EP36 Keith Smith Cover

Episode 36 – Physician-Owned Surgery Center Says “Goodbye Insurance…Hello EXCELLENCE!”


Dr. Keith Smith cofounded the remarkably successful and wonderfully disruptive Surgery Center of Oklahoma. He and fellow anesthesiologist, Dr. Steven Lantier, left their hospital-based practices in 1997 to launch a physician-owned surgery center promising high quality care at a fair, transparent, and all-inclusive price. They had become fed up watching hospital administrators profit mightily while those who were actually caring for patients struggled. The inequitable and often outrageous billing practices of the hospital, the low Medicare reimbursement to physicians, and the cost-shifting to compensate for poor government reimbursement were all affronts to their values.

Dr. Smith is clear on the ethics of medicine (excellent quality at a fair price), the ethics of business (a mutually beneficial exchange between parties) and the importance of free market forces establishing the pricing and the success of an organization. He describes the morass created by government policies that harm patients while offering fertile ground for the “rising administrative class” to step in and profit from the chaos. He doesn’t mince words in his criticism of influence-peddling in Washington, D.C.

Currently, the Surgery Center has 36 physician owners, 107 physicians on staff, 42 employees, and is internationally renowned. Healthcare institutions, including UCLA, have copied the Surgery Center’s transparent pricing webpage with its human form and drop-down menu of prices.

The Surgery Center accepts no insurance or government reimbursement and their prices are often one-sixth to one-tenth the prices patients are quoted elsewhere. This means that patients come from all over the US and beyond for high quality care at a price that is often much lower than what they would pay with their (allegedly) “full insurance” coverage. Dr. Smith describes several examples of the financial foul play patients are faced with when they believe they have insurance coverage but their deductible and co-insurance can bankrupt them.

The uninsured and underinsured (maybe we should call them pseudo-insured) greatly benefit from fair, clear, and transparent pricing. Self-insured employers, who pay employees’ healthcare costs out of their operating revenue, quickly understand the benefits of partnering with the Surgery Center. In this episode, Dr. Smith describes the good will that develops when he passes vendors’ price reductions on to patients and self-insured corporate clients.

This innovation is being replicated and Dr. Smith fans the flames at the Free Market Medical Association, an organization he cofounded.

In This Episode:

  • Non-Profit, Not-for-Profit, Tax-Exempt means Don’t Pay Tax”
  • Dr. Smith walks through The Scam: the Charge Master obfuscation which allows collusion between insurance companies and hospitals to profit mightily and do harm
  • “And then there were four: BUCA (Blue Cross, United, Cigna, Aetna)”
  • Regarding government programs and BUCA: “We didn’t so much tackle them—we seceded”
  • Physician leadership + strong operating principles = superb organizational culture
  • “We all need our boundaries—so insurance companies are not a part of my day”

Meet G. Keith Smith MD

Dr. G. Keith Smith, a board certified anesthesiologist, cofounded The Surgery Center of Oklahoma in 1997.  Dr. Smith serves as the medical director, CEO and managing partner of the Surgery Center while maintaining an active anesthesia practice. 

In 2009, Dr. Smith launched a website displaying all-inclusive pricing for various surgical procedures, a move that has gained him and the facility, national and even international attention.  Many Canadians, uninsured Americans and beneficiaries of self-funded health plans have been treated at his facility, taking advantage of the low and transparent pricing available.  The Surgery Center, located in Oklahoma City, Oklahoma, has gained the endorsement of policymakers and legislators nationally.  In 2014, he co-founded the Free Market Medical Association, an organization whose mission is to promote the application of free market principles.

Self-funded insurance plans take advantage of Dr. Smith’s pricing model because it results in significant savings to their employee health plans.  

He has made many appearances on an array of national television programs and has been featured in Forbes, Time Magazine, the New York Times and other print media.

Surgery Center of Oklahoma  https://surgerycenterok.com/

@SurgeryCenterOK https://twitter.com/SurgeryCenterOK

Free Market Medical Association https://fmma.org/

Atlas Billing Company  https://atlasbillingcompany.com/

Episode 3: “The Story of the $100 hospital aspirin” | Surgery Center of Oklahoma https://www.youtube.com/watch?v=y9H0CGgMnAM