and to the specific needs of their patients.
Simply stated, physicians are striving for, and have found in ASCs, professional autonomy over their work environment and over the quality of care that has not been available to them in hospitals. These benefits explain why physicians who do not have any ownership interest in an ASC (and therefore do not benefit financially from performing procedures in an ASC other tahn through physician fee developing and refining) choose to work in ASCs in such high numbers.
Given the history of their involvement in making ASCs a reality, it is not surprising that physicians continue to have at least some ownership in virtually all (90%) ASCs. But what is more interesting to note is that many ASCs are jointly owned by local hospitals that now increasingly recognize and embrace the value of the ASC model:
Physician ownership allows for maximum professional control over the clinical environment and over the quality of care delivered to patients. As a result, patients say they have a 92 percent satisfaction rate with both the care and service they receive from ASCs.1
This advanced model of service enhances the delivery of care by allowing physician operators to:
Focus exclusively on a small number of processes in a single setting, rather than having to rely on a hospital setting that has large-scale demands for space, resources and the attention of management.
Intensify quality control processes since ASCs are focused on a smaller space and a small number of operating rooms.
Afford patients the ability to bring any concerns directly to the physician operator who has direct knowledge about each patient’s case, rather than deal with hospital administrators who almost never have detailed knowledge about individual patients or their experiences.
Physician ownership helps reduce frustrating wait-times for patients and allows for maximum specialization and patient-doctor interaction.
Unlike large-scale institutions, ASCs:
Provide responsive, non-bureaucratic environments tailored to individual patient needs.
Exercise better control over scheduling, so virtually no procedures are delayed or rescheduled due to the kinds of institutional demands that often occur in hospitals (i.e., unforeseen operating room demands).
Allow physicians to personally guide innovative strategies for governance, leadership and quality initiatives.
Some policy makers and regulators have questioned whether the financial considerations associated with physician ownership of ASCs could lead to more surgeries or procedures than are medically necessary.
However, a study by the prestigious health economics and policy analysis firm KNG Health Consulting shows no evidence that ASCs drive up the demand for medical care.2
In fact, the study showed that, except for colonoscopies (while current levels of screening in this country still lag behind those recommended to achieve effective rates of cancer screening), no growth in the total number of procedures being performed was observed as the number of ASCs increased.
In addition, all physicians are bound by a strict code of medical ethics, and ASCs, their owners and the health care professionals who work in ASCs hold themselves to a very high standard of care and professionalism.
1 Press-Ganey Associates, “Outpatient Pulse Report,” 2008.
2 The American Journal of Gastroenterology, “Growth of Ambulatory Surgical Centers, Surgery Volume, and Savings to Medicare,” 2013.