Driving through the mountain town built around a lake, I couldn’t help but notice the David Isaac empire. (David Isaac isn’t his real name, I’ve changed it for this post.)
There was David Isaac Boat Sales. A mile or so away, there was the David Isaac Marina. And, there was David Isaac Toyota. A quick Google search reveals that he has similar car and boat businesses in other towns, too.
Mr. Isaac built a web of interlocking “motorized” businesses, each of which could stand alone, and each of which, some more than others, serves to drive customers to other elements of his ventures.
Over the past decade, much of the web building in healthcare has involved hospitals creating “systems.” Hospitals purchased physician practices, employed and otherwise aligned physicians, and pushed into outpatient care.
But now, with an increasing number of procedures capable of being performed in free-standing facilities, from urgent care to emergency medicine, to free-standing surgical facilities ranging from interventional radiology ASCs to orthopedic surgery ASCs, to, well, almost, you-name-it ASCs, physicians have an increasing opportunity to create their own interlocking webs around the central themes of healthcare and wellness.
It’s true that there’s significantly more regulation of healthcare investments by physicians than there are regulations throttling David Isaac’s motorized empire. But Stark, the federal Anti-Kickback Statute, their state law counterparts and so on are just details. Important details, yes, but not roadblocks to creating you own business structure larger than a single physician practice.
Mr. Isaac could have stopped with his single boat sales lot on Main Street. He didn’t.
