Global Surgical Partners: J.A. Ziskind, President & CEO

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J.A. Ziskind and Kenneth Arvin founded Global Surgical Partners in 1999. The two had practiced law together for a number of years and, building on combined backgrounds that included healthcare management and tax and financial work for healthcare entities, they first opened Manatee Surgical Center in Bradenton, Florida. The four-operating room, three-procedure room facility had 23 physician investors.

“That was our first project and we’re still there,” says Ziskind, President and CEO. “It’s been one of our more successful projects, not withstanding the fact it has a large Medicare population and, of course, this is a highly prolific area in terms of managed care. Rates are probably not what they are in other areas of the country and state.”

Global does not advertise and gets its projects through referral. The business has now developed six ambulatory surgery centers in the states of Florida and Mississippi and manages two additional centers. All eight sites are multi-specialty.

Full-Service Development and Management

“We are a turnkey company,” says Ziskind. “We don’t outsource very many of the things that we do to set up a center. We’ve been very successful on all of our projects, and I think have developed a focused identity with regard to ensuring success.”

Global exclusively develops ambulatory surgical centers that are physician owned or physician-hospital joint ventures. Ziskind feels that it is important that the physicians own as much of the equity as possible “In all cases the physicians have a significant equity stake,” says Ziskind. “We think that’s helpful in terms of keeping the surgeons associated with our projects and focused as opposed to looking or testing the waters elsewhere.”

“You start with a group of doctors and they think in six months they are going to have a place to happens. That’s just not the way it works,” Ziskind says. Each ambulatory surgery center Global develops meets full licensure requirements for the state it is in and meeting those requirements can take considerable time and effort. Mississippi, for instance, is a certificate of need state for multi-specialty centers. If you don’t have an identity with a local hospital, the chances of getting that certificate are greatly diminished. “We were fortunate we identified with local hospital systems that either had a certificate of need or were well on their way to obtaining one, so it worked out for everybody.”

Ziskind also requires that all of Global’s ambulatory centers be Joint Commission Accredited. “We feel that if our hospital partners are Joint Commission Accredited, we ought to stick to the same gold standard. We’ve done that and all of our centers operate profitably.”

Assuring High Quality

In the years Global Surgical Partner’s centers have been in operation, Ziskind can only recall two or three minor claims combined, the group’s centers are performing approximately 70,000 cases per year now. “We have an incredible system of peer review, bench marking, and oversight that insures that kind of quality.”

“I think a lot of that success has to do with our medical staff and our physician ownership. One of the things we are very cognizant of when we start a center is associating with quality doctors. I know a lot of people give lip service to that, but our physician founders have been very selective. We don’t take every comer,” Ziskind says.

Ambulatory Centers vs. Hospital Surgeries

“Surgical centers are the low cost provider in any community. They have to be by definition,” Ziskind says. He believes that although hospitals have traditionally been opposed to physician-owned surgical centers—based on the fact that they tend to take elective surgeries, and therefore money, out of the hospitals—the growing trend is hospitals joint-venturing with physicians to build such centers.

“Every hospital management person involved in our Centers is proud to be associated with the physician-hospital joint-venture surgical center. They know the care is more appropriate.  There are less infections and complications, that has already been proven. As well, the cost both to the third party payor and, most importantly, to the patient, is less.”

Surgeons like the ambulatory center setting because it allows them greater control over their patients, over their activity, and they have a lot less down time between cases. “I can’t tell you how many doctors tell me that this is their best investment, not only financially, but also from a time perspective,” says Ziskind. “They say, ‘I am able to do six or seven surgeries and get out of the center by 1 or 1:30. If I were doing this at the local hospital, I’d be there all day.’ Doctors tend to, once they get into a block booking situation, find they have significant time available to devote to other activities.”

Ziskind expects his company will stay busy in the future. “I think surgical centers will continue to be winners and there will continue to be growth. Whether it’s 10 million or 30 million new people coming onto the insurance rolls, there will definitely be more people seeking services at surgery centers.”

-by T.M. Simmons

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