Andy Berg – Opening an ASC: Finding Your Dream Team
Here’s what to expect on this week’s episode. 🎙️
🎙 When hiring your team, it’s vital to ensure that the people you bring on are skilled and competent, align with your center’s values, and fit in with your team dynamics. It’s no easy feat.
Andy Berg is the Director of Clinical Staffing at MedHQ. From 13-week contracts to direct hires to peer interviews, he’s sharing advice on how to find your dream team. In this week’s episode of This Week in Surgery Centers, Andy answers:
How is recruiting for an ASC different from a hospital setting?
What type of flexibility can you offer?
How important is flexibility for the staff, providers, and the facility?
What qualities should you look for in a leader?
What kinds of professional growth are available at an ASC?
How can you make the team you already have feel included in the interview process?
Interesting in learning more about opening a new surgery center? Check out our previous episodes:
• Michael McClain – Opening an ASC: Navigating Payer Contracts
• Wil Schlaff – Opening an ASC: Conducting a Comprehensive Feasibility Assessment
• Dawn Pfeiffer – Ask the Expert: Best Practices for Opening a New Surgery Center
• Beata Canby – Opening an ASC: Managing the Regulatory and Certification Process
• Gregory DeConciliis – Opening an ASC: Clinical Preparation
Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details.
Episode Transcript
0:00
welcome to this week in surgery centers
0:03
if you’re in the ASC industry then
0:05
you’re in the right place every week
0:08
we’ll start the episode off by sharing
0:10
an interesting conversation we had with
0:11
our featured guests and then we’ll close
0:13
the episode by recapping the latest news
0:15
impacting surgery centers we’re excited
0:18
to share with you what we have so let’s
0:20
get started and see what the industry’s
0:22
been up to
Welcome
0:23
[Music]
0:27
hi everyone here’s what you can expect
0:30
on today’s episode
0:32
Andy Berg is the director of clinical
0:34
Staffing at medhq and for the sixth
0:38
episode in our de novo series I had a
0:40
chance to sit down with him to chat
0:42
about how to find your dream team when
0:45
you’re opening a new surgery center now
0:47
even if you are opening an ASC there’s a
0:51
ton of great tips throughout the episode
0:52
about how to recruit staff flexible
0:55
hiring options qualities to look for in
0:58
a leader and how to make your current
1:00
team feel included in the interview
1:02
process
1:03
in our news recap we’ll cover the
1:06
gigafrication of the healthcare industry
1:09
aska’s official comments in response to
1:11
medicare’s 2024 proposed payment rule
1:14
the nurses strike still going on at
1:17
Robert Wood Johnson University Hospital
1:19
in New Jersey and of course end the new
1:23
segment with a positive story about a
1:25
nuclear prostate cancer treatment that
1:27
is improving lives
1:29
hope everyone enjoys the episode and
1:31
here’s what’s going on this week in
1:33
surgery centers
About Andy Berg
1:36
[Music]
1:38
hi Andy welcome to the podcast hi Erica
1:41
thanks for having me can you share a
1:44
little bit about yourself and about
1:45
medhq with our listeners please
1:48
sure so actually my first career out of
1:51
college I ran minor league baseball
1:53
teams and then transitioned 15 years
1:57
later over I actually just accidentally
2:00
fell into Healthcare Staffing and I’m
2:02
going to do it at 22 years since
2:04
medhq is all about the surgery centers
2:08
and part of my role in this is to help
2:12
provide a Staffing Solution and we do
2:14
that through something we call a talent
2:16
portal
2:17
very cool I can imagine that that is
2:20
much needed with the last couple of
2:22
years with the way things are trending
2:25
we’ll certainly get into that
Opening an ASC
2:28
so we are in the middle of our de novo
2:31
Series where we’re sharing advice with
2:33
our listeners about how to open up a
2:35
surgery center and last week we covered
2:37
clinical preparation which touched a
2:39
little bit on which staff members to
2:41
hire it in which order but we didn’t go
2:43
too deep into it so today we’re going to
2:45
expand on that and then talk about how
2:47
to actually find your dream team
2:49
so for those who are working on opening
2:51
up a surgery center or considering it
2:53
how early on do you start recruiting
2:55
members of your team and which roles do
2:58
you look for to fill first
3:00
so if a center is utilizing an advisory
3:02
firm such as avanza strategies they’ll
3:06
typically focus on finding the
3:08
administrator first and that’ll be
3:10
typically six months out okay gotcha and
3:14
how is recruiting for a surgery center
3:17
different than recruiting for a hospital
3:20
setting
3:22
so this may be a little more long-winded
3:24
answer than you’re looking for so
3:26
obviously the number of employees in a
3:29
hospital is significantly larger than in
3:32
a surgery center so recruitment in a
3:35
hospital specifically in the OR and
3:37
we’ll use a level one Trauma Center as
3:39
an example so they’re open 24 7 365 and
