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Dr. John Vitolo's interview on Becker's ASC Review

Q: When did you realize you wanted to be a doctor?
Dr. John Vitolo: I went to Brown, and was actually a history major. Sophomore year, I injured my knee playing football — I tore my ACL. I couldn't play. I did some volunteer work at Rhode Island Hospital. Pretty soon, I'd decided on medicine. I got my history degree, then moved to New York and took pre-med courses at night at Columbia University School of General Studies — the same place Sandy Koufax studied while he was with the Brooklyn Dodgers. I applied to medical schools and went to Rutgers, the cheapest place I could afford. Tuition my first year was $3,800.

Q: How did you wind up in sports medicine?
JV: I had a knack for anatomy. In medical school, you work with cadavers and learn all the structures, the microstructure, the entire human body, like the Renaissance artists. It's quite an undertaking. I took an extra 6-week elective anatomy course with Paul Morante. I did my internship at the University of Massachusetts, and was picked to work with Arthur Pappas, the team doctor for the Boston Red Sox. It was a plus that I had played high school and college football. In my application, I mentioned that I wanted to help other athletes. Q: So you took care of the Red Sox? JV: That was part of the job. I assisted Pappas with surgery. Athletes are great patients. They really want to get better, because it's their livelihood. They're going to do everything you tell them. I had Andre Dawson; Bill Buckner; Dwight Evans. They were all regular guys: athletes, fathers. The same guys you played Little League, high school football with — but with this gift in one particular area.

Q: What was surgery like then?
JV: Most was done at the hospital. You'd be lumped in with gall bladders, spinal cases. You never knew when you would be delayed. Patients stayed overnight. Most surgery was not arthroscopic, so recovery took a lot longer.

Q: When did you start thinking about ambulatory surgery centers?
JV: In the 1990s. The first one was a group of doctors almost solely motivated by money. They were constantly at each other's throats. It was very tense. It came through to the employees, to everybody involved. It wasn't a pleasant experience. But it was more efficient than the hospital. After I moved to New Jersey, a bunch of us orthopedic surgeons and anesthesiologists got together with the idea to make life better for ourselves and our patients. We built a center in Denville, and I've been here 10 years. This is one of the better things that has happened to my professional career.

Q: How did you get launched in Denville?
JV: We visited surgical centers and interviewed the management groups and surgeons. Some of them spoke highly of Murphy HealthCare Group, so we talked to them. What raised the comfort level for us was that the Murphys' approach was personal.

Q: At your center, what does management do, and what do the doctors do?
JV: After we brought them in, Murphy HealthCare helped us financially and hired people to manage the construction and create a turnkey operation. They recruited doctors in ENT, urology, pain management, and podiatry. We have 26 doctors. Murphy handles our billing, insurance, employees, and compliance. They have an equity interest, but the doctors have as much or more input. There's nobody like a hospital administrator to tell us, "You can't have this equipment." We do a trial of various equipment, and the surgeons vote. We also make scheduling and hiring decisions as a group.

Q: How does your efficiency compare to hospital surgery?
JV: Tuesday I did eight cases. I started at 7:15 a.m. and went to 4:30 or 5:00. At the hospital, I would have been there at least till 10:00 p.m. More likely, it would have been two 8-hour days.

Q: Why is it so much faster at an ASC?
JV: We always know what cases we have. Our nurses are familiar with the procedures. Our equipment is better. There's less aggravation and red tape. If you have to put on a case, it's easier to deal with your peers than with the head nurse in an OR who's worried about her overtime and when her employees are going to go home. The surgeons and the staff like what they're doing. Everyone works better that way. I get a lot of satisfaction from solving that riddle of repairing people's injuries, and getting athletes back to doing the things they enjoy.

Q: Do patients respond differently at your ASC, compared to a hospital?
JV: When they go for surgery, patients are nervous. A warm atmosphere goes a long way toward calming them down. Our nurses aren't stressed out from taking care of too many patients; there's a good ratio. A man told me after his surgery, "I felt like I went into your home, everybody was so nice. It's like you're not a patient, you're a guest."

Q: What's the biggest thing your ASC has changed in your life?
JV: When I get home, I have an extra 5 hours with my wife and family that I wouldn't have had. That's a big change. If it were not for the surgery center, I probably wouldn't still be in surgery.

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