Surgeons do more procedures when they take a cut of the profit

Surgeons who become owners of surgical centers perform 14 percent to 22 percent more surgery than when they were nonowners, according to the Workers Compensation Research Institute, a nonprofit on public policy for compensation systems.

The study looked at nearly 950 surgeons at ambulatory surgical centers in Florida. Although it did not determine whether the surgeries were medically necessary, researchers found that orthopedic surgeon owners, in particular, performed 52 percent to 111 percent more surgery than nonowners.

The study draws questions about self-referral and cost efficiency. Another study, published in the Archives of Surgery in 2010, found that more patients are scheduled for procedures by doctors who own a facility than by those who don't. For example, patients who underwent carpal tunnel surgery were 54 percent to 129 percent more likely to do so at a surgeon-owned facility, when compared with other facilities.

Workers Compensation Research Institute Executive Director Richard Victor said the research points to a growing pattern of physician self-referral. "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."

Although these studies question if ownership stakes affect practice patterns, others say the research simply points to what surgeons do--surgery. As one commenter noted on an Insurance Journal article, it's like saying "people who drive cars are more likely to drive."

Study author Christine Yee noted that "ASCs are more likely to recruit high-volume surgeons to become owners. Similarly, high-volume surgeons are more likely to become owners of surgery centers." 

For more information:
- see the Workers Compensation Research Institute announcement
- read the Insurance Journal article

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