3:45
it’s not as structured as a surgery
3:48
center they don’t know what’s coming in
3:50
next and so the nurses that work in the
3:53
or in the hospital are typically going
3:56
to be more specialized again because
3:59
they don’t know what’s coming on the
4:01
surgery center because there’s fewer
4:03
employees those nurses and employees are
4:06
typically more of a generalist and one
4:09
of the things that nurses and employees
4:12
enjoy about a surgery center is there’s
4:14
no nights no weekends no holidays no on
4:17
call which is a tremendous benefit the
4:20
other difference is so in a hospital
4:23
they have many different units and so
4:27
this may come to the HR Talent
4:29
acquisition team
4:30
and say Hey you remember that ICU that I
4:32
closed down six months ago well we need
4:35
to reopen it because the census is going
4:37
through the roof so we need you to go
4:39
out and find 40 full-time equivalents
4:42
that team is going out they’re finding
4:44
500 resumes that are going through those
4:46
resumes narrowing it down to a hundred
4:50
that look like they have the experience
4:52
they’re doing a phone interview with
4:54
those 100 of the hundred they may be
4:57
like 25
4:58
and so they’ll bring the 25 in for an
5:02
in-person interview
5:03
and these in-person interviews are no
5:06
longer coming in an interview with HR
5:09
and we’ll let you know if you have a job
5:10
or not it’s now the directors of nursing
5:13
it’s the unit managers it’s pure panel
5:16
reviews and so the process is way more
5:19
involved and so when the group gets
5:22
through those 25 in-person interviews
5:24
they may have five out of the 40 that
5:27
they’ve need to hire so they have to
5:30
redo that process and part of how we
5:33
approach this helps them address that
5:35
gotcha yeah that’s great it is a numbers
5:39
game right you need Apple it is cool
5:42
and yep all right so let’s talk about
Staff and flexibility
5:46
flexibility so when you are looking to
5:48
hire people what kind of options do they
5:51
have when it comes to staff and
5:52
flexibility
5:54
so it’s a great question and different
5:57
centers are at different places in their
5:59
life cycle if they’re at the beginning
6:01
it’s different than if they’re a year or
6:04
two in and they’ve got their feet wet
6:06
now they’re ready to grow
6:07
we have a center that we’re working with
6:09
that has a plan in place with multiple
6:11
different phases and our part of helping
6:15
them out is being strategic about how
6:18
they grow their staff so we operate your
6:21
typical 13-ly contract which is they
6:24
show up they work for 91 days and then
6:26
they’re gone
6:27
we do attempt to perm with no conversion
6:29
fee again no conversion fee because
6:32
we’re trying to be very mindful of
6:35
the centers and the amount of money that
6:38
they have
6:39
to be able to put out for new staff
6:42
and then we have a direct hire solution
6:44
which in my experience is typically for
6:48
leadership type positions but what we’re
6:51
finding is the centers are looking
6:53
primarily a direct hire for all their
6:56
staffing needs so in the example where
6:59
that facility is working in stages
7:01
they have the ability to as they know
7:04
their cases are going to grow
7:06
they can bring a nurse in for 13 weeks
7:09
and then when they know that the growth
7:12
is going to continue then they could do
7:14
attempt to perm or if they’re an
7:17
established Center and somebody leaves
7:19
they can simply do a direct hire search
7:22
gotcha
7:24
and do you find when
Transparency
7:26
obviously transparency is key right the
7:29
person being hired knows exactly what
7:31
their trajectory is the length of their
7:32
contract all of that do you find that
7:35
obviously being flexible with all these
7:37
options increases the applicant pool or
7:40
how does that typically what do you see
7:42
there so typically when you compare a
7:46
nurse working in a hospital and a nurse
7:48
working in an ASC the pay scale on the
7:51
ASC side is typically a little bit lower
7:54
again because they’re more of a generals
7:56
than the specialist in the hospital
7:58
again it all goes back to that work-life
8:00
balance for the nurse nurses
8:02
specifically Hospital nurses have gone
8:06
through something absolutely horrific
8:09
over the last three and a half years and
8:11
quite honestly some of them are looking
8:14
for that to ease a little bit
8:16
yeah absolutely and how important is
Flexibility
8:20
flexibility for the providers how does
8:23
that work the same with them
8:25
well again it goes back to the work life
8:27
balance where they can actually
8:30
celebrate Christmas with their family
8:32
rather than having to work the night
8:33
shift and typically there’s a rotation
8:36
in the hospital where you’re going to
8:38
work one or two holidays in the surgery
8:40
center that doesn’t exist and it’s a
8:43
wonderful thing
8:45
yeah that’s certainly a nice perk and
Qualities of a leader
8:48
when you are in your search what
8:50
qualities should you be looking for in a
8:52
