Through this discussion of the opportunity physicians have to develop ambulatory surgery centers with partners in their communities, the argument is strong for physicians to look at this strategy now. Physicians were the pioneers who built some of the first ambulatory surgery centers and recognized the shift in the locus of care from inpatient facilities to outpatient settings. Wall Street investors have picked up on this trend to invest in companies that manage and develop ambulatory surgery centers throughout the country. Managed care organizations have stated their preference to work with physician-owned facilities in order to negotiate bundled services and prepayment in order to share in the risk and rewards with physicians. With no dramatic obstacles in federal or state regulations in building ASC’s, physicians have to ask themselves what is the price of not looking at and acting upon a strategy that will enhance their practice.