'Hospitals are scared to death': Why ASCs have the advantage in recruiting spine surgeons

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Allowing physicians to have ownership in the places they work can make ASCs more attractive in recruiting, spine surgeon Stephen Hochschuler, MD, said. 

Dr. Hochschuler, of Texas Back Institute in Plano, spoke with Becker's about his outlook for ASCs and the essential nonsurgical skills physicians should have. 

Note: This conversation was edited for clarity and length.

Question: How can ASCs gain an edge in surgeon recruiting?

Dr. Stephen Hochschuler: Hospitals are scared to death right now because they're wondering where their future is. Most hospitals are owned by hospital companies or not for profits. From a surgeon standpoint, why shouldn't they own part of the facility that does the production? 

Unlike chiropractors, and unlike dentists who help each other, surgeons are always competing to be at the top. Not all of them, but the majority. That's ingrained. And if it wasn't, the surgeons would be more in charge than they are today. Right now, hospital companies, insurance companies, attorneys, you name it, they run medicine. At least 60% of orthopedic surgeons and maybe even higher, the neurosurgeons are now working for somebody either a hospital or a company like United Healthcare.

So doctors are looking to simplify their life. The more modern people all want what the older guys have, but they want it yesterday. It's just a totally different philosophy. So how can you get physicians on the same page? So we started with surgery centers years ago. The way you do it, you give them a commonality. The commonality is if myself and my main competitors in the marketplace all own part of the surgery center instead of being jealous of how much work they are doing, I'm thrilled because they're feeding the surgery center, which I own a big part of.

Q: Would you say having some knowledge in business is essential for early-career spine surgeons?

SH: Without a doubt. I went to medical school at Harvard and I kept saying, "Why don't we send our guys six to eight weeks to Harvard Business School?" That was 50 years ago. I was 50 years too soon. We need to know business, and the smart physicians will take the time and get an MBA and work in the business/medical realm. I was criticized years ago for trying to marry the best of business with the best of medicine. 

But you gotta play the game, and you got to be involved. You have to look at what's next. And every industry does that. Medicine has not done it, and we've been hamstrung. So now when you bring business knowledge into the medical realm, tie it in with logic, and the number one criterion, we've always stressed this is not how much money the doctor makes. It's not how famous the guy is. It's not how much the insurance makes or doesn't make. It's not the attorney, it's the patient. The only one that people should focus on is the patient. Next to the patient should be the doctor, and all the rest is ancillary. 

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