We're not sure what the Missouri Hospital Association (MHA) is trying to achieve with its multimedia smear campaign against so-called limited-service providers - such unsavory outfits as physician-owned ASCs and imaging centers - but somebody please let these fine folks know they can stop throwing good money after bad on direct mail, telephone calls and writeOutLink("myhealthcarematters.org",1) to broadcast their needlepoint nag: "What you don't know can hurt you."

Some Missouri physicians suspect that the MHA's goal is to sway state lawmakers to levy a tax against for-profit ASCs - and make it so high that they couldn't stand to compete.

Earth to MHA: The war's over. And you've won.

All you have to do is sheathe the swords you have trained on surgeons' jugulars (wallets) and extend a hand to your friendly neighborhood physician. Together, you can focus on the most profitable services - imaging, radiation therapy, and cardiac and orthopedic surgery.

Look around. More and more hospitals are doing it. Partnerships between physicians and hospitals were the only type of ownership category to show growth from 1999 to 2004, growing 4 percent, according to the American Association of Ambulatory Surgery Centers. It might not be coincidental that physician-owned ASCs dropped by 4 percent over that same period.

"It appears that most hospital systems in the country have decided that they desire to have a joint-venture surgery center with their surgeons. We have seen a radical sift in the viewpoint of hospitals on this subject," writes Scott Becker, Esq., CPA, co-chairman of the healthcare department at McGuire Woods in Chicago. Another very wise man once said:

What you're for, strengthens you ...

Hospitals that are for participating in the best surgical delivery model are forming joint-venture surgery centers with their surgeons.

... and what you're against, weakens you.

The stubborn hospitals, the ones suffering from hardening of the smarteries, continue to wage a war against physician ownership that they cannot possibly hope to win. They're fighting with laws and taxes and economic credentialing. And they're losing. Just last month, a Texas state court judge issued a temporary injunction against Baptist St. Anthony's Health Systems, preventing the Amarillo-based integrated health system from dropping two physician-owners of a specialty surgical hospital from the system's preferred provider organization.

Count us among those who'd like to see more hospitals for outpatient surgery, rather than against ASCs.