As 2023 comes to a close, 27 physicians who practice on an outpatient basis recently joined Becker's to share where they are placing their focus in 2024.
The physicians featured in this article are all speaking at Becker's 2024 ASC conferences. This includes the 21st Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, which is set for June 19-22 at the Swissotel in Chicago. This also includes the 30th Annual The Business and Operations of ASCs, which is set for Oct. 30 to Nov. 2 at the Hyatt Regency in Chicago.
If you work at an ASC and would like to join as a speaker, please contact Claire Wallace at cwallace@beckershealthcare.com.
As part of an ongoing series, Becker's is connecting with healthcare leaders who will speak at our events. The following are answers from our speakers.
Note: Responses were slightly edited for length and clarity.
Question: What is your top priority for 2024?
Marco Araujo, MD. Anesthesiologist at Advanced Pain Management (Green Bay, Wis.): Starting a new pain practice and a new ASC in Stevens Point, Wis.
Robert Bell, MD. CEO at NW Surgery Center (Houston): The main priority for our surgery center in 2024 is to continue to market and promote our liability business.
Grant Booher, MD. Neurosurgeon at Longhorn Brain and Spine (Fort Worth, Texas): My goal for 2024 is practice growth. I have partnered with a management group and several local surgeons to build out an ASC. I'm utilizing robotics and plan to focus on endoscopic approaches with regional blocks for more outpatient surgeries. I'm currently a solo practitioner and I would love to bring on a like-minded physician partner this next year as well.
George Bovis, MD. Neurosurgeon at Ascension Illinois (Chicago): In 1999-2000, we thought computers were too dumb to handle the millennial change. In 2023-2024, we think computers/AI are too smart and pose an existential threat to mankind. So in 2024, I look forward to reconciling how this promethean technology can be harnessed safely and intelligently optimize patient care and outcomes.
Adam Bruggeman, MD. Orthopedic Surgeon at Texas Spine Care Center (San Antonio): My top priority is working toward a permanent fix to the Medicare physician payment system. We have gained significant momentum and awareness on the topic in Washington, D.C., and recently had the chair of the Senate Finance Committee state that their committee would need to address the issue next year. Meaningful reform with a tie to the actual cost of providing care is needed to ensure access for patients and the long-term viability of physician practice.
Justin Bundy, MD. Orthopedic Spine Surgeon at Augusta-Aiken Orthopedic Specialists (Augusta, Ga.): My top priority for 2024 is to advance outpatient spine with new technology and patient-appropriate care.
James Chappuis, MD. Orthopedic Surgeon at Spine Center Atlanta: My top priority for 2024 is community building. Creating new bonds around Atlanta and our satellite locations fortifies my purpose to help others get back to the life they want to live without pain. I look forward to expanding our practice in areas where pain is a living constant due to the lack of resources and providing an alternative solution to solve the problem instead of placating it.
Dan Chen, MD. Assistant Professor of Orthopedic Surgery at Geisinger Commonwealth School of Medicine (Scranton, Pa.): 2024 will be a year of growth for hospitals and physicians alike as we return to normalcy after the COVID pandemic and as the aging U.S. population begins seeking increased elective procedures to treat their ailments. My top priority continues to be the best minimally invasive spine surgeon and physician that I can be for my patients, and to provide them with individualized care to maximize their return to function. Product innovation, coupled with integrating the evolving body of knowledge, will be critical to providing the best spinal treatments. Along these lines, I think the spinal implants industry will continue to advance and innovate in 2024, and I'm looking forward to what new technology is available to my patients.
Jayesh Dayal, MD. Anesthesiologist at White Flint Surgery (Rockville, Md.): As an independent ASC, as we transition to the higher acuity ortho and spine cases, it is becoming very apparent that remaining independent is becoming impossible, as we have absolutely dismal rates, no scope of negotiating anything at our scale — with the insurers or the vendors — and the personnel costs are out of control. For 2024, we have started talking to national chains, private equity firms and hospital systems to partner with so that the rates get better, the cost of disposables and implants get better, and the day-to-day operations and RCM are optimized. The days of in-house billing, long-term relationships with one's team, the independence to run your own outfit, are sadly gone. It was fun while it lasted, but it's time to bring in the suits — like the hospital days of yore.
