Start an Ambulatory Perioperative Pain Specialist Service

1. 1

   Define the clinical product the surgery center is buying

   The service is a packaged perioperative pain protocol: regional anesthesia and nerve blocks, multimodal non-opioid analgesia, and structured post-discharge follow-up designed to keep acute pain controlled and patients out of the ER. The buyer is the ambulatory surgery center and its surgeons, whose outpatient economics and quality metrics are destroyed by an unplanned admission or readmission. Frame the product around that avoided cost. This is a B2B clinical service, not a patient-facing clinic.

2. 2

   Build the protocol and the evidence

   Codify the multimodal, opioid-sparing protocol so it is consistent, teachable, and measurable, and track the outcomes that matter to facilities: admission rates, readmissions, pain scores, opioid use, and discharge times. That data is your sales pitch and your renewal argument. Opioid-sparing is both clinically and commercially valuable as prescribing scrutiny rises. A protocol with real outcome data sells itself to risk-conscious surgery centers.

3. 3

   Contract with ambulatory surgery centers and surgical groups

   Structure a service agreement (coverage model, staffing, on-call, and fees) with each facility, ensuring it is fair-market-value and Anti-Kickback compliant since the facility may also refer. You can bill professional fees for blocks and consults and/or charge a service fee to the facility, depending on structure and counsel's guidance. Multiple facility contracts create a scalable, capital-light service business. The clinician and the protocol are the assets, not equipment.

4. 4

   Staff and schedule for coverage

   The service must cover surgical schedules reliably, so staffing (physicians, and where scope allows, CRNAs and APPs) and on-call logistics are the core operating challenge. Because you are embedded in someone else's facility, you carry little fixed capital but you must be dependable to the surgeon's block schedule. Reliability is the retention mechanic. Scale by adding facilities and clinicians, not by building real estate.

5. 5

   Measure, report, and expand the contract

   Report the avoided admissions, reduced opioid use, and faster discharges back to each facility on a regular cadence, because renewal and expansion depend on proving the value you promised. Strong data lets you expand into more service lines (chronic-pain referrals from post-surgical patients, or an enhanced-recovery program). The service can also feed a chronic-pain practice with referrals. Position the service as a measurable quality-and-cost partner, not a staffing vendor.

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