Engage anesthesia group to expand volume

Editor's Note

Consistent case volume is the lifeblood of any successful ambulatory surgical center (ASC), but one often overlooked limiting factor in driving ASC volume is the anesthesia group, according to Michael Bernard, MD, in the September 2025 issue of Surgical Business.

Staffing shortages of anesthesia professionals are a major culprit, but Dr Bernard said a more nuanced challenge here is when anesthesia teams adopt an overly conservative or rigid approach to case approval, which can “quietly hinder growth and profitability.” To openly address this issue, he said ASC leaders should focus on these strategies:

*Align anesthesia and ASC leadership—Involve anesthesia leadership in operational meetings and strategic planning because this can be highly effective in building trust and opening lines of communication.

*Build a strong pre-surgical testing department—These nurses should be experienced, detail-oriented, and closely engaged with anesthesia providers to gather patient medical histories, diagnostic studies, and coordinate closely with referring physicians.

*Select the right cases by balancing caution and opportunity—Borderline cases can often be safely accommodated through due diligence from the pre-surgical testing team by gathering relevant data and clarifying the patient’s medical history. In more complex cases, an anesthesia partner can communicate with the patient or their primary care physician to understand key factors such as their functional status.

Ultimately, Dr Bernard suggested that developing a successful ASC requires intentional collaboration between surgeons and anesthesia providers, as well as administrators and staff. He also advised that an engaged and aligned anesthesia group should understand outpatient care, participate in decision making, and be supported by a robust infrastructure to help unlock additional case volume and improve profitability.