leader so I think it varies from Center
8:56
to Center again if you’re a new center
8:58
you’re going to hire somebody that has
9:01
experience in setting up a new center
9:03
and developing a culture
9:05
are they a center that’s been
9:07
underperforming do they need someone to
9:09
come in and really
9:10
get the group going some of the the
9:13
information that we want to know from
9:16
the center when we do a search is again
9:19
about the culture top selling points of
9:21
the center what the interview process is
9:24
like how many cases per month does the
9:26
center handle all of those bits of
9:28
information
9:30
give us a better understanding of what
9:32
we’re looking for
9:33
sure yeah that makes sense
Professional growth
9:36
and what kind of professional growth do
9:39
you find to be available at a Surgery
9:41
Center
9:43
so again less specialized more
9:46
generalized
9:48
so in the hospital you’ll have a nurse
9:50
that does the pre-op
9:52
you’ll have a nurse that does the or
9:54
you’ll have a nurse that does the pacu
9:56
or the post-op
9:58
in these surgery centers a lot of times
10:00
the pre-op nurse is also the post-op
10:03
nurse and sometimes you know in as much
10:06
to speaking to professional growth a lot
10:09
of times these nurses can come in as one
10:11
thing and be cross-trained to become a
10:13
much more different thing expanding
10:15
their growth and their ability
Resources
10:18
yeah and are there between all the state
10:20
associations and all the accrediting
10:23
bodies and all that are there resources
10:25
out there for them if they do want to
10:28
get into another area of the ASC or or
10:31
continue to learn
10:33
I think there’s always an opportunity
10:36
for continued education and you can find
10:39
those really almost anywhere whether you
10:42
go to the American Heart Association or
10:44
the state ASC Association they have all
10:48
that information available
Making your team feel included
10:50
sure okay and so when you are going
10:53
through the interview process how can
10:55
you make your team that you already have
10:58
feel included and why would that be
11:00
important
11:01
well obviously valuing everyone’s input
11:04
on the team
11:06
that’s the definition of inclusion but
11:09
when you include them on that peer panel
11:11
on in the interview process it really
11:14
allows everybody to have a say and at
11:17
the end of the day one of the things or
11:19
two of the things that you really want
11:20
to make sure you focus on is are they
11:23
clinically what they say they are
11:24
because obviously that’s most important
11:28
and also will they be a cultural fit
11:30
with the team and who better to help
11:33
drive that than the actual team
Interviewing the candidate
11:36
yeah and do you have them actually
11:39
interview the candidate or do you just
11:40
go back and share the experiences you’ve
11:43
had with the team or you want them
11:45
actually interviewing the candidate too
11:46
or at least meeting them I think I think
11:49
actually having them meet them when the
11:51
other thing it does is it allows the
11:53
candidate this interviewing to really
11:55
get an idea from a peer level what is it
11:59
really like to work here I get what the
12:01
administrator says I get what the
12:02
director of nursing says I get what the
12:04
charger says but
12:06
really what is it like what is it like
12:08
to show up at eight and leave at five
12:10
and the kind of cases that we have how
12:13
how complex are they those kind of
12:16
questions I think the interviewee will
12:20
have an easier time asking that of their
12:23
peers or would be peers yeah that makes
12:26
sense and actually getting like here’s
12:28
what I hear here’s the spin I’m hearing
12:30
but is it actually true and I know we’ve
12:33
talked about the hospital a couple of
12:34
times but I would imagine maybe there’s
12:37
a smidge of disbelief coming from the
12:39
hospital is it true over here that this
12:41
is what the experience is actually like
12:43
exactly awesome well this was all super
Improving your surgery center
12:48
helpful and we do this every week with
12:51
our guests what is one thing our
12:53
listeners can do this week to improve
12:55
their surgery centers
12:57
the two suggestions that I would offer
13:00
and I this comes from
13:02
a perspective of somebody who works in
13:04
healthcare staffing that we’ve decided
13:07
that we’re going to be a patient-centric
13:09
organization
13:10
and by patient-centric obviously we work
13:13
with nurses we work with facilities and
13:16
both of their goals are to make sick
13:19
people feel better so everything that we
13:21
do at medhq needs to be in support of
13:25
that so that’s why we’re patient-centric
13:27
so one of the things I would say is
13:30
continue to be overly communicative with
13:34
the patients and families because
13:37
they don’t know what a gallbladder is
13:39
and they don’t know what it does
13:41
but the nurse does and the nurse can
13:44
explain it so it’s a tremendous resource
13:47
for the patients and their families the
