Before You Buy Into an ASC: Ownership, Partners, and Control | LOF #134

<p>Before you buy into an ASC, ask what you actually own—and who controls the decisions.</p><p><br></p><p>Dan Lieberman, MD joins Dr. Lucas Ferrer and Dr. Miguel Montero-Baker to unpack ambulatory surgery center ownership, the partners you choose and the agreements that shape your independence.</p><p><br></p><p>Dan trained in neurosurgery at UCSF, spent nearly two decades in solo practice and chaired the governing board of a physician-owned hospital. After essential tremor ended his operating career, his experience building ASCs became a new way to help physicians shape where and how they work.</p><p><br></p><p>Miguel brings the question many independent physicians hesitate to ask: after building a practice you control, why put your future in other people&#39;s hands? Dan&#39;s answer moves from the cost of taking a vacation to the financial model, exit arrangements and decisions physicians need to understand before signing.</p><p><br></p><p>In this conversation, Dan reveals:</p><p>⬛ Why owning a hospital made him rethink the environment in which he wanted to practice</p><p>⬛ How OBLs, ASCs and hospitals can serve different needs—and why patient selection comes first</p><p>⬛ Why owning your practice does not necessarily mean owning your time</p><p>⬛ What to ask about leaving a partnership before you agree to enter it</p><p>⬛ How to challenge a pro forma instead of treating its assumptions as promises</p><p>⬛ Why your ownership percentage does not tell the whole story about control</p><p>⬛ How the wrong partner can undermine an otherwise attractive business</p><p><br></p><p>The conversation ends with a practical checklist: understand the entity you would own, question the model, assess management, read the operating agreement and know your partners.</p><p><br></p><p>Which question would you insist on answering before buying into an ASC? Tell us in the comments.</p><p><br></p><p>TIMESTAMPS</p><p>00:00 Ownership, partners and control</p><p>00:57 Life of Flow intro</p><p>01:12 Welcome Dan Lieberman</p><p>02:10 From neurosurgery to ASC development</p><p>05:59 The microhospital question</p><p>21:00 OBLs, ASCs and choosing the setting</p><p>24:49 Medical necessity comes first</p><p>33:58 The trust question</p><p>37:02 Independence and the cost of time away</p><p>40:53 Ask how the partnership ends</p><p>45:56 Challenging the financial model</p><p>52:20 Governance and physician control</p><p>53:38 Pitfalls and choosing partners</p><p>55:58 Choosing an operator: the next conversation</p><p>1:00:16 Closing thoughts and farewell</p><p><br></p><p>FOLLOW DAN LIEBERMAN</p><p>LinkedIn: https://www.linkedin.com/in/dan-lieberman-md/</p><p>BestPracticeHealth / Phoenix Spine &amp; Joint: https://bestpracticehealth.tv/about-us/</p><p><br></p><p>RESOURCES DISCUSSED</p><p>• Ambulatory surgery centers (ASCs), office-based labs (OBLs) and physician-owned hospitals</p><p>• Medicare reimbursement, ASC safe-harbor considerations and physician participation</p><p>• Project financial models, operating agreements, exit provisions and supermajority voting</p><p>• Essential tremor and the transition away from an operating career</p><p><br></p><p>LIFE OF FLOW</p><p>Hosted by Dr. Lucas Ferrer &amp; Dr. Miguel Montero-Baker.</p><p>Website: https://lifeofflowpodcast.com</p><p>YouTube: https://www.youtube.com/@LifeofFlowPodcast</p><p>Spotify: https://open.spotify.com/show/5GMv47SJ0ePxbjtIb1GZ5U</p><p>Apple: https://podcasts.apple.com/us/podcast/life-of-flow/id1705596604</p><p>Partner with the show: info@lifeofflowpodcast.com</p><p><br></p><p>Connect with the hosts:</p><p>Lucas: https://www.linkedin.com/in/lucasferrermd/</p><p>Miguel: https://www.linkedin.com/in/miguel-montero-baker-a44354214/</p><p>Follow the show:</p><p>Instagram: https://www.instagram.com/lifeofflowpodcast/</p><p>X: https://x.com/vascularpodcast</p><p>LinkedIn: https://www.linkedin.com/company/lifeofflow</p><p><br></p><p>Cold-open music: “Funkorama” by Kevin MacLeod (incompetech.com), licensed u