Dr. Nikhil Shetty, Chief Operating Officer, Midwest Interventional Spine Specialists

Summary

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Podcast Summary

Podcast: Becker’s Healthcare Podcast
Episode: Dr. Nikhil Shetty, Chief Operating Officer, Midwest Interventional Spine Specialists
Date: December 15, 2025
Host: Grace Lynn Keller
Guest: Dr. Nikhil Shetty

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Episode Overview

In this episode, Dr. Nikhil Shetty, COO of Midwest Interventional Spine Specialists and practicing interventional pain physician, shares insights on the evolving Ambulatory Surgery Center (ASC) market. Discussing both the major trends propelling rapid growth and the operational realities facing independent ASCs, Dr. Shetty covers innovation in technology integration, the impact of payer and hospital dynamics, and the importance of patient-centric, transparent care.

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Key Discussion Points & Insights

1. ASC Market Growth & Trends

• ASC Market Surge: The U.S. ASC market is projected to hit $60.8 billion by 2030, fueled by shifting care models and demand for efficiency.

• Hospitals Overburdened: ASCs are growing because they “solve a very real problem”—namely, overtaxed hospitals and patient demand for efficiency and transparency.

• Migration of Higher Acuity Cases:

  • Technological improvements have made it possible to perform more complex, higher acuity procedures safely in ASCs.
  • “We’ve been able to take certain cases, quicker turnover, faster turnaround, minimally invasive procedures... in a safer, controlled environment... improving outcomes.” (Dr. Shetty, 01:47)

• Contract Pressures and Consolidation:

  • Rising payer consolidation and competitive contracting put independent centers in a tough spot, competing against large hospital systems.
  • Policies often don’t favor small physician owners, impacting reimbursement and operations.

2. Technology Integration in ASCs

• AI and Workflow Optimization:

  • “Technology is a massive enabler for independent physician centers.” (Dr. Shetty, 03:55)
  • Dr. Shetty’s practice uses Sora—an AI-powered video generation tool—to provide personalized, easily digestible pre-procedure instructions to patients.
  • Patients review custom educational content on tablets in the waiting room, improving both understanding and pre-op workflow.

• Enhancing Patient Experience and Efficiency:

  • “The patient’s able to review my instructions... before we bring them back into pre-op. These are the same conversations I’d have in clinic, but it’s always good to have that refresher.” (Dr. Shetty, 04:20)
  • Reduces patient anxiety and bottlenecks, streamlining ASC throughput.

3. Collaboration and Joint Ventures

• Equitable Partnerships:

  • Collaboration between independent ASCs and hospitals is rising, but must properly balance autonomy and innovation.
  • “Independent ASCs bring agility, flexibility, local insight… hospitals bring scale and infrastructure. The challenge is ensuring partnerships don’t erode physician autonomy or innovation.” (Dr. Shetty, 05:37)

• Pandemic Lessons:

  • During pandemic shutdowns, ASCs demonstrated flexibility, stepping up to handle lower acuity cases as hospitals closed outpatient departments.
  • That “mindset continues into 2025,” enabling rapid, patient-friendly care transitions for higher acuity cases.

• Personalization & Flexibility:

  • Patients commonly note the difference in ASC care: “You guys really know my name… I like one cream, one sugar in my coffee. When I came back for my second procedure, it was ready, waiting for me.” (Dr. Shetty, 07:17)
  • ASCs can open early or adjust schedules on short notice—“That level of flexibility is just not achievable... too many moving parts in a major health system.” (Dr. Shetty, 08:20)

4. Price Transparency and Patient Value

• Passion for Transparency:
  • Dr. Shetty emphasizes transparent pricing as a path to winning patient trust and system efficiency.
  • “When we make those prices transparent, ASCs will win... insurers can see that ASCs are faster, more efficient, safer. Our outcomes prove that.” (Dr. Shetty, 09:10)
  • Transparent pricing “levels the playing field” and drives more volume to ASCs.

