Becker's Spine Review

11 Becker's ASC 22nd Annual Meeting - The Business and Operations of ASCs – Call (800) 417-2035 "I don't think you have to be a mega group to sur- vive, but I think you have to make a choice," says Daniel Murrey, MD, CEO of OrthoCarolina. "If you are going to be a comprehensive provider for the community and if you're going to stay indepen- dent, I think you need a certain level of infrastruc- ture. You need to recreate the hospital infrastruc- ture to meet the regulatory and market mandates." That infrastructure should support data gather- ing and reporting, business office functions and managing risk in the coming years. OrthoCaro- lina currently includes more than 150 orthope- dic surgeons, and more providers are scheduled to join next year. Dr. Murrey finds managing the larger group of surgeons easier than manag- ing a smaller group, especially one with 17 to 22 physicians. "I usually call that range the valley of death for growing practices," says Dr. Murrey. "If you are 20 physicians, one physician can hold up the show and that's challenging. You are big enough that it's hard to get everyone around the table for meetings, but small enough that if someone threatens to leave, others will cave and they'll get their way. If you become 30 people or more, the practice is more about the brand than individual surgeons." Many markets are seeing hospitals employ prima- ry care physicians and encouraging them to refer within the hospital network. "e challenge there is who you align yourself with and how do you make sure you have a seat at the table with access to patients," said David Rothbart, MD, a neuro- surgeon with Spine Team Texas. But there are still opportunities for independent physicians, especially in markets that can support boutique-style practices. Patients are becoming more educated and savvy about their healthcare, as well as how to spend their healthcare dollars. "We are getting the sector of the population that likes the boutique, one-stop-shop approach," says Richard Wohns, MD, founder of NeoSpine in Puyallup, Wash. "I'm not worried about los- ing patients in the future because of forces that are pulling them into other networks. e people have spoken and this is what they want." e panelists were also less concerned with spe- cialists becoming hospital employees, seeing most orthopedic and spine surgeons desiring indepen- dence, if possible. Dr. Murrey has even spent time traveling the country and educating surgeons-in- training about their options to join independent groups and alternatives to hospital employment and academic medicine. "I don't find many surgeons who voluntarily join a hospital aer they've been in private practice," says Dr. Murrey. "Some do it because they don't have any hope. We have to get the message out there about private practice. If you are willing to invest in your physicians leadership and willing to be transparent about your results — financial, operational and clinical within your partnership — and willing to hold yourself accountable, you can stay independent forever." Outpatient surgery center investment has also been a smart choice for several orthopedic groups across the country. Physicians in Dr. Rothbart's group have investments in ASCs as well as phy- sician-owned hospitals in Texas, and Dr. Wohns credits the ASC setting for his flexibility in grow- ing other professional endeavors. "e outpatient center frees up your time because you become extremely efficient," he said. "You can work 40 hours per week clinically and do a huge amount of cases because you don't have to do rounds. Outpatient surgery becomes your pas- sion, but it's also an enabling factor for you to do so many other things." All three surgeons were optimistic about the fu- ture for their practice. "I don't see many threats to my practice," says Dr. Wohns. "We are busy as can be; we have more cases than we can handle. We joined two ACOs. We are part of the network in that sense, but we didn't feel like we needed to join the hospital em- ployment ranks." n How Orthopedic & Spine Practices Can Thrive Over the Next 5 Years — Drs. Richard Wohns, Daniel Murrey, David Rothbart (continued from cover) Dr. David Rothbart Dr. Richard Wohns Dr. Daniel Murrey SAVE THE DATE October 22 - 24, 2015 • Swissôtel - Chicago, Illinois learn more & register at https://www.regonline.com/22ndAnnualASC Becker's ASC 22nd Annual Meeting The Business and Operations of ASCs 51 Great Surgeons, 55 Leading Administrators and 110 Surgery Center Speakers in Total

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