Ep. 46 Cardiology Procedures and Ambulatory Surgery Centers: Key Insights with Dr. Fadi Saab

What are the real-world challenges and rewards of running an ambulatory surgery center (ASC)? On this episode of BackTable Cardiology, host Dr. Hady Lichaa interviews Dr. Fadi Saab about his transition from an outpatient-based lab (OBL) to an ASC, focusing on business, regulatory, and clinical considerations that go beyond procedural technique. They discuss how rising healthcare costs are driving ASC expansion, the benefits of improved patient experience, efficiency, convenience, and physician autonomy, as well as concerns about private equity influence and systemic pressures to shift cases out of hospitals. \--- Get the BackTable app https://www.backtable.com/app \--- Timestamps 00:00 - Introduction 03:10 - Why ASCs Are Expanding 05:36 - Autonomy, Efficiency, and Key Concerns 10:43 - Ensuring Safety and Outcomes 14:07 - OEIS Registry and Certification 17:02 - Managing Complications and Transfers 22:36 - EP Procedures in the Outpatient Setting 27:09 - OBLs Under Pressure 34:43 - Reimbursement Challenges and Burnout 39:22 - Business Skills and Consultants 44:07 - Income Reality and Partnerships 50:12 - Reflection on the Transition 55:46 - Closing Thoughts and Advice \--- More about this episode Dr. Saab outlines critical safety oversight measures including state regulations, registry reporting, transfer agreements, ACLS-trained teams, and peer review. He shares data showing that PCI outcomes in ASCs are comparable to those in outpatient hospitals, and reviews the expansion of electrophysiology procedures into ASCs enabled by CMS codes. The conversation highlights infrastructure needs, differences in OBL versus ASC reimbursement, and the importance of hiring experienced leaders and consultants. Dr. Saab provides practical advice on partnering with like-minded physicians, understanding Stark and anti-kickback rules, and setting realistic expectations for profitability, which may take 18 to 30 months. The episode closes with reflections on mentorship, operational excellence, and how ASCs are adapting to the changing landscape of cardiovascular care. \--- Resources Interventional Cardiologists' Perspectives on Percutaneous Coronary Intervention at Ambulatory Surgical Centers https://pubmed.ncbi.nlm.nih.gov/41088884/ OEIS https://oeisweb.com/ Administrative Expenses In The US Health Care System https://jamanetwork.com/journals/jama/fullarticle/2785479#google\_vignette \--- BackTable Cardiology is the go-to podcast for interventional cardiologists, cardiac surgeons, and other healthcare professionals that manage cardiovascular conditions. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app