Physician-owned hospitals in orthopedic and spine surgery

Hospitals owned wholly or in part by doctors are known as physician-owned hospitals (POHs) (1). Such hospitals are full-service centers, providing both inpatient and outpatient surgical services. This is in contrast to ambulatory surgery centers (ASCs), which are free-standing facilities in which only outpatient procedures are performed (2). Surgery in the ASC setting may not be appropriate for higher risk patients who have an increased likelihood for complications necessitating postoperative inpatient monitoring and care (3). Advocates of POHs and ACSs argue that these facilities are better able to optimize quality, efficiency, and outcomes because they tend to focus on a limited number of service lines (4,5). Furthermore, by virtue of holding equity, physicians may have more power to enact the changes they deem necessary to improve clinical care. These factors are of increasing importance in the context of ballooning overhead costs, compliance requirements, and complexity of payment schemes (6,7).