13:49
other thing I would say is these ASCS
13:52
are much smaller most don’t have a
13:55
recruiter on staff
13:56
and obviously I’m biased I would suggest
14:00
using a patient goes to a surgery center
14:03
to have surgery
14:04
by an expert and that’s understandable
14:07
you wouldn’t go anywhere else other than
14:11
where there was an expert
14:13
in regard to building your dream team as
14:16
it were I would suggest using
14:18
professionals also because they’re going
14:20
to know what you’re looking for and they
14:22
can deliver the right kind of people so
14:23
you’re not wasting your time you’ll save
14:26
hours and you’ll save money by using
14:28
experienced Healthcare recruiter perfect
14:31
that is great advice all right Andy we
14:34
appreciate your time and all your
14:36
expertise thank you thanks Erica take
14:38
care
Gig economy in healthcare
14:40
[Music]
14:42
as always it has been a busy week in
14:45
healthcare so let’s jump right in our
14:47
first story comes from Med City news
14:50
as a result of the Staffing shortages
14:52
that the industry has been facing
14:54
Healthcare organizations are now leaning
14:57
into the gig economy and they’re calling
14:59
it The gigafrication of Health Care
15:02
so first what does that even mean so the
15:05
gig economy is defined as a labor market
15:08
characterized by the prevalence of
15:10
short-term contracts or freelance work
15:13
as opposed to permanent jobs
15:15
individuals work on specific tasks or
15:18
gigs rather than being employed in
15:20
traditional ongoing jobs with a single
15:23
employer salary all of that
15:25
so what is fueling this the U.S Bureau
15:29
of Labor Statistics predicts over 2.6
15:33
million new health care jobs by 2031
15:36
meaning employers need to accommodate
15:38
how the next generation of healthcare
15:41
professionals want to work now this of
15:44
course does not apply to everyone and
15:46
not everyone will be interested in these
15:48
types of relationships and contracts it
15:50
definitely takes a certain type of
15:53
person who has the interest and ability
15:55
to manage you know I have a couple
15:58
shifts here a couple shifts here I do
16:00
this at night this during the day you
16:02
know that life is certainly not for
16:04
everybody but it at least has to be an
16:07
option
16:08
so the first tip that they gave is to
16:11
lean into apps that allow you to view
16:13
schedules swap shifts and receive
16:15
payments these tools can offer autonomy
16:18
to workers who seek careers that allow
16:20
them to work more on their own terms
16:23
the second tip is flexible work and
16:26
flexible pay so if people want to work
16:28
remotely maybe you can weave different
16:30
Telehealth options into your practice or
16:33
as most Millennials and genziers live
16:36
paycheck to paycheck maybe you have an
16:38
instant payment option versus bi-weekly
16:41
deposits and lastly growth-based perks
16:44
could be enticing as well so unique
16:47
rewards and benefits instead of the
16:49
usuals such as financial literacy and
16:52
coaching tuition coverage cash back on
16:55
gas and other offerings will give you a
16:58
big advantage over those around you that
16:59
don’t offer things like that
17:01
so the moral of the story is that
17:03
tapping into the talent pool of gig
17:05
workers might help ease Staffing
17:09
shortages and retain and motivate your
17:11
team and then also get you set up for
17:14
success for kind of the next generation
17:16
of healthcare workers that are coming
ASCA submits comments
17:19
Switching gears ASCA officially
17:22
submitted their comments in response to
17:24
medicare’s 2024 proposed payment rule
17:27
for ASCS and hopdees so their final
17:31
comments ended up being 22 pages long so
17:33
I’m just going to give you some of the
17:35
highlights here but I will link their
17:37
full comments in the episode notes as
17:39
well so you can easily check those out
17:41
they really went to bat for the industry
17:44
as expected and I was really impressed
17:47
because like they just presented their
17:48
arguments extremely well lots of
17:50
detailed reports and data points so a
17:52
lot of the stuff they were sharing
17:53
didn’t come off as opinion it came off
17:55
as fact so here’s a quick recap
17:58
Asuka commented on ongoing payment
18:01
issues such as the need for alignment of
18:04
inflation update factors between ases
18:06
and hospitals
18:07
the removal of secondary adjustments
18:10
that depress ASE reimbursement rates and
18:13
issues with medicare’s process for
18:15
moving procedures to the ASC covered
18:17
procedures list as you probably remember
18:20
they only accepted one I know I think
18:23
aska is 60 something that they had
18:25
submitted and they only took one so
18:29
hopefully when the proposed rule comes
18:31
out we’ll see a lot more on there
18:34
ASCA also commented on proposed updates
18:37
to the ASC Quality Reporting program
18:39
including opposing the newly proposed
18:43
ASC 7 volume measure and continuing to
18:46
request removal of the ASC 11 cataract
18:49
