Neurosurgeon Dominic Maggio, MD, is stepping into a new chapter as sole owner of Little Rock, Ark.-based Legacy Spine & Neurological Specialists as the sole owner, a transition that comes at a pivotal time in spine care and outpatient surgery.
Dr. Maggio completed the transition to full ownership in the first quarter of 2026, taking over a practice that includes a surgery center and MRI facility. For him, the milestone represents years of planning, professional development and a long-term vision for patient-centered care.
The road to ownership began during his fellowship, Dr. Maggio said. He explored different options including academic medicine, hospital employment and research. Although he was interested in academic neurosurgery for the majority of his training, he ultimately landed in the private practice setting.
“What appealed to me most about private practice was the flexibility,” Dr. Maggio said. “There are so many different ways to structure a practice, and I liked the idea of building something that reflects my own vision of patient care and efficiency. “
From there his interest expanded into ASCs and the opportunities they offer physicians to improve both the patient experience and operational efficiency.
“I believed that having ownership in a surgery center and an imaging center or even leading one directly, would provide the greatest flexibility while ensuring patients receive the best possible experience from start to finish,” he said.
Dr. Maggio eventually joined Legacy Spine & Neurological Specialists, founded by Scott Schlesinger, MD.
“Dr. Schlesinger is a talented and caring neurosurgeon,” Dr. Maggio said. “He created a wonderful practice with a comprehensive goal regarding patient care. The practice has two operating rooms, two procedure rooms, a surgery center and its own MRI within the clinic space. It also has physical therapy,and injection services all working together. Among the groups I interviewed with, it felt like the most complete and patient-focused environment.”
Before assuming full ownership, Dr. Maggio had already completed a partial buy-in and spent years learning the financial and operational aspects of the business. Now, just over a month into his new role, he says the transition has been smooth overall.
“It’s really been a dream come true,” he said. “Even though this was always the plan, there’s a lot involved with financing and preparing for a transition like this. A year ago, I was still learning and planning for the future. Now that it’s officially happened, I’m excited to focus on what comes next.”
One of the biggest developments has been the rapid growth in patient volume at the ambulatory surgery center. Dr. Maggio credited recent Medicare policy changes, including the removal of several spine procedures from the inpatient-only list, with helping expand access to outpatient surgery.
“Previously, there were cases I had to perform at the hospital simply because of insurance requirements,” he said. “Now I have more flexibility in determining the best setting for each patient. There will always be patients who are better suited for hospital care, but many more patients can now safely undergo surgery in an outpatient setting. In my experience, patients generally prefer an outpatient option if given the choice.”
Dr. Maggio said ASC volume at the practice increased about 30% to 40% between January and early May 2026. He also credits the practice’s experienced staff for that growth.
“A lot of our team members have been here for more than 10 years,” he said. “One advantage of having our own facility is the consistency. Patients see familiar faces, and our staff works together seamlessly. That continuity naturally improves efficiency and the overall patient experience.”
Looking ahead, Dr. Maggio plans to expand the practice over the next several years, including adding more surgeons to meet growing demand in the region.
“We’re going to need to keep growing,” he said. “There’s a significant need for spine care in our area, and we want to make sure patients can receive treatment within a reasonable timeframe.”
At the same time, he emphasized the importance of continuing innovation and staying current with advancements in spine surgery.
“If you fast forward 50 years, spine surgery is going to look very different from what it does today,” he said. “It’s important to stay open to new technologies and techniques, critically evaluate them, and determine whether they truly improve patient care.”
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