The Mass Exodus: Why the Best Doctors Are Leaving Hospitals in Droves
Exploring the Shift: Why Top Doctors Are Choosing ASCs Over Hospitals for Better Pay, Efficiency, and Patient Care
MORGAN SMITH - ISMAIL KASSEM
10/17/24 - 5 MIN READ
It used to be that if you wanted the best care, you went to the hospital, right? That’s where the most skilled doctors, cutting-edge treatments, and top-tier services were supposed to be. But recently, something strange has been happening. The best doctors are no longer hanging their lab coats in hospitals. Instead, they're walking away, choosing to work at Ambulatory Surgery Centers (ASCs), private clinics, and other innovative care models. Why is this happening? The reasons are complex but boil down to a few major factors: pay gaps, job satisfaction, and the cold, hard truth that hospitals are the only places that can afford to keep the mediocre.
The Great Pay Divide
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Let’s start with one of the most glaring issues: money. Hospitals, traditionally seen as the stronghold of medical care, often offer lower compensation than their outpatient counterparts. This doesn’t just apply to your average practitioner but even to top-performing surgeons and specialists. Imagine spending over a decade studying, interning, and working insane hours, only to be told you could make more at an ASC. ASCs are booming because they operate with leaner staff, more efficient procedures, and a laser focus on profitability, which allows them to offer highly competitive salaries (American Medical Group Association [AMGA], 2023).
For example, compensation packages at ASCs can be as much as 20% higher than hospitals for certain specialties (Association of American Physicians and Surgeons [AAPS], 2023). When the best doctors are forced to choose between making less at a hospital or earning more with better work-life balance at an ASC, it’s no wonder they’re flocking to the latter.
As you can see, ASCs offer more competitive compensation packages compared to hospitals, which is driving doctors to make the switch.
Hospitals: The Last Refuge for Bad Doctors?
Here’s an uncomfortable truth that many hospital administrators would rather you not know: hospitals can afford to hire mediocre or even bad doctors and still make money. How? Simple. The hospital business model relies heavily on volume. As long as they can keep the beds filled and bill insurers or government programs like Medicare, they can continue to rake in profits—even if the quality of care dips (Health Resources & Services Administration [HRSA], 2023).
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On the flip side, ASCs and private clinics have much more skin in the game. They’re smaller, more agile, and rely heavily on reputation. A botched surgery or bad online reviews can sink an ASC much faster than it would affect a hospital (Journal of Ambulatory Care Management, 2022).
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Not only are ASCs paying doctors more, but they are also more cost-efficient, as illustrated in the graph above.
Bundles Are Better: Why New Payment Models Are Driving the Shift
Another reason for the exodus of top doctors from hospitals is the shift in how care is paid for. Traditional fee-for-service models are slowly being replaced by bundled payments. In a bundled payment system, doctors and facilities are paid a lump sum for an entire episode of care—think of it as getting paid one fee to cover everything from pre-op to post-op for a knee replacement, rather than billing separately for each service along the way (Centers for Medicare & Medicaid Services [CMS], 2023).
Bundled payments put the emphasis on quality and efficiency, which aligns with what ASCs do best. A Health Affairs study shows that bundled payment models have been proven to reduce overall healthcare costs by up to 10% while improving patient outcomes (Health Affairs, 2023).
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Beacon Ortho Strategy: Leading the Charge
One great example of this shift is Beacon Ortho, a leader in orthopedic care, which has fully embraced the ASC model. By cutting out the hospital middleman, Beacon Ortho has been able to attract top-tier talent while offering lower costs and better outcomes for patients (Beacon Orthopedics & Sports Medicine, 2024).
Beacon Ortho’s approach proves that bundles, efficiency, and attracting the best talent isn’t just good for patients—it’s good for business too. Hospitals, on the other hand, are left in a bind. They can’t compete with the pay, work environment, or focus on quality care that ASCs offer, so they’re left with the dregs of the medical workforce.