Outpatient Advocate and “Founding Father” Witnesses Big Changes in the Industry and in His Life

Outpatient Advocate and “Founding Father” Witnesses Big Changes in the Industry and in His Life

By Michelle Beaver

Mike Lipomi, a long-time advocate of ambulatory surgery centers (ASCs) and specialty hospitals, is busier than ever these days, but not too busy to reflect on where the industry is going. Indeed, it’s how he spends many of his waking hours.

Lipomi became administrator of the Surgery Center of Pinehurst (N.C.) last fall after 21 years at the famed Stanislaus Surgical Center in Modesto, Calif. The wave of the future, Lipomi says, involves healthy relationships between acute-care hospitals and nearby alternative care facilities. The Surgery Center of Pinehurst is one such example.

“I’m proud to say that the facility that I’ve moved to, although it’s not a specialty hospital (it’s an ASC), has substantial investment from the local hospital and a lot of support,” he says. “I think that’s the right way, because you’re combining all the best resources to provide the best healthcare for the patient.”

The presence of a local hospital allows specialty hospitals and ASCs to further specialize their practices.

“Adding the hospital partner to the mix provides an umbrella of support,” says Lipomi, 53. “The acute-care hospital has services that may be more efficient when you have a higher volume and/or inpatient care. By partnering with a hospital, the ASC can take advantage of these services while still focusing on ambulatory surgery.”

It’s a nice picture, but these kinships are rare and difficult to forge when mainstream hospitals are still trying to annihilate the competition, Lipomi says. “Hospitals, they’re still fighting and continue to come out with different reports to help fight against the competition,” he says. “Their main focus has been legislative where they’re trying to regulate the industry to prevent growth and development of the specialty industry.”

Lipomi expected friction with hospitals early on, but two aspects of it have surprised him.

“One, is the amount of resources and efforts they put into fighting us,” he says. “Two, is their unwillingness to accept surgical hospitals once the federal government had come out with report after report that surgical hospitals were serving a need. I would think that if (acute care hospitals) wanted to focus on their mission of providing good quality healthcare to the community, that they would willingly accept this innovation and assimilate it into their future plans.”

The relationship is far better than it used to be though, and has made significant gains the last three years, according to Lipomi.

“I think (hospitals) are a great deal more accepting (of alternative facilities) now that this is the reality and the future,” he says. “From that aspect then if you know something is going to happen with or without you supporting it, you’re better off coming along and being part of the process then being left behind.”

It takes a creative and open mind to embrace a new model, Lipomi says. “I think some of the more progressive, innovative, hospital administrators have been working in this regard for quite a while,” he adds. “(Some) mainstream hospitals have come on board in the last couple years when they began to witness the shift in D.C. and read the reports that came out of Congress regarding the benefits associated with surgical hospitals, and finding that the government was unable to uncover any wrong doings or inappropriate or unnecessary surgeries associated with this model.”

Lipomi understands hospital administrators’ reluctance to open the field to competition, but he feels the hesitation has to be overcome if the patient is to prosper.

“I think it has a lot to do with the leadership of the hospital and the political situation,” he says. “If you’re in a state with heavy certificate of need regulation and you still think you can keep the competition out, your tendency would be to keep the competition out.”

Lipomi was president and one of the founders of the California Ambulatory Surgery Association. He is no longer affiliated, but does serve on the executive committee of Physician Hospitals of America (PHA), the North Carolina Ambulatory Surgery Association, the American Association of Ambulatory Surgery Centers (AAASC), and FASA.

Lipomi has an impressive occupational pedigree, but that doesn’t change his “new guy” status at Pinehurst.

“Certainly I’m the new guy on the block,” he says.

That title brings some tribulations, but overall, Lipomi is enjoying “a wonderful opportunity.”

“It’s just a great facility,” he says. “I’m able to share so much more of my experience here because I’ve been with a facility when it was young and new like this and I’ve seen all the good things that can happen and the potholes that you can stumble through. I can tell you that this facility is on the steps of greatness.”

