Patrick Garman

Not everyone's embraced it.

Others have.

So it's kind of 50 50.

Forming a joint venture with either a hospital system or a management company has to fit the needs of the doctors.

The doctors, the surgeons are the single most important component.

Without the doctors writing the prescription or the order to have the surgery performed, whether it's an admission at the hospital or a procedure in the surgery center, that's where it starts.

It's all centered around the doctor.

My opinion, I've been in the field 35 years, the doctors rule.

So that's why hospital groups try to employ them.

That's why surgery centers were invented as an extension of physician practice and entrepreneurial spirit.

So leave it up to the doctors.

If the doctors want a collaboration, if they think it makes sense to partner with a management company to get enhanced insurance contracts or cost savings on purchasing supplies, things like that, a bigger, larger network, if it makes sense to partner with a local hospital because the hospital would...

you know, find a creative way to get them privileges and have them earn a stipend for doing inpatient care at the same hospital.

There's all that stuff will play out, but it has to be focused to start on the doctor, whether it's a group of physicians all aligned or just an individual surgeon.

Yes.

It's a painful one.

Anesthesia.

is becoming an unsustainable expense, okay?

Five, six years ago, pre-COVID, it was not an issue that we really, really had to concern ourselves with.

But as in most professions, you have one segment of the population retire, either replaced properly with enough volume or not.