measure and lastly continuing to request
18:53
the removal of the ASC 20 covid-19
18:56
vaccination measure
18:58
and last but not least ASCA also
19:01
submitted comments in response to the
19:04
2024 updates to the Medicare physician
19:07
fee schedule now these policies don’t
19:10
always or rarely directly impact ASCS
19:13
but they do impact the clinicians who
19:15
work in surgery centers
19:17
so thank you to aska for advocating on
19:20
behalf of the industry and we can expect
19:22
the final rule to be released around
19:24
November 1st
New Jersey nurses strike
19:26
our third story is from Healthcare dive
19:29
more than 1700 nurses have been on
19:33
strike in New Jersey since the beginning
19:35
of August at Robert Wood Johnson
19:38
University Hospital
19:40
the strike just hit its 40th day last
19:43
week but the parties were expected to
19:45
meet on September 14th so hopefully by
19:48
the time you are listening to this there
19:50
has been some resolution or progress
19:52
made in the right direction
19:54
if you haven’t been following the story
19:56
the nurse’s first authorized a strike in
20:00
July after failing to negotiate a new
20:03
contract so nurses walked off the job on
20:06
August 4th citing unsafe Staffing levels
20:09
and insufficient pay as primary concerns
20:12
in addition to reining in health
20:14
insurance costs so the parties have
20:17
remained at an impasse since August 16th
20:20
despite even bringing in federal
20:21
mediators
20:23
and as with all strikes both parties are
20:27
suffering ultimately the 965 bed
20:30
hospital said it spent 45 million
20:33
dollars on a team of a thousand
20:35
contracted replacement nurses and of
20:38
course the 1700 nurses who are on strike
20:41
just lost their health insurance amongst
20:43
experiencing other Financial losses so
20:47
again hopefully the hospital will commit
20:49
to enforceable nurse to Patient ratios
20:52
which seems to be the biggest hold up
20:54
here and of course
20:56
staff safety and pay and just other
20:59
Staffing agreements and I hope they can
21:01
come to a resolution so life can resume
21:03
back to normal as much as possible
New treatment for prostate cancer
21:07
and to end our new segment on a positive
21:10
note a revolutionary Search and Destroy
21:13
drug for treating Advanced prostate
21:15
cancer could improve the quality of life
21:18
for thousands of men each year psma acts
21:22
like a guided missile by hunting down
21:24
cancerous cells and delivering a
21:26
targeted dose of radiation leaving
21:28
healthy tissue untouched
21:31
a total of 617 patients took part in a
21:35
trial led by The Institute of cancer
21:37
research in London and it found that men
21:40
treated with the drug lived for longer
21:42
before their pain levels increased for
21:45
patients taking psma it took 9.7 months
21:49
for quality of life to worsen compared
21:51
to 2.4 months amongst men who were
21:54
receiving standard care
21:56
so hopefully this could pave the way for
22:00
a new era of these nuclear treatments
22:02
for other cancers as well
Outro
22:04
and that news story officially wraps up
22:07
this week’s podcast thank you as always
22:09
for spending a few minutes of your week
22:11
with us make sure to subscribe or leave
22:14
a review on whichever platform you’re
22:15
listening from I hope you have a great
22:17
day and we will see you again next week
22:25
why are you keeping me
22:27
[Music]
welcome to this week in surgery centers
0:03
if you’re in the ASC industry then
0:05
you’re in the right place every week
0:08
we’ll start the episode off by sharing
0:10
an interesting conversation we had with
0:11
our featured guests and then we’ll close
0:13
the episode by recapping the latest news
0:15
impacting surgery centers we’re excited
0:18
to share with you what we have so let’s
0:20
get started and see what the industry’s
0:22
been up to
Welcome
0:23
[Music]
0:27
hi everyone here’s what you can expect
0:30
on today’s episode
0:32
Andy Berg is the director of clinical
0:34
Staffing at medhq and for the sixth
0:38
episode in our de novo series I had a
0:40
chance to sit down with him to chat
0:42
about how to find your dream team when
0:45
you’re opening a new surgery center now
0:47
even if you are opening an ASC there’s a
0:51
ton of great tips throughout the episode
0:52
about how to recruit staff flexible
0:55
hiring options qualities to look for in
0:58
a leader and how to make your current
1:00
team feel included in the interview
1:02
process
1:03
in our news recap we’ll cover the
1:06
gigafrication of the healthcare industry
1:09
aska’s official comments in response to
1:11
medicare’s 2024 proposed payment rule
1:14
the nurses strike still going on at
1:17
Robert Wood Johnson University Hospital
1:19
in New Jersey and of course end the new
1:23
segment with a positive story about a
1:25
nuclear prostate cancer treatment that
1:27
is improving lives
1:29
hope everyone enjoys the episode and
1:31
here’s what’s going on this week in
1:33
surgery centers
About Andy Berg
1:36
[Music]
1:38
hi Andy welcome to the podcast hi Erica
1:41