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: My top priority for 2024 is to increase my focus on patient experience, endoscopic spine surgery and my efforts in patient and physician advocacy. With the recent cuts to reimbursement by siloed bureaucracy, seemingly in the favor of the payers, it is more important than ever to shine a light on the real forces that drive the increase in the cost of healthcare. In my own practice, we are focused on having physician-led care with high levels of contact with the patients and clarity of their care plans, with good outcomes, happy patients and the same attention to detail our patients are accustomed to. Truly minimally invasive surgery for selected cases will drive good outcomes, and I think will lead to more outpatient cases and patients convalescing comfortably at home sooner after surgery, when it is safe and appropriate.
Reuben Gobezie, MD. Director of the Gobezie Shoulder Institute (Mayfield Heights, Ohio): Incorporate our ASCs into our overall practice strategy to provide risk-based contracts to payers and employers in order to reduce their total cost of musculoskeletal spend. We are using provider-based technology platforms like Genie Health to enable our practice to leverage all of its services to the payers and self-insured employers who are desperately seeking ways to reduce their ever-increasing MSK spend. Surgical procedures are amongst the most expensive services MSK practices provide, and the ASCs are an ideal ancillary to leverage in any strategy to reduce the total cost of care for musculoskeletal care.
Omar Khokhar, MD. Partner at Illinois GastroHealth (Bloomington): Top priority is staff engagement to meet our goals. Historically we haven't enrolled our staff into the why — the patient experience, the revenue cycle and bottom line. We need to find the right staff who are willing to understand the why and then choose to walk the walk with the ASC in order to improve patient access and profitability. We also need to be more aggressive and proactive with contract management/optimization.
Earl Kilbride, MD. Orthopedic Surgeon at Austin (Texas) Orthopedic Institute: My top priority for 2024 is to work smarter, not harder. Being 22 years post-residency, I feel as though I have optimized the clinical workflow side of practicing orthopedics. The administrative side is another story. We can all document better, empower our team and streamline that side of the practice.
Timothy Lubenow, MD. Professor of Anesthesia and Pain Medicine at Rush University Medical Center (Chicago): I'm planning to improve my payer mix by networking with workers' compensation nursing organizations. I also am limiting the number of Medicare patients seen on a daily basis.
Eric Mehlberg, MD. Anesthesiologist at Comprehensive Pain Specialists (Golden, Colo): My priority for 2024 is to continue diversifying my skill set. This serves a couple aims. One, it prevents one's practice from getting stale. Two, it makes you attractive to referrers and employers, and three, it serves our patients better.
Manoj Mehta, MD. Medical Director at Endoscopy Center of the North Shore (Wilmette, Ill.): 2024 will see another year of shrinking reimbursements, a declining available physician pool and increasing patient health needs. While I anticipate that hospital systems will respond in the usual way (cutting appointment times, squeezing doctors for more productivity, slashing salaries and letting patients' wait times languish), this is an opportunity for the more flexible private practices and outpatient surgicenters to fill the void. We plan to increase our availability, provide more endoscopy slots and onboard new physicians to meet these needs. I would encourage all of you who have your own practices to take ownership of the needs of your patients in this next year more than ever. These efforts are not unrecognized, and pay dividends in patient satisfaction scores, new referrals, reputation and even your own satisfaction with work.
Taif Mukhdomi, MD. Pain Physician at Pain Zero (New Albany, Ohio): Growth! There is a changing tide in physicians across the country as young physicians are assuming the roles of their seasoned counterparts. There is new energy behind young physicians eager to shape healthcare: excitement to help patients, offer new and innovative therapies, understanding of the healthcare industry and are poised for growth. We are looking to grow our presence in the national and regional healthcare spotlight, build on our clinical team, and expand our care across the Columbus and Central Ohio area.
