Healthcare is ever-changing, as it has been for decades. Sometimes, these changes are for the better, while other times, they may be for the worse.
Becker’s connected with several physicians across a range of specialties to discuss the future of their specific fields, from predicted shortages to continued payer battles and AI booms.
Here is what 10 medical specialists are saying about the future of five ASC-based medical specialties:
Orthopedics
Frank Liporace, MD. Orthopedic Surgeon with RWJBarnabas Health Medical Group and Senior Vice President for the Musculoskeletal Service Line for RWJBarnabas Health’s Northern Regions (West Orange, N.J.): Advances in imaging will lead to greater customization of implants and jigs, which will provide better outcomes for patients. More orthopedic surgeries will be performed using robotic-assisted technologies, which offer consistent results and faster patient recoveries. Use of genetic stem-cell derivative treatments will continue to grow, particularly for the treatment of conditions such as osteoarthritis and ligament injuries. In the area of education, virtual-based trainings and simulated surgical education will be the norm, making it easier for surgeons to stay up to date on the latest research and technologies. Patient-based education must continue to be a major focus to help ensure that patients are getting accurate information about their conditions and treatment options so that they have realistic expectations. Studies show a strong link between patient education and how patients rate their quality of life following their orthopedic procedures. In addition, over the next 10 years, we will see rapid growth in the number of orthopedic practices transitioning to hospital-based employment models. Efforts are continuously being made to prevent “surprise bills for care” to patients, and likely, more standardization in payment models to physicians will continue to evolve.
Yu-Po Lee, MD. Spine Surgeon at UCI Health (Orange, Calif.): The field of orthopedic surgery continues to evolve and grow every year. Advances continue to be made in general orthopedic surgery and all the subspecialties. Advances are continuously being made in minimally invasive surgery, biologics, navigation and instrumentation. While all these innovations will improve care for patients, the one concern about them is that these new innovations may increase the cost of surgery. The research and development needed for advancement and innovation costs money. Ultimately, this gets passed on to patients and payers. One of the ways that the costs of these new innovations can be offset is by reducing the days of admission. So, it is possible that orthopedic surgery cases continue to move to shorter hospital stays and more outpatient cases.
To continue to decrease costs, it is possible that hospitals use artificial intelligence to reduce costs. There are many areas where artificial intelligence can be used to reduce costs. Examples would be in record keeping and eliminating the use of scribes and transcriptions for record keeping. Other areas where artificial intelligence can be used may be for screening patients to help facilitate access to care. For example, many new patient visits may be eliminated by having them go to physical therapy prior to having the initial visit. Artificial intelligence programs may be a potential first visit screen for many patients.
Growth and innovation continue to make orthopedic surgery an exciting field. But orthopedic surgeons must find a balance between cost containment and technological innovation to be sure that patient care can be maximized without having cost become unmanageable. But it is possible that orthopedic surgery moves to more outpatient cases and more artificial intelligence to help offset the costs of new innovation.
Gastroenterology
Benjamin Levy III, MD. Gastroenterologist at University of Chicago Medicine: 2025 will be an important year for the rollout of artificial intelligence in gastroenterology, including AI-assisted endoscopic tools to help us identify polyps during gastroenterology procedures. Increasingly, gastroenterologists will use AI dictation software in clinic, which will help improve the accuracy of notes, decrease the amount of time we spend typing, lower the potential for repetitive stress wrist/hand injuries for endoscopists and hopefully allow gastroenterologists to increase the number of patients we can see in clinic each day.
In 2025, we will see a dramatic expansion of intestinal ultrasound use for [inflammatory bowel disease] patients so that we can monitor disease activity in clinic. Intestinal ultrasound does not require fasting or a bowel prep. This will allow gastroenterologists to determine response to biologic therapies in clinic, even before a colonoscopy is performed.
In addition, we hope to increase the percentage of patients nationally being screened for colorectal cancer. We have many screening options today, including colonoscopies, which can prevent colorectal cancer by removing polyps, [fecal immunochemical test], Cologuard and the new Shield blood test, which received FDA approval in 2024. It’s important for us to continue educating patients to begin colorectal screening at age 45 due to the increasing number of early onset colorectal cancers being diagnosed.
Purna Kashyap, MBBS. AGA Center for Gut Microbiome Research and Education Scientific Advisory Board; Mayo Clinic (Rochester, Minn.): GI is evolving rapidly, making it a really exciting time for clinicians managing patients with digestive disorders. [These] four developments have promise to transform [GI] over the next decade:
Advances in sequencing technologies. The declining cost of DNA sequencing and smaller size of sequencers has brought next-generation sequencing closer to clinical applications. Pharmacogenomic panels have already been introduced to the clinic, and I expect to see epigenetic and microbiome-based applications in the near future. The next decade will see a sharper focus on the mechanistic role of gut bacteria, and we can expect both diagnostics as well as data-driven therapeutics targeting the gut microbiome.
Artificial intelligence. The rapid accumulation of clinical, imaging and multiomics data has lured AI into GI, laying the path for precision medicine. [AI has already used] deep learning [to detect] polyps and GI bleeding [in real-world settings]. As we integrate clinical, imaging and -omics data, we will begin to see widespread application of AI-based models aimed at improving diagnosis and outcomes of complex GI diseases, such as cirrhosis and inflammatory bowel disease, as well as early detection of GI cancers.
Endo-robotics. Interventional endoscopy is already seeing a transformation with the emergence of endo-bariatrics. The current innovative pipeline will pave the way for endo-robotics for complex organ-sparing endoscopic surgery, nonthermal ablation and regenerative [biologics] therapies for chronic GI diseases, endoscopic therapies for diabetes and nonalcoholic fatty liver disease, and expansion of third-space endoscopy procedures over the next decade.