thanks for having me can you share a
1:44
little bit about yourself and about
1:45
medhq with our listeners please
1:48
sure so actually my first career out of
1:51
college I ran minor league baseball
1:53
teams and then transitioned 15 years
1:57
later over I actually just accidentally
2:00
fell into Healthcare Staffing and I’m
2:02
going to do it at 22 years since
2:04
medhq is all about the surgery centers
2:08
and part of my role in this is to help
2:12
provide a Staffing Solution and we do
2:14
that through something we call a talent
2:16
portal
2:17
very cool I can imagine that that is
2:20
much needed with the last couple of
2:22
years with the way things are trending
2:25
we’ll certainly get into that
Opening an ASC
2:28
so we are in the middle of our de novo
2:31
Series where we’re sharing advice with
2:33
our listeners about how to open up a
2:35
surgery center and last week we covered
2:37
clinical preparation which touched a
2:39
little bit on which staff members to
2:41
hire it in which order but we didn’t go
2:43
too deep into it so today we’re going to
2:45
expand on that and then talk about how
2:47
to actually find your dream team
2:49
so for those who are working on opening
2:51
up a surgery center or considering it
2:53
how early on do you start recruiting
2:55
members of your team and which roles do
2:58
you look for to fill first
3:00
so if a center is utilizing an advisory
3:02
firm such as avanza strategies they’ll
3:06
typically focus on finding the
3:08
administrator first and that’ll be
3:10
typically six months out okay gotcha and
3:14
how is recruiting for a surgery center
3:17
different than recruiting for a hospital
3:20
setting
3:22
so this may be a little more long-winded
3:24
answer than you’re looking for so
3:26
obviously the number of employees in a
3:29
hospital is significantly larger than in
3:32
a surgery center so recruitment in a
3:35
hospital specifically in the OR and
3:37
we’ll use a level one Trauma Center as
3:39
an example so they’re open 24 7 365 and
3:45
it’s not as structured as a surgery
3:48
center they don’t know what’s coming in
3:50
next and so the nurses that work in the
3:53
or in the hospital are typically going
3:56
to be more specialized again because
3:59
they don’t know what’s coming on the
4:01
surgery center because there’s fewer
4:03
employees those nurses and employees are
4:06
typically more of a generalist and one
4:09
of the things that nurses and employees
4:12
enjoy about a surgery center is there’s
4:14
no nights no weekends no holidays no on
4:17
call which is a tremendous benefit the
4:20
other difference is so in a hospital
4:23
they have many different units and so
4:27
this may come to the HR Talent
4:29
acquisition team
4:30
and say Hey you remember that ICU that I
4:32
closed down six months ago well we need
4:35
to reopen it because the census is going
4:37
through the roof so we need you to go
4:39
out and find 40 full-time equivalents
4:42
that team is going out they’re finding
4:44
500 resumes that are going through those
4:46
resumes narrowing it down to a hundred
4:50
that look like they have the experience
4:52
they’re doing a phone interview with
4:54
those 100 of the hundred they may be
4:57
like 25
4:58
and so they’ll bring the 25 in for an
5:02
in-person interview
5:03
and these in-person interviews are no
5:06
longer coming in an interview with HR
5:09
and we’ll let you know if you have a job
5:10
or not it’s now the directors of nursing
5:13
it’s the unit managers it’s pure panel
5:16
reviews and so the process is way more
5:19
involved and so when the group gets
5:22
through those 25 in-person interviews
5:24
they may have five out of the 40 that
5:27
they’ve need to hire so they have to
5:30
redo that process and part of how we
5:33
approach this helps them address that
5:35
gotcha yeah that’s great it is a numbers
5:39
game right you need Apple it is cool
5:42
and yep all right so let’s talk about
Staff and flexibility
5:46
flexibility so when you are looking to
5:48
hire people what kind of options do they
5:51
have when it comes to staff and
5:52
flexibility
5:54
so it’s a great question and different
5:57
centers are at different places in their
5:59
life cycle if they’re at the beginning
6:01
it’s different than if they’re a year or
6:04
two in and they’ve got their feet wet
6:06
now they’re ready to grow
6:07
we have a center that we’re working with
6:09
that has a plan in place with multiple
6:11
different phases and our part of helping
6:15
them out is being strategic about how
6:18
they grow their staff so we operate your
6:21
typical 13-ly contract which is they
6:24
show up they work for 91 days and then
6:26
they’re gone
6:27
we do attempt to perm with no conversion
6:29
fee again no conversion fee because
6:32
we’re trying to be very mindful of
6:35
the centers and the amount of money that
6:38
they have
6:39
to be able to put out for new staff
6:42
and then we have a direct hire solution
6:44
which in my experience is typically for
6:48
leadership type positions but what we’re
6:51
finding is the centers are looking
6:53
primarily a direct hire for all their
