COVER STORY


After Your Physician Leaves Do you have a strong infrastructure and potential leads in the bag to eat the loss? BY ROBERT KURTZ


I


n 2018, two high-volume orthope- dic surgeons left CenterOne Surgery


Center in Jacksonville, Florida, to pur- sue a new endeavor. While the loss was not crippling, says Executive Director Robert Haen, their unexpected depar- ture left a challenging void. “Our ASC had infrastructure in place


designed to support volume levels that included these surgeons,” Haen says. “Their loss would not only translate to a good percentage drop in volume but had the potential to negatively impact earnings at a much greater percentage because of our infrastructure costs.” The ASC, however, faced an important deci- sion: work to scale back its infrastructure to account for the reduced volume or fill the openings in its surgical schedule. Most ASC managers prefer to have


some advance notice before a physi- cian leaves. That is not always the case, however, as John Schario, chief oper- ating office of Medical Facilities Cor- poration in Nashville, Tennessee, has


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experienced. “Not long after we opened a new ASC, one of the heaviest hitters in terms of volume died in a car accident. At another center, an accident forced a surgeon to suddenly change careers because he lost the use of his hands.” Situations like those make ongoing


physician succession planning criti- cal, says Ken Rosenquest, senior vice president and chief operating officer of Constitution Surgery Alliance in Avon, Connecticut. “You cannot effectively


respond to these developments if your response begins when you learn a phy- sician is leaving, regardless of the rea- son. Your ASC needs a plan for what to do when that day comes.”


Know Your Options Fortunately, Haen says, that was the case for CenterOne Surgery Cen- ter. “Rather than consider the exiting of the two surgeons a loss, the ASC viewed it as an opportunity to add a new specialty. “We knew total joints were becoming more commonplace in ASCs, so we contacted a busy total joint physician in our market to gauge his interest in coming to and investing in the ASC. He had some expensive equipment requirements, but we deter- mined the case volume would justify the investment. It has and then some.” The addition of total joints alone did not fill all the available operating room time, which permitted Haen to pursue another new specialty as well. He had a relationship with an infertil- ity and gynecology physician who was interested not only in joining the ASC, but also in becoming an investor. “We later added two of his associates as


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