Home testing. Finally, the breakthrough in DNA-based testing allowing for in-home screening of CRC has opened a new avenue, making care accessible to larger populations. We can expect a continued push for point-of-care testing using miniaturized devices and digital technology for detection and monitoring of chronic GI conditions and cancers over the next decade.
While the list above is by no means comprehensive, it gives a snapshot of where our field is moving. I am excited to see what the next decade brings for GIs and our patients.
Cardiology
John Onufer, MD. Cardiologist and Medical Director of VCS: This [cardiology’s ASC migration] is the wave of the future. Even some academic centers are opening up ASCs. You have to realize that we need to use the technology we have to provide our services more economically, and at the same time, more efficiently, for the providers. I certainly can do a lot more cases in the ASC in one day than I can in the hospital.
Anesthesia
Alfonso del Granado. Administrator and CEO at Covenant High Plains Surgery Centers in Lubbock, Texas: The main headwind I’m facing in my market for 2025 is anesthesia coverage. We have an outstanding relationship with the independent anesthesia group that covers our centers, but even with a good payer mix they simply cannot afford enough CRNAs and anesthesiologists to cover all of our ORs so we have had to dig into our pockets for the first time this year to subsidize our coverage. Our area is geographically isolated, so we don’t have access to as many providers as other regions do, and what happens is a natural result of demand exceeding supply. CMS cuts to physician compensation will affect us directly as a consequence, so it was very disappointing to see that the version of the continuing resolution Congress passed to avert the government shutdown did not include the draft bill’s provision to offset this year’s Medicare conversion factor decrease. The draft version of the continuing resolution included a 2.5% increase to the Medicare conversion factor to offset the scheduled 2.8% cut. In a year with a projected increase in healthcare operating costs of 7.5% to 8%, any cut in compensation is especially egregious, and we urge the incoming administration to prioritize addressing this shortfall.
Matthew Hulse, MD. Chief of the Division of Critical Care Medicine at Medical University of South Carolina (Charleston): Adaptive. No other medical specialty works more closely with technological innovations than anesthesiology. The field is evolving rapidly in response to advancements in AI-driven monitoring, automation and novel drug delivery systems. At the same time, workforce dynamics and healthcare economics are shifting, requiring us to rethink care models. The key to the future of anesthesia is adaptability — leveraging these changes to enhance patient safety, optimize perioperative outcomes and improve efficiency across diverse practice settings.
Corey Collins, DO. Medical Director at Anesthesia Consults of Massachusetts (Boston): Unsustainable. Salaries for anesthesiologists and CRNA are increasing at a pace that is unsustainable based on decreasing reimbursement. This will create a need for the dramatic shift in service delivery. Insurers have tried already to change the landscape (e.g. endoscopy, fixed fees based on procedure codes) but it will likely be the healthcare systems that implement these changes.
Spine
Ali Ghalayini. ASC Administrator of Advanced Spine Center of Wisconsin (Neenah): As the U.S. healthcare landscape continues to evolve, hospital consolidation is emerging as a dominant trend and one with profound implications for spine care delivery. From the perspective of ambulatory surgery centers, this consolidation wave represents both a significant challenge and a unique strategic opportunity. With hospitals merging into large, integrated networks, ASCs must adapt to preserve their share of the spine care market and continue offering high-quality, cost-effective alternatives.
One of the most immediate consequences of hospital consolidation is the increased dominance of health systems and their ability to control referral networks. As hospitals acquire physician groups and consolidate services, spine referrals are more frequently kept in-house and directed to hospital outpatient departments. This limits access for independent ASCs, particularly those without formal affiliations or joint ventures with hospital systems. To remain competitive, ASCs must build stronger partnerships with independent spine surgeons and maintain robust relationships with referring providers.
While referrals may become more restricted, the migration of complex spine procedures to the outpatient setting presents a major opportunity. As payers and CMS expand the list of approved outpatient spine procedures, ASCs with the right clinical protocols and capabilities are well-positioned to take on this growing volume. Spine-focused ASCs that invest in equipment, overnight recovery capabilities and enhanced anesthesia protocols can safely manage 23-hour stays and more advanced procedures, offering a compelling value proposition to both payers and patients.
In parallel, health systems themselves may increasingly look to acquire or partner with high-performing ASCs as part of their broader outpatient growth strategy. For ASCs, this raises a critical decision point: remain independent and compete through agility and efficiency or consider strategic partnerships that enhance access to cases while potentially sacrificing some operational autonomy. In either scenario, demonstrating superior outcomes, financial transparency, and patient satisfaction will be key to sustaining long-term viability.
Finally, the rise in healthcare costs driven by consolidation may ultimately work in ASCs’ favor. As patients and employers become more cost-conscious, ASCs offer a transparent, lower-cost alternative to hospital-based care. Spine procedures, in particular, often carry a significant price difference between HOPDs and ASCs. By emphasizing affordability, convenience, and quality, ASCs can position themselves as the preferred site of service for spine care, even in a market increasingly dominated by consolidated health systems.
Cynthia Burleson. Administrator at Brunswick Surgery Center (Leland, N.C.): The use of minimally invasive techniques has been shown to reduce stress and impact on the body. With robotics being used more for joint and spine procedures, in addition with the use of artificial intelligence will continue to aid in smaller incisions, less manipulation and faster recovery times, creating a growing market for ambulatory surgical care.
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