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Notable Quotes & Memorable Moments

• On ASC Growth & Technology:

  • "The ASCs are growing... We’re not just competing on outcomes anymore. We're navigating policy structures that were never designed with small physician owners in mind." (Dr. Shetty, 02:39)

• On Patient Experience:

  • “My number one comment that I hear is... you guys really know my name… that level of touch points, that level of patient care is something unique in a system like our surgery center.” (Dr. Shetty, 07:17)

• On Price Transparency:

  • “Price transparency makes what sort of levels the playing field. Insurers can see that ASCs... are faster, more efficient, safer number one, and our outcomes prove that.” (Dr. Shetty, 09:14)

• Advice to ASC Leaders:

  • “Be flexible, leverage technology, always focus on better outcomes for patients and staff, and look for ways to adopt best practices from around the industry.” (Paraphrased final remarks, 09:40)

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Key Timestamps

• 00:57: Dr. Shetty’s background and ASC landscape
• 01:47: Major drivers of ASC market growth and trends
• 03:55: Impact of technology and AI on care delivery and operations
• 05:37: Opportunities and risks in ASC-hospital collaboration
• 07:17: The “personal touch” and flexibility of ASC patient care
• 09:10: Advantages of transparency and ASC cost structure
• 09:40: Dr. Shetty’s closing thoughts and importance of industry collaboration

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Closing Thoughts

Dr. Shetty’s episode is a concise but comprehensive look at the fast-evolving ASC environment. He offers real-world examples from independent practice, candid thoughts on market and policy forces, and an optimistic perspective on technology and transparency. The conversation underscores the importance of adaptability, patient focus, and innovation for independent ASC leadership.

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Transcript

[A]

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[B]

Is Grace Lynn Keller with the Beckers Healthcare Podcast and we are recording live at the 31st Annual Business and Operations of ASCS. I'm currently joined by Dr. Nikhil Shetty who is the Chief Operating Officer at Midwest interventional spine specialists. Dr. Shetty, thanks for being here to kick us off. Can you please share a little bit more about your work in the ASC space?

[C]

Thank you for having me. Nikhil Shetty, Interventional Pain Physician, Midwest Interventional Spine Specialist Chief Operating Officer there and I've been with that practice for the past eight and a half years in Northwest Indiana. We're a single specialty interventional pain practice. I have a couple of partners, three nurse practitioners, and we've really been able to build and grow that area over the last 20 years. It's very satisfying treating patients in Northwest Indiana and also being able to live in Chicago. And it's good to be back on the podcast.

[B]

Wonderful. Well, thanks for being here. And let's start with the ASC market because in the US this is projected to reach $60.8 billion by 2030 and it continues to experience strong year over year growth. So from your perspective, what are the most significant trends in market forces driving this expansion and how should ASC leaders be preparing today?

[C]

Well, I think it's a very good question and that's an astounding figure. 60.8 billion by the year 2030. I would say the ASC space continues to grow because it solves a very real problem. Hospitals are overburdened, patients are demanding transparency and efficiency. The biggest trend I see is the migration of higher acuity cases into the ASCs, supported by improvements in anesthesia, imaging and technology. That's a personal interest of mine. Being in interventional pain, we've been able to see how we're able to take certain cases, quicker turnover, faster turnaround, minimally invasive procedures that we're able to do in a safer, controlled environment where we lower our infection risk, we improve our quality of outcomes we restore function in a faster way. And we're also seeing this reflect in the landscape. The ASCs are growing. Hospitals have caught onto that. Major health players have caught onto that and are partnering with other physicians in the area looking to build their own asc. I would say that we're also seeing increasing payer consolidation and contract pressures. That's where independent ASCs like ours feel the squeeze. We're not just competing on outcomes anymore. We're navigating policy structures that were never designed with small physician owners in mind. It puts us sometimes at a disadvantage when we're playing the same game with the major hospital institutions that are spending. Like you said, that's 60.8 billion by 2030, though I think it's great for the country. ASCs are able to service patients in a faster, safer, more efficient and streamlined process. And with advance of technology, leveraging that technology into the asc, we're able to do more sophisticated procedures that weren't otherwise or previously able to be done in a quick outpatient surgery center.

[B]

And from AI and robotic surgeries to advanced EHR systems, technology remains both a make or break factor and a critical driver of ASC operations at at scale. So how do you see deeper tech integration shaping the ways that ASCs deliver care and manage their business over the next few years?

[C]

Well, I'd say technology is a massive enabler for physician independent physician centers. We're using AI driven tools in everything from patient education to workflow optimization. I'll just give you a quick example. I'm a big fan of the application called Sora where we're able to use video AI generation. And so I've been able to do that in my practice using using my Likeness to explain interventional pain procedures to the patients in a quick shareable video form. Content that the patient can review before their procedure. So we hand that to them in the, in a tablet while they're in the waiting room and the patient's able to review my instructions on the procedures that they're about to get before we bring them back into the pre op area. These are the same conversations I have with the patient in the clinic when I'm evaluating them. However, it's always good to have that refresher. AI has made that process so much easier. And applications, video applications like Sora, for example, make that so much more streamlined. They're able from the patient perspective. It makes them feel comfortable because they're seeing the physician that's about to perform the procedure go through once again explaining to the patient what exactly is going to be done answering some of those last minute questions that sometimes can cause log jams or slow up the throughput of the asc. I think that's a very good tech that we're now starting to leverage in our ASC.