6:56
staffing needs so in the example where
6:59
that facility is working in stages
7:01
they have the ability to as they know
7:04
their cases are going to grow
7:06
they can bring a nurse in for 13 weeks
7:09
and then when they know that the growth
7:12
is going to continue then they could do
7:14
attempt to perm or if they’re an
7:17
established Center and somebody leaves
7:19
they can simply do a direct hire search
7:22
gotcha
7:24
and do you find when
Transparency
7:26
obviously transparency is key right the
7:29
person being hired knows exactly what
7:31
their trajectory is the length of their
7:32
contract all of that do you find that
7:35
obviously being flexible with all these
7:37
options increases the applicant pool or
7:40
how does that typically what do you see
7:42
there so typically when you compare a
7:46
nurse working in a hospital and a nurse
7:48
working in an ASC the pay scale on the
7:51
ASC side is typically a little bit lower
7:54
again because they’re more of a generals
7:56
than the specialist in the hospital
7:58
again it all goes back to that work-life
8:00
balance for the nurse nurses
8:02
specifically Hospital nurses have gone
8:06
through something absolutely horrific
8:09
over the last three and a half years and
8:11
quite honestly some of them are looking
8:14
for that to ease a little bit
8:16
yeah absolutely and how important is
Flexibility
8:20
flexibility for the providers how does
8:23
that work the same with them
8:25
well again it goes back to the work life
8:27
balance where they can actually
8:30
celebrate Christmas with their family
8:32
rather than having to work the night
8:33
shift and typically there’s a rotation
8:36
in the hospital where you’re going to
8:38
work one or two holidays in the surgery
8:40
center that doesn’t exist and it’s a
8:43
wonderful thing
8:45
yeah that’s certainly a nice perk and
Qualities of a leader
8:48
when you are in your search what
8:50
qualities should you be looking for in a
8:52
leader so I think it varies from Center
8:56
to Center again if you’re a new center
8:58
you’re going to hire somebody that has
9:01
experience in setting up a new center
9:03
and developing a culture
9:05
are they a center that’s been
9:07
underperforming do they need someone to
9:09
come in and really
9:10
get the group going some of the the
9:13
information that we want to know from
9:16
the center when we do a search is again
9:19
about the culture top selling points of
9:21
the center what the interview process is
9:24
like how many cases per month does the
9:26
center handle all of those bits of
9:28
information
9:30
give us a better understanding of what
9:32
we’re looking for
9:33
sure yeah that makes sense
Professional growth
9:36
and what kind of professional growth do
9:39
you find to be available at a Surgery
9:41
Center
9:43
so again less specialized more
9:46
generalized
9:48
so in the hospital you’ll have a nurse
9:50
that does the pre-op
9:52
you’ll have a nurse that does the or
9:54
you’ll have a nurse that does the pacu
9:56
or the post-op
9:58
in these surgery centers a lot of times
10:00
the pre-op nurse is also the post-op
10:03
nurse and sometimes you know in as much
10:06
to speaking to professional growth a lot
10:09
of times these nurses can come in as one
10:11
thing and be cross-trained to become a
10:13
much more different thing expanding
10:15
their growth and their ability
Resources
10:18
yeah and are there between all the state
10:20
associations and all the accrediting
10:23
bodies and all that are there resources
10:25
out there for them if they do want to
10:28
get into another area of the ASC or or
10:31
continue to learn
10:33
I think there’s always an opportunity
10:36
for continued education and you can find
10:39
those really almost anywhere whether you
10:42
go to the American Heart Association or
10:44
the state ASC Association they have all
10:48
that information available
Making your team feel included
10:50
sure okay and so when you are going
10:53
through the interview process how can
10:55
you make your team that you already have
10:58
feel included and why would that be
11:00
important
11:01
well obviously valuing everyone’s input
11:04
on the team
11:06
that’s the definition of inclusion but
11:09
when you include them on that peer panel
11:11
on in the interview process it really
11:14
allows everybody to have a say and at
11:17
the end of the day one of the things or
11:19
two of the things that you really want
11:20
to make sure you focus on is are they
11:23
clinically what they say they are
11:24
because obviously that’s most important
11:28
and also will they be a cultural fit
11:30
with the team and who better to help
11:33
drive that than the actual team
Interviewing the candidate
11:36
yeah and do you have them actually
11:39
interview the candidate or do you just
11:40
go back and share the experiences you’ve
11:43
had with the team or you want them
11:45
actually interviewing the candidate too
11:46
or at least meeting them I think I think
11:49
actually having them meet them when the
11:51
other thing it does is it allows the
