Two physicians opened the first ambulatory surgical center (ASC) in 1970 in Phoenix, Arizona to create a workplace where they could call the shots. For the first time, physicians were in control of everything from scheduling to the types of medical equipment purchased.

While many ASCs remain independent (100 percent physician-owned) like the very first one, the intense market demand for care outside of the hospital setting has led to an influx in corporate investment and co-ownership of practices. Still, today, more than 5,800 ASCs exist all over the country, providing economic and convenience benefits to providers and patients alike for same-day surgical procedures.

“Over the last several years, it’s become apparent that the hospital setting just isn’t the most appropriate for a lot of surgical and procedural care,” according to Dr. Michael Owens, a gastroenterologist in Portland, Oregon. “Patients, health systems, and payers are all looking to the ASC now for mutual benefit.”

ASCs offer a plethora of procedures today, ranging from orthopedic surgery to endoscopy. According to March 2022 data from the U.S. Centers for Medicare & Medicaid Services (CMS), 32 percent of single specialty ASCs, or EASCs, perform endoscopies – upper endoscopy, colonoscopy, etc. – and 37 percent of multispecialty centers offer endoscopy services.

“EASCs fit well for everyone in this healthcare scenario,” according to a study in Clinics and Colon and Rectal Surgery. “They are more efficient than hospital-based procedures, they are less costly to payers than hospital-based procedures, and they provide an additional source of revenue to healthcare providers.”

Pros and Cons of Physician Ownership

For providers with a full or partial stake in ASC ownership, the benefits extend beyond those offered owners of any profitable business, according to Owens. Physicians also have the chance to offer greater value-based care, he said.

For physicians with any stake in outpatient service ownership, benefits for them and their patients include:

• Eliminating the need for negotiations over types of medical equipment used.
• Having the opportunity to specialize in certain specialties of care.
• Controlling scheduling and offering greater flexibility for patients.

“ASCs are typically nimbler, faster to react to change and may therefore have the ability to embrace new methods, technology and policies,” Owens said. “But this is not always the case, a poorly run ASC might be more disadvantaged than other sites of service.”

Having a good business partner can be crucial to success, Owens said, but it is not imperative for physicians to have a business administrative background to put the needs of their patients first and run a successful practice.

“We are professionals who do understand the delivery of health care as experts, and I’d encourage my colleagues to want more seats at the table,” he said.