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When the surgeon takes a cut

By Jay MacDonald ·
Tuesday, May 15, 2012
Posted: 10 am ET

Surgeons who own a share of their surgical center perform between 52 and 111 percent more surgeries than those who don't, according to a new survey by the Workers Compensation Research Institute.

The nonprofit research organization compared the number of knee, shoulder and wrist surgeries performed by 941 orthopedic surgeons in Florida before and after they became owners of an ambulatory surgical center, or ASC.

The study found that the average surgeon performed 14 to 22 percent more surgeries after becoming an ASC owner.

Although the study did not weigh in on whether the additional surgeries were necessary, researchers did conclude that the financial incentive of ownership was a primary reason for the disparity.

Surgeons who also are owners receive both a fee for the surgery and share in the profits of the surgical center.

Study author Dr. Christine Yee says ASCs are more likely to recruit high-volume surgeons and high-volume surgeons are more likely to become owners of ASCs. The relative efficiency of ASCs compared to hospital outpatient departments also enables surgeons to schedule and perform more surgeries by joining an ASC, she adds.

Dr. Richard Victor, WCRI executive director, says the findings reflect the changing landscape of American health insurance brought on by health care reform.

"This is just one example of physician self-referral – a growing issue being addressed by state and federal policymakers concerned about spiraling health care costs," he says. "As payers limit price increases for physician services, the physicians look for other avenues to supplement their income – ownership of surgery centers and MRI facilities as well as physician dispensing of prescription drugs have become much more common."

What's your diagnosis? Should you question a surgical procedure ordered by a doctor who owns a cut of the business?

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