Orthopedic surgeons who own one of the growing number of ambulatory surgical centers (ASC) are doing a lot more surgery than non-owners surgeons, new workers’ compensation research shows. There is plenty of financial incentive for this — surgeon-owners not only get paid for the surgery but they also share in their ASC’s profits.
In Florida, orthopedic surgeons who owned ASCs did between 52 and 111 percent more surgery than orthopedic surgeons who were not owners, according to the Workers Compensation Research Institute (WCRI).
The study, “Why Surgeon Owners of Ambulatory Surgical Centers Do More Surgery Than Non-Owners,” examined 941 surgeons – some of whom ultimately became owners of surgery centers. It compared the number of knee, shoulder, and wrist surgeries that each surgeon did before becoming an owner with the number performed after becoming an owner.
The study found that the average surgeon did 14-22 percent more surgery after becoming an ASC owner. The study did not determine whether these additional surgeries were necessary.
The study also found other important reasons why orthopedic surgeons who own ASCs do more surgery than orthopedic surgeons who are not owners. One is that ASCs are more likely to recruit high-volume surgeons to become owners. Similarly, high-volume surgeons are more likely to become owners of surgery centers, according to the study’s author, Dr. Christine Yee.
Dr. Yee also said that surgery centers are often more efficient than hospital outpatient departments, so the surgeons were able to schedule and perform more surgeries once they were affiliated with surgery centers.
“This is just one example of physician self-referral – a growing issue being addressed by state and federal policymakers concerned about spiraling health care costs,” said Dr. Richard Victor, the research institute’s executive director. “As payers limit price increases for physician services, the physicians look for other avenues to supplement their income – ownership of surgery centers and MRI facilities as well as physician dispensing of prescription drugs have become much more common.”
WCRI is a not-for-profit research organization based in Cambridge, Mass. WCRI’s members include employers; insurers; governmental entities; managed care companies; health care providers; insurance regulators; state labor organizations; and state administrative agencies.
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