Was the pandemic good or bad for ASC physician recruitment?

The pandemic accelerated the shift to outpatient surgery and ASCs as physicians and patients sought elective surgeries away from hospitals treating COVID-19 patients. But the pandemic also placed financial constraints on surgery centers that made it more difficult for some to bring on new physicians.

Did the pandemic make it easier or harder for ASCs to recruit physicians? It depends on the specialty and location.

"The pandemic has made it more difficult to recruit in person, which is always necessary when asking a physician to begin practicing in your facility," Margaret Chappell, RN, CEO of the Center for Advanced Surgery in Ladson, S.C., told Becker's. "Most centers are limiting visitors, so the simple act of touring a facility to get the lay of the land is limited. Physicians are more skeptical of change during these uncertain times of a pandemic."

Ms. Chappell's center was closed for two months last year during the pandemic, which makes it difficult to attract surgeons because the center doesn't have a recent 12 months of profitability to share with potential new recruits.

The dominance of hospital employment in some markets also affects how ASCs recruit, as it did before the pandemic. Daniel Larose, MD, CEO of Advanced Surgery Center in Omaha, Neb., said it is still challenging to bring on new physicians not already aligned with a health system.

"I do not believe that there have been significant changes in the last year. However, at the practice level we are seeing an increase in the response to our recruiting efforts," he told Becker's.

He said the most significant increase in response has been from physicians who have been in practice and are relocating.

"New grads from strong programs are still in high demand especially, in the total joint replacement specialty," Dr. Larose said.

Sarah Paul, CEO of Dublin (Ohio) Surgery Center said: "We have three big hospital systems in central Ohio and they're all trying to scoop up as many independent physicians as they can. So the tough part, as we're staying independent, is to find physicians to recruit."

Taylor Cera, COO of Orthopaedic Surgery Center in Youngstown, Ohio, said his center has recruited four orthopedic surgeons and added plastic and reconstructive surgery, eye surgery and women's health service lines in the past four years. But looking ahead, he sees competition for surgeons as a big challenge.

"I think if we take a step back and look at our five-year plan, our vision, we've had pretty great success in the physician and staff recruitment area," he told Becker's. "But I think [the field is] changing daily, and [physician recruitment] is going to continue to be a priority for us and a challenge to overcome."

Other ASC administrators report an increased interest from physicians in using the ASC, which brings new challenges. Administrator of Danbury, Conn.-based Orthopaedic & Specialty Surgery Center, Danilo D'Aprile, said more physicians began asking to be credentialed at his center in March and April last year when hospitals halted elective procedures.

"You want to be diligent about what their motives are," he said. "When we were in the initial period of trying to figure out what was going on in the early stages of the pandemic, the question was whether it was a long-term plan for the physician to come to the surgery center or were they just looking to do a few cases because they weren't able to do them at the hospital they were working at."

Almost a year later, Mr. D'Aprile continues to see interest in the center, especially since CMS is moving toward paying for more orthopedic procedures in the ASC. The Orthopaedic & Specialty Surgery Center also includes robotic technology and an overnight stay program, which is attractive to surgeons who perform cases at the hospital.

"Our total joint replacement program is very robust," he said. "We are in a good position to attract a lot of these doctors, and I have a lot of physicians coming to me to request privileges and ownership because they want to be here."

Jan Dees, president and CEO of Palm Harbor, Fla.-based American Vascular Associates, said more physicians reached out to the practice during the pandemic to open new centers as an alternative to the hospital.

"Physicians who were contemplating opening a vascular center have seen the pandemic as an opportunity to make that commitment," Ms. Dees told Becker's. "We have continued in select markets to recruit for additional physicians in our existing locations, as well, and have been successful for the same reasons."

More articles on surgery centers:
Dr. Michael Ast: 3 ways orthopedics, ASCs will change in the next 3 years
23 ASCs adding robotics in 2020
6 interesting ASC deals in the last year


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