Physician autonomy is top of mind for many ASC leaders — especially as around 108,700 physicians left private practice for employment between 2019 and 2021, according to a report from Avalere.
While many physicians have moved toward employed models, not all are satisfied with that transition. Some are now pivoting back to private practice. A survey from consulting firm Bain & Co. found that nearly 25% of physicians in health system-led organizations are considering changing employers, compared to just 14% in physician-led practices. Notably, 37% of those considering a switch are looking to move to physician-owned settings.
Employed physicians also report higher levels of burnout, anger, and anxiety than their independent counterparts, according to a recent survey from the Physicians Foundation. A key contributor to this dissatisfaction is reduced autonomy. A survey from NORC at the University of Chicago revealed that 61% of employed physicians say they have moderate or no autonomy when making referrals outside their practice or ownership system.
For many healthcare leaders, autonomy is increasingly tied to the value proposition of ASCs. Benjamin Stein, MD, co-founder and chairman of ASC development firm Capital Surgical Solutions, pursued independence after witnessing culture changes at a former employer following its acquisition by a larger healthcare company.
He told Becker’s last year that, following the acquisition, he observed “a noticeable shift in the culture among the staff and the surgeons,” which he said could ultimately affect the patient experience.
Almost a year later, Dr. Stein reports that the independent model is thriving.
“What I can tell you now, having an operational, very busy facility of this model that’s doing over 1,250 joint replacements per year, with 2,900 total orthopedic surgeries… When you empower those delivering the care to have substantial control over all elements related to that care, you get higher rates of not only surgeon satisfaction, but also employee satisfaction and retention, and ultimately patient outcomes,” he said.
When looking at Google Reviews, Capital Surgical’s two facilities “are the shining stars of the entire Maryland, DC, Virginia marketplace.” The newest facility, District Surgery Center, which opened in January 2024, is “already trending very strongly,” Dr. Stein said. He attributes the success to surgeon engagement and control.
“It spills out into everything: better outcomes, better patient satisfaction, surgeon happiness — because they can actually dictate some of what they’re doing and how they’re doing it — and employees who feel good and stable, in a family-like environment where they feel supported and cared for,” he said.
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