Issue link: https://beckershealthcare.uberflip.com/i/1467576
36 THOUGHT LEADERSHIP 'I'd rather rule in hell than be a janitor in heaven': Why one physician stays independent By Patsy Newitt W hile many physicians are flocking to the more stable hospital employment, Rajiv Sharma, MD, is turning the other direction. Dr. Sharma, founder of Digestive Health Associates in Terre Haute, Ind., joined Becker's to discuss his commitment to independence. Editor's note: This interview was edited lightly for clarity and brevity. Question: What will attract the next genera- tion of physicians to private practice? Dr. Rajiv Sharma: This is the best time in history to be self-employed and be your own CEO. CEO of your life, own your book of business and manage your time. Time is money. Technology and social hyper-connectedness has opened avenues for doctors to promote themselves to the end-consumer of their service, that is, patients. Staying independent and using technology to enhance access to you is the focus. The ones who want to stand out and be found will enjoy the glory. The ones who want to live in obscurity will get abundant opportunity by being victimized at the hands of employers and employer-minded practices. Being private means being the king of your castle. Either you own the castle or rent it. The outside-the-box, networking-friendly and open-minded doctors will bear the fruit of success and happiness. Twice, I had walked away from highly lucrative employed opportunities due to suffocating toxic behaviors of my employers and fellow physician colleagues. By being independent and by factoring in tax benefits of a business, you can enhance your effective income by 1.5 times. I'd rather rule in hell than be a janitor in heaven. n A glimpse into the Western ASC market By Patsy Newitt S ome ASC leaders say the Western market, particularly Cali- fornia, is primed for ASC growth aer that state's COVID-19 regulations required hospitals and ASCs in the area to coordi- nate equipment, staffing and patient needs in the area, highlighting the benefits of care within ASCs. Four ASC leaders spoke with Becker's ASC Review about the Western ASC market and what may or may not make it unique. Editor's note: Becker's followed U.S. Census regions for this piece. is piece was edited lightly for brevity and clarity. Question: How does the ASC industry in the West differ from other markets in the country? Beth LaBouyer, RN. Executive Director of the California Ambula- tory Surgery Association: e response to the COVID-19 pandemic was different, particularly in California, with rapidly changing rules that impacted healthcare providers and patient access to care. e state created a pathway for regional responses based on the unique impact of the pandemic at different times in different geographies. is made it a necessity for ASCs and hospital systems to maintain real-time co- ordination on the availability of equipment, staffing and patient needs in their area. ASCs filled a very important role in allowing patients to continue to get access to surgical care and have elective procedures done even when hospitals were overloaded and the backlog of care was increasing. In this way, COVID-19 accelerated the adoption and awareness of ASCs as an important part of the patient care system, and those lessons will have long-term benefits that fuel the continued growth trajectory for the ASC industry. We will continue to see more cases, as well as more complex cases, migrate to the ASC setting due to its clear value proposition. In par- ticular, there is continued growth in orthopedics, gastroenterology and cardiovascular cases. As an industry, we have to be prepared to meet this growing demand, which means building out the surgery center teams, refining processes and prioritizing quality training to ensure case migration is done the right way. Brian Gantwerker, MD. Neurosurgeon and Head of Craniospinal Center of Los Angeles: For one, the majority of the ASCs were started by physicians. Most of the ASCs in the Los Angeles market began with physicians' seed money, with angel investors. A number of them were acquired or bought out by larger hospital systems and are now joint ventures. ey, for the most part, are fairly well-run, but the days of big buyout money are long gone. While we all expected the majority of spine to be transitioned to outpatient, the pullback of the inpatient- only codes now slingshotting back out of outpatient and returning to inpatient has cooled the outpatient spine market. at being said, there is still room for growth in outpatient spine surgery, as long as it's done responsibly and safely. Sharon Benson. Past President of Arizona Ambulatory Surgery Center Association and COO of American Vision Partners: e Western market is dealing with the same issues that are impacting the rest of the country. Specifically, declining payer reimbursements, rising inflation costs that are impacting our employees who are mainly living paycheck to paycheck, the lingering impact of COVID-19 and the "Great Resignation's" impact on staffing, as we see more people leaving the medical profession. ere is no magic formula for success in the Western market. Success in any market is predicated on cultural fit, scheduling flexibility and overall employee benefits.