Choosing an ASC for Procedures

[Got Em]

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I am starting a small practice and will start out hoping to do 1/2 day of procedures at an ASC every week. Goal is to do all procedures here before transitioning to in-office set up. All of ones that I'm looking at perform pain procedures and already have at least 1 interventional pain physician. What questions would you ask an ASC to determine if it's feasible?

 

[Bostonspine]

I am starting a small practice and will start out hoping to do 1/2 day of procedures at an ASC every week. Goal is to do all procedures here before transitioning to in-office set up. All of ones that I'm looking at perform pain procedures and already have at least 1 interventional pain physician. What questions would you ask an ASC to determine if it's feasible?

I think equipment need(RFA machine) is important, potential referral source (Ortho), close to office,

 

[geauxg8rs]

I am starting a small practice and will start out hoping to do 1/2 day of procedures at an ASC every week. Goal is to do all procedures here before transitioning to in-office set up. All of ones that I'm looking at perform pain procedures and already have at least 1 interventional pain physician. What questions would you ask an ASC to determine if it's feasible?

Can you get two rooms? What block time?
Where do they get lunch? Are the nurses quick or slow

 

[Got Em]

Can you get two rooms? What block time?
Where do they get lunch? Are the nurses quick or slow

Since I'm starting out without that many patients, I didn't think they would give me 2 rooms. This is a great idea though!

Block time will after in the afternoon (preferred for me). I am not sure if they'll tell me how fast the nurses/techs are, so not sure how to get this information.

I think equipment need(RFA machine) is important, potential referral source (Ortho), close to office,

Yep they all have RFA machines. Have you seen a difference between Medtronic, Stryker, or Neurotherm?

Have you gotten more referrals from neurosurgery/ortho spine or regular ortho?

 

[Dr. Ice]

They know what to do for you. Bite the bullet until you can get into the office. You will realize how inefficient an asc is compared to office based set up. The days of capitalizing on ASCs are done in my opinion.

 

[Bostonspine]

Since I'm starting out without that many patients, I didn't think they would give me 2 rooms. This is a great idea though!

Block time will after in the afternoon (preferred for me). I am not sure if they'll tell me how fast the nurses/techs are, so not sure how to get this information.



Yep they all have RFA machines. Have you seen a difference between Medtronic, Stryker, or Neurotherm?

Have you gotten more referrals from neurosurgery/ortho spine or regular ortho?

both Spine will be most efficient but sports (torch bursa vs L5 radic), Foot and ankle/Podiatry(L5 and S1 radic and CPRPS), Total joint specialist(L2/3/4 radic, Hand (cervical radic and CRPS) etc you can network

 

[drusso]

Can you get shares? Juice might not be worth the squeeze.

 

[Got Em]

Can you get shares? Juice might not be worth the squeeze.

Yes, but I'm trying to keep expenditures as small as possible. I am willing to make less money now. When I have enough patients, then I will either buy shares or move to in-office procedures.

 

[BobBarker]

You can not afford to not have in office procedures. ASC is for major cases only.

 

[Got Em]

You can not afford to not have in office procedures. ASC is for major cases only.

I will start out working 1-2 days per week at my own practice and do outside shifts to build up the practice slowly.

I will not be spending $150k on a C-arm and sign at least a 3-5 year lease for office space until I build up my patient base. I need a short term lease and will likely lend from existing docs.

 

[hyperalgesia]

It's really important that you will be able to get block time. In some ASCs this is competitive and they can only give you this time or that time, if you're lucky. So it does matter how badly they want you.

Some ASCs aggressively pick/refuse to do procedures that pay well or don't. It can be annoying when they suddenly say, "we're not allowing you to do any hip injections from now on because we lose money". They ended up losing all procedures = idiotic management.

Personally, I would prioritize an ASC that is NOT Joint Commission accredited. This turns admin/nurses into zombies that require you to do mounds of useless extra work.

If you can talk to a doc that works there, they can sometimes tell you a thing or two.

One ASC that I worked at has cancelled entire procedure days because they were too incompetent to find staff. GI folks had pts who already took their preps and were cancelled and barely an apology was given.

 

[BobBarker]

Just lease the c arm. You are cutting your own throat if you don’t.

 

[BobBarker]

It's really important that you will be able to get block time. In some ASCs this is competitive and they can only give you this time or that time, if you're lucky. So it does matter how badly they want you.

Some ASCs aggressively pick/refuse to do procedures that pay well or don't. It can be annoying when they suddenly say, "we're not allowing you to do any hip injections from now on because we lose money". They ended up losing all procedures = idiotic management.

Personally, I would prioritize an ASC that is NOT Joint Commission accredited. This turns admin/nurses into zombies that require you to do mounds of useless extra work.

If you can talk to a doc that works there, they can sometimes tell you a thing or two.

One ASC that I worked at has cancelled entire procedure days because they were too incompetent to find staff. GI folks had pts who already took their preps and were cancelled and barely an apology was given.

Agree. I tried to take some cases to a surgery center near my satellite office. But it would never work out. I gave up. Somehow the hospital 15 miles away had no problem with the same cases.

 

[Hoya11]

Can you get shares? Juice might not be worth the squeeze.

I would think thats the only real question for the center, can you be a partner in the center? they do well..

 

[Vie221]

Just lease the c arm. You are cutting your own throat if you don’t.

I agree. Probably my biggest mistake was not doing in office procedures my first year of practice. You can lease, buy or rent the C-arm. The revenue will more than make up for this cost. Also, patients appreciate the convenience and this should help build your patient base.

 

[geauxg8rs]

Agree. I tried to take some cases to a surgery center near my satellite office. But it would never work out. I gave up. Somehow the hospital 15 miles away had no problem with the same cases.

Also make sure the ASC is in network with payors. You don’t patients getting crazy bills. Especially if you aren’t profiting from such craziness, lol

 

[gaseous_clay]

They know what to do for you. Bite the bullet until you can get into the office. You will realize how inefficient an asc is compared to office based set up. The days of capitalizing on ASCs are done in my opinion.

Not true in all cases. It depends on many factors like multi-specialty vs single-specialty, how well it’s managed, quality of contracts, and % ownership one has in the center.