Surgery centers, however, do not remove the need for acute-care hospitals, Lipomi says. He doesn’t want to rid himself of competition — he wants to align with it.

“There’s always going to be a need for the traditional hospital model,” he says, “just like there’s always going to be a need for a full-service repair shop, but that doesn’t mean that Midas Muffler and an oil change shop don’t serve a very definite purpose.

“The whole industry is growing up,” he adds. “If you look back 10 years, no one knew what a specialty hospital was. Now there’s a tremendous awareness of specialty hospitals and it’s growing.”

Part of that growth has to do with the increasing savvy of healthcare consumers.

“I think that patients today are much more knowledgeable about healthcare than they have ever been in the history of this country,” Lipomi says. “There’s a flatting of information.

The Internet allows patients to research their illness, the treatment options, the physicians and facilities. They can look up reports on quality measures and make an informed decision on where they want to go. Once they’re doing the research then they’re driving the shift.”

The growth of specialty hospitals and ASCs is primarily from word of mouth, and from the press, Lipomi says. It’s a shame though, he adds, that most of the facilities are only in nine states.

“The problem with this industry is that the certificate of need regulations and strong monopolies in certain marketplaces prohibit this type of development,” he reports. “People in the other states where they don’t have these facilities have limited options.”

Regardless, the industry continues to grow, says Molly Gutierrez, executive director of PHA. In 2003, there were 90 physician-owned hospitals in the country, and now there are 130, she says.

Lipomi has certainly contributed to the success, Gutierrez added. She met him in 2002.

“He has been a major advocate and he’s been an incredible asset for our industry,” she says. “He was very much one of those founding members of our association and was one of those members who had the insight to know what we would need going forward as far as an advocacy association, and political ties and looking toward growth.

“He’s definitely a neat deal,” she adds. “He’s been a wonderful role model for me ever since I got to know him, personally and professionally.

He’s a marvelous individual, someone I can always count on to assist me in my current role and someone I can always go to for some great advice as well.”

Overall, specialty hospitals and surgery centers are doing “an excellent job” meeting their goals, Lipomi says. The main aspiration in the industry, according to him, is to deliver quality healthcare via physician leadership.

Lipomi’s personal goals are also being met, especially now that he is in an area with a lower cost of living than Modesto’s, and now that he has a little more time for family.

“My focus is on my family so I spend a lot of time with my wife, Monica, and my two young boys (ages 8 and 10),” he says. Lipomi also has two adult “kids” who live out of state. “I love to golf with all of them and help coach baseball teams and play tennis and boat,” Lipomi says.

The relocation was a good move, but Lipomi does miss California and Stanislaus.

“I certainly had a great experience and career in Modesto,” he says. “I want to thank everybody there for giving me the opportunity to serve the community for so long. Now that I’m here it’s a rebirth for me. I’m meeting new people and experiencing new things. I just want to describe (Pinehurst) as ‘elegant.’ The people here are very, very gracious and extend themselves to you without being asked. The people are gentle and well educated.”

Pinehurst is small — only about 12,000 people — but it’s rapidly growing and already has some fantastic restaurants and schools, Lipomi says. And even better news in his book: the Pinehurst area is host to about 40 golf courses. The sport helps Lipomi balance his life, which is not always an easy feat.

“Part of starting a new career or life, if you will, is to carve out time and focus on what things you want to take on,” he says. “I’ve continued to try and be supportive and helpful and stay in the leadership of the specialty hospital group.”

Lipomi has branched out as well to support local entities such as the rotary and chamber of commerce, but he knows where his roots are and wants to “stay loyal to the surgery centers.”

“I think (the outpatient industry) is just going to continue to grow,” he says. “We’ve got this baby boomer thing that’s going to keep hitting all of us. There’s going to be a tremendous need for quality healthcare in this country and there’s going to be a shortage. I think that surgery centers and surgical hospitals have a definite place in the future of healthcare in this country.”