Kenneth Nwosu, MD. Spine Surgeon at Neospine (Puyallup, Wash.): My top priority for 2024 is to transition "higher acuity" spine procedures like transforaminal lumbar interbody fusions back to the ASC. These procedures were routinely performed safely in the ASC for Medicare beneficiaries due to provisions from the Hospital Without Walls program announced by CMS in March 2020 due to the COVID-19 pandemic. However, as the pandemic abated, so did the HWW program and its associated provisions, making it cost restrictive to perform these procedures in the ASC setting.
Currently, a majority of these patients are discharged home on the same day of surgery when performed in the hospital setting, but at a higher cost. Rather than wait and hope for CMS to recognize and address this discrepancy in value delivery, we plan to demonstrate the discrepancy empirically in our experience, with hopes we will be granted a carve out to begin performing these "higher acuity" spine procedures in the ASC again.
Joe O'Brien, MD. Medical Director of Minimally Invasive Orthopedic Spine Surgery at VHC Health (Bethesda, Md.): Our top priority for 2024 is to grow our ASC with another room.
Peter Passias, MD. Orthopedic Spine Surgeon at NYU Langone Health (New York City): Top priorities are expanding AI applications in spine surgery not just in the OR but in terms of patient selection, risk stratification and predicting outcomes. Also diminishing invasiveness options are expanding with advanced technologies, and traditional surgery is becoming minimized.
Sheel Patel, MD. Anesthesiologist and Interventional Pain Specialist at APAC Centers for Pain Management (Chicago): Top priority for 2024 is to have our two ASCs at 75% capacity in terms of the number of days we have surgeons performing cases. We are currently only providing interventional pain services; however, the idea is to expand into podiatry and possibly ortho cases as well. Additionally, we hope to start offering ketamine infusion services in the ASC on days where we do not have any surgeons performing cases.
Ken Rich, MD. President at Raleigh (N.C.) Neurosurgical Clinic: I would like to see insurers including Medicare allow surgeries that can be done in ASCs to be done there. All too often I find our group doing surgeries in a hospital at three or four times the expense that could easily be done in an ASC. The insurers would save a lot of money, and the patients would have a much better experience.
Scott Sigman, MD. Surgeon at OSA Orthopaedics (Chelmsford, Mass.): My top priorities in 2024 are to identify solutions to improve the quality of life for physicians. Every day we are asked to do more with the ever-present threat of getting paid less. Physician burnout must be addressed. We need to leverage technology to our advantage to improve physician time management. We need to identify alternative revenue sources that also benefit patient care, such as companies that are utilizing remote therapeutic monitoring codes. I will continue to work on my passion for alternative pain management options for our patients to keep them moving so they can champion their personal success.
Pankaj Vashi, MD. Department Head of Gastroenterology/Nutrition and Vice Chief of Staff at City of Hope Chicago: My priority for 2024 is to see the impact of AI in the field of gastroenterology. Artificial intelligence is in its infancy, and we are already seeing it being used for screening for colon cancer and surveillance for Barrett's esophagus. New applications of AI will change how we practice in the near future.
Judy Wolfe, MD. Enterprise Associate Chief Experience Officer at Cleveland Clinic: Over half of the patients seeking care nationally run into operational friction — barriers to care that frustrate and degrade loyalty in the system and caregivers. A top priority in 2024 is to help make getting care at Cleveland Clinic easier. As an enterprise, we're reinvigorating communication skills and service behaviors in all care settings, empowering caregivers to remove obstacles to care, and illuminating opportunities to improve processes and procedures with the patient at the center of our efforts. Technology, retail and hospitality have focused on ease as part of the customer experience for years — it's time for healthcare to adapt, too.