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Physicians with ownership in surgery centers operate more often, study finds
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Physicians invested in outpatient surgery centers perform twice as many surgeries as physicians with no such financial stake, according to a recent study from the University of Michigan Health System.
Results of the study appear in the April issue of Health Affairs.
“Our data suggest that physician behavior changes after investment in an outpatient facility,” John M. Hollingsworth, MD, an author of the study stated in a University of Michigan Health System press release. “Through what some have labeled the ‘triple dip,’ physician owners of surgery centers not only collect a professional fee for the services provided, but also share in their facility’s profits and the increased value of their investment. This creates a potential conflict of interest.”
Study parameters
The study looked at all patients in Florida who underwent one of the following five common outpatient procedures: carpal tunnel release, cataract excision, colonoscopy, knee arthroscopy and myringotomy with tympanostomy tube placement.
The investigators determined which physicians were owners of a surgery center, then compared the rate of surgery among owners in two time periods – before and after they acquired ownership – with that of physicians who remained non-owners.
Hollingsworth’s group found that owners operated on an average of twice as many patients as non-owners and, while caseloads increased overall between the earlier and later time periods for all physicians, the increases were more rapid and dramatic among owners.
“To the extent that owners are motivated by profit, one potential explanation for our findings is that these physicians may be lowering their thresholds for treating patients with these common outpatient procedures,” Hollingsworth stated in the release.
Understanding the implications
The number of surgery centers has increased nearly 50% during the last decade, according to the release.
Hollingsworth noted that patients at these facilities can often see shorter wait times and more amenities.
“There are some definite advantages for surgeons, as well as patients, associated with care at surgery centers,” he stated. “However, we need to better understand the implications of these new findings, in particular their overall effect on health care expenditures. Insofar as our results are due to lowered treatment thresholds, policymakers should consider, at the very least, requiring all physicians to disclose their financial interests to their patients.”
- Reference:
Hollingsworth JM, Ye Z, Strope SA, et al. Physician-Ownership Of Ambulatory Surgery Centers Linked To Higher Volume Of Surgeries. Health Aff (Millwood). 2010 Apr;29(4):683-689.
