ASC not only to see patients but also with critical issues for the success of the ASC such as selection of infor- mation systems, the capital expendi- ture process, upgrades to the facility and involvement with discussions with commercial payers. As pay-for-perfor- mance continues to take hold in the marketplace, you must have your cur- rent physicians engaged, and you need those physicians who are coming up to have the same level of interest in and appreciation for the ASC.”

When a Doctor Leaves

Physician succession planning needs to remain top of mind BY ROBERT KURTZ


uccession planning of physician partners, a critical process for ensur- ing the ongoing viability of an ASC, often does not receive the attention it deserves, says Brian Brown, regional vice president of operations for AmSurg Corporation, an ASC management and development company based in Nash- ville, Tennessee. “Many people put succession plan- ning on the back burner because they do not think it is something they are ever going to need to address,” he says. “But then, when a physician actu- ally does leave the ASC, they are left scrambling to determine what to do.” If an ASC does not take succession planning seriously, the consequences could be dire, says John Newman, senior vice president and general coun- sel for ASC management and develop- ment company Constitution Surgery Centers in Newington, Connecticut.

18 ASC FOCUS AUGUST 2015 “If you are not constantly looking to

grow the complement of physicians who utilize the ASC, the center will inevita- bly see a decline as physicians retire or leave for other reasons,” he says. “You are going to lose the patient throughput, and you are not going to be able to fund buyouts. Succession planning is an issue for the current generation of ownership because their buyouts are dependent upon having a generation behind them who can finance those redemptions.” Succession planning also is impor- tant from a physician engagement per- spective, says Thomas Feldman, chief executive officer of the Center for Health Ambulatory Surgery Center in Peoria, Illinois. “You have to ensure a strong part- nership remains even after the cur- rent complement of physicians moves on,” he says. “That strong partner- ship entails physicians involved in the

Be Proactive An ASC’s leadership should have regu- lar conversations about succession plan- ning with its physician partners, Brown advises. “It is something you have to look at constantly, with a particular focus on those physicians you know are going to exit in the next 24–48 months. Once you know about that exit plan, really start working with these physi- cians. Discuss whether there is a suc- cession plan within their practice that would include bringing on a new physi- cian who would have interest in acquir- ing their ownership stake in the ASC. If they are planning to sell the practice, you can work with the buyer and try to facilitate a sale of the ASC ownership stake if it is a good fit for both parties.” It is particularly important to have succession plan discussions when a physician who brings substantial case volume to the ASC is planning to leave, Feldman says. “You need to have ongoing conversations to find out, for example, what an orthopedic prac- tice is doing to eventually replace its major foot and ankle physician. Just one bad quarter resulting from the loss of a major player who is not effectively replaced can kill an entire year.” It is imperative for ASCs to have more than one succession plan, Brown advises. “If plan A does not pan out, you always have to be thinking about plan B and C. If the share of the business can- not be passed on within a practice or

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