[B]

And with 60% of health systems considering ASC joint ventures, many ASCs are already partnering with systems in their communities. So what opportunities do you see for collaboration, whether with other providers or vendors, to strengthen patient care and operational efficiency?

[C]

Yeah, I think collaboration can be powerful, but it has to be equitable. Independent ambulatory surgery centers bring agility, flexibility, local insight, and hospitals bring scale and infrastructure. The challenging is ensuring these partnerships don't erode physician autonomy or innovation. I've seen great models where hospital offload their lower acuity cases to the ASCs, improving throughput on both sides. But that only works if reimbursement and governance are structured fairly. I'll say this using the example of the pandemic. During the pandemic, about five and a half years ago now, when everything was shut down, hospital outpatient departments were completely shut down. Everybody was under these government mandated shutdowns, including our own practice, and we were abiding by the CDC guidelines. With time we were able to open up and those lower acuity cases that were getting pushed back by the big hospitals, big hospital or healthcare systems, we were now able to open up our doors for them. We take that same mindset into 2025 now where we're able to transition these higher acuity cases into the surgery center and when the patient checks in with us, it's a quick and easy process. I explained to you already how the pre op area works. The patient's reviewing a tablet that has once again my instructions on the procedures that the patient's about to get. They get brought back to the pre op area and by the time they're in the pacu, everybody knows their name, we're familiar, we're able to control that environment and streamline that process, making it so much more comfortable for the patient. My number one comment that I hear is patients that previously were done at bigger health systems transition to the ASCs is Wow, you guys really know my name. You remember I like one cream, one sugar in my coffee. And when I came back for my second procedure, it was ready, waiting for me after my procedure. This level of touch points, this level of patient interaction and patient care is something that's unique in a, in a system like our surgery center where we're able to streamline that flow, we're able to work in a lean fashion and we're able to be flexible to accommodate the needs of the patient. Whereas if you want to add on a case at the hospital, it'll take you a week or two before they give you or time. Whereas with us, we'll open up, I'll open up early like I did for example, this morning before coming to the conference. We opened up our surgery center early this morning to accommodate some patients to come in sooner. That level of flexibility is just something that's not achievable. Too many moving parts in a major health system. And so this flexibility, this lean operating structure, makes it very convenient for the patients to come in and get their procedures done. That's the number one comment I hear from patients who have had the same procedure done at two different institutions, one of them being rasc. That's our number one comment. And then if we're going to go deeper into this, one of my biggest passions is price transparency. Make prices of procedures transparent across our surgery center landscape as well as the overall major health system landscape. As patients start to see exactly what they're getting charged in major healthcare systems compared to what our ASC's overall cost is. When we make those prices transparent, ASCs will win. And I think the country is seeing that. And that's where that 60 billion figure is going by the year 2030. It saves healthcare dollars across the country. Price transparency make sort of levels the playing field and so that insurers can see that ASCs, these independently physician owned ASCs, are faster, more efficient, safer, number one. And our outcomes prove that more volume will be driven to the asc and I think which overall lowers cost and streamlines that health, that healthcare efficiency throughput to, especially for these lower acuity, minimally invasive procedures that don't need hospital or time and can be done in the surgery center.

[B]

Well, Dr. Shetty, thanks so much for joining me today on the podcast. Is there anything we didn't touch on or any final thoughts you'd like to share before we wrap up?

[C]

Thank you very much for having me. I, I think Beckers is a very important conference for independent practices ASC leaders to come together, talk policy, learn more about the environment that we're in and learn how we can make our system better. We're always focused on focusing on how can I be, number one, a better physician, better for my patients, but also better for my employees, my staff that I work with, what are some of the trends out there in a different ASC market that they're employing that I can now employ in our practice. I do appreciate Becker's for being a good host for that. I do appreciate the, the, the panels that we have and I've been a part of, as well as this podcast. So thank you for having me.

[B]

Wonderful. Well, thanks for being here. And again, we are recording live at the 31st annual business and operations of ASCS.