Nick Vailas, founder and CEO of Bedford Ambulatory Surgical Center (BASC), has been focused on providing affordable and accessible healthcare in his more than four decades in the industry.

That’s why the trend of hospital consolidations and mergers concerns him.

“We’re seeing these consolidations that basically haven’t saved patients any money, and that a lot of these consolidations have to do with getting a return on investment,” he said. “Venture capital and healthcare are oftentimes like oil and water; they don’t mix very well. You have the return on investment versus the best interest of the community and again, those aren’t aligned.”

Patients are seeing healthcare costs escalate, whether that’s through hospital bills directly or insurance premiums. Vailas thinks medical cost inflation is outpacing cost-of-living inflation. The primary reasons, are coming from the increasing pricing of medical supplies or employee compensation. Meanwhile, patients struggle to even find a provider who can address their needs in a timely manner, and who will still be around when it’s time for a follow-up appointment.

Vailas believes a culture shift is needed for healthcare’s long-term success and to provide care that is accessible and affordable. He believes that culture shift must focus on people over profits and that a community-minded team approach is best to address the quality of care patients receive and deserve.

Benefits of an independent practice

This mission-focused sense of culture is apparent in the set-up and actions of Bedford Ambulatory Surgical Center (BASC).

Overhead costs are typically much lower at ambulatory surgery centers like BASC as compared to hospital-based outpatient departments.

As founder and CEO of BASC, Vailas sees his role as to set the mission and plan how to get there.

“My greatest advice to any leader is: be humble, be grateful. That’s hard for some people,” he said. “Even though you are in a position of immense responsibility, you will not succeed unless you invest in human capital and surround yourself with really good people and empower them.”

Most of the BASC surgeons are practice owners, meaning they are more likely to stay longer and the clinic will see lower turnover.

“We started out with six physicians, and we’re close to 40. That’s a lot of growth in 32 years,” Vailas said. “I’d love to take all the credit for it, but I can’t. I’ve had great people who’ve been with me and I have been blessed to have some great physician leadership over those 32 years.”

Doctors at an ASC also have a more focused list of services allowing them to excel in their specialties, which can improve patient outcomes. The physicians have a lot of control over the practice and Vailas said that if you were to look at their organizational chart, you would see that it is relatively flat. This structure reduces bureaucracy and is central to the promotion of BASC’s operational philosophy.

“We have tremendous patient satisfaction, tremendous employee satisfaction as evidenced by their longevity here, and we have tremendous physician satisfaction,” Vailas said “We have tremendous physician leadership, surgeon leadership, who are laser-focused on providing great care for our patients at a far less price point than hospitals.”

Empowered managers foster team camaraderie

Vailas relies on the expertise of the physician-owners to make the decisions that will hit those targets.

“The team sport metaphor is very appropriate in many arenas in life, and especially healthcare,” Vailas said. “There are a lot of hands involved in the care and recovery of a patient.”

The team mentality helps raise expectations across the board. While the physicians and staff aim to meet accepted industry benchmarks, a spirit of camaraderie helps push them to exceed expectations.

“Surgery is the ultimate team sport,” Vailas said. “It gets pretty intense in the operating room, and everyone needs to be on their A-game. Fumble in the operating room? No, certainly not.”

Every part of the team is necessary to have a winning season, whether that’s a surgeon improving a patient’s life in the operating room or a clerk in the billing department who is making sure payments come in to keep the practice running.

“The team mentality is such that there are certain expectations everyone has because the bar is high and it all starts with caring,” Vailas said.

With the physicians as the leadership of BASC, they can make decisions based on the needs they observe through regular patient contact. The team of doctors, nurses and support staff at BASC maintain a high degree of quality while providing affordable care to their patients. They are given the latitude to do what they need to do to best care for patients.

“It takes discipline to conform to industry standards, proven metrics, and the reason why you’re motivated to hit those targets is that you love what you’re doing,” Vailas said. “You love the team. You love the organization and what it does. You take great pride in the final outcome. BASC is a great place to get care.”

ASCs have infection rates about one-tenth that of surgeries that occur in hospitals. ASCs tend to serve a patient population that is not as medically complex and focused on surgical specialties. They also can have stricter infection control protocols and less exposure to critically ill patients compared to hospitals.

Creating a culture of care

Excellent patient care at BASC starts with a workplace culture that cares about physician, nurse, and staff work-life balance.

Beyond competitive compensation, Vailas said the team environment and feeling like your work has value and impact are critical.

“In health care, the staff often look up to physicians and surgeons, and it’s powerful when a surgeon expresses gestures of appreciation,” Vailas said. “We’ve had surgeons go off to a snowy parking lot and push the snow off nurses’ cars because the nurses stayed late to accommodate a late case. And it’s those gestures that go a long, long way.”

Going above and beyond isn’t just something that stays between staff.

“Even though it may not be in your job description, you will do whatever it takes to make sure that those patients, and their families, are getting the care and attention they deserve,” Vailas said of his staff.

“I would argue that healthcare is the ultimate service industry, evident by the fact that when people have a bad outcome in healthcare, they remember it for life,” Vailas said. “You always remember how you were treated as a patient.”

Vailas emphasized that a culture of caring is stronger when people are part of the community they are serving. That is why he’s so concerned with outside investors owning healthcare providers.

“The vast majority of healthcare is local,” Vailas said. “I believe healthcare systems that don’t empower physicians and that are all about return investment won’t last long.”

Patients who are seeking a provider who will invest in their care should consider looking into the surgical, imaging, and ophthalmology services offered by BASC.

11 Washington Place, Bedford, NH 03110 • 603-622-3670 • bascnh.com