11:53
candidate this interviewing to really
11:55
get an idea from a peer level what is it
11:59
really like to work here I get what the
12:01
administrator says I get what the
12:02
director of nursing says I get what the
12:04
charger says but
12:06
really what is it like what is it like
12:08
to show up at eight and leave at five
12:10
and the kind of cases that we have how
12:13
how complex are they those kind of
12:16
questions I think the interviewee will
12:20
have an easier time asking that of their
12:23
peers or would be peers yeah that makes
12:26
sense and actually getting like here’s
12:28
what I hear here’s the spin I’m hearing
12:30
but is it actually true and I know we’ve
12:33
talked about the hospital a couple of
12:34
times but I would imagine maybe there’s
12:37
a smidge of disbelief coming from the
12:39
hospital is it true over here that this
12:41
is what the experience is actually like
12:43
exactly awesome well this was all super
Improving your surgery center
12:48
helpful and we do this every week with
12:51
our guests what is one thing our
12:53
listeners can do this week to improve
12:55
their surgery centers
12:57
the two suggestions that I would offer
13:00
and I this comes from
13:02
a perspective of somebody who works in
13:04
healthcare staffing that we’ve decided
13:07
that we’re going to be a patient-centric
13:09
organization
13:10
and by patient-centric obviously we work
13:13
with nurses we work with facilities and
13:16
both of their goals are to make sick
13:19
people feel better so everything that we
13:21
do at medhq needs to be in support of
13:25
that so that’s why we’re patient-centric
13:27
so one of the things I would say is
13:30
continue to be overly communicative with
13:34
the patients and families because
13:37
they don’t know what a gallbladder is
13:39
and they don’t know what it does
13:41
but the nurse does and the nurse can
13:44
explain it so it’s a tremendous resource
13:47
for the patients and their families the
13:49
other thing I would say is these ASCS
13:52
are much smaller most don’t have a
13:55
recruiter on staff
13:56
and obviously I’m biased I would suggest
14:00
using a patient goes to a surgery center
14:03
to have surgery
14:04
by an expert and that’s understandable
14:07
you wouldn’t go anywhere else other than
14:11
where there was an expert
14:13
in regard to building your dream team as
14:16
it were I would suggest using
14:18
professionals also because they’re going
14:20
to know what you’re looking for and they
14:22
can deliver the right kind of people so
14:23
you’re not wasting your time you’ll save
14:26
hours and you’ll save money by using
14:28
experienced Healthcare recruiter perfect
14:31
that is great advice all right Andy we
14:34
appreciate your time and all your
14:36
expertise thank you thanks Erica take
14:38
care
Gig economy in healthcare
14:40
[Music]
14:42
as always it has been a busy week in
14:45
healthcare so let’s jump right in our
14:47
first story comes from Med City news
14:50
as a result of the Staffing shortages
14:52
that the industry has been facing
14:54
Healthcare organizations are now leaning
14:57
into the gig economy and they’re calling
14:59
it The gigafrication of Health Care
15:02
so first what does that even mean so the
15:05
gig economy is defined as a labor market
15:08
characterized by the prevalence of
15:10
short-term contracts or freelance work
15:13
as opposed to permanent jobs
15:15
individuals work on specific tasks or
15:18
gigs rather than being employed in
15:20
traditional ongoing jobs with a single
15:23
employer salary all of that
15:25
so what is fueling this the U.S Bureau
15:29
of Labor Statistics predicts over 2.6
15:33
million new health care jobs by 2031
15:36
meaning employers need to accommodate
15:38
how the next generation of healthcare
15:41
professionals want to work now this of
15:44
course does not apply to everyone and
15:46
not everyone will be interested in these
15:48
types of relationships and contracts it
15:50
definitely takes a certain type of
15:53
person who has the interest and ability
15:55
to manage you know I have a couple
15:58
shifts here a couple shifts here I do
16:00
this at night this during the day you
16:02
know that life is certainly not for
16:04
everybody but it at least has to be an
16:07
option
16:08
so the first tip that they gave is to
16:11
lean into apps that allow you to view
16:13
schedules swap shifts and receive
16:15
payments these tools can offer autonomy
16:18
to workers who seek careers that allow
16:20
them to work more on their own terms
16:23
the second tip is flexible work and
16:26
flexible pay so if people want to work
16:28
remotely maybe you can weave different
16:30
Telehealth options into your practice or
16:33
as most Millennials and genziers live
16:36
paycheck to paycheck maybe you have an
16:38
instant payment option versus bi-weekly
16:41
deposits and lastly growth-based perks
16:44
could be enticing as well so unique
16:47
rewards and benefits instead of the
16:49
usuals such as financial literacy and
16:52
coaching tuition coverage cash back