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

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.

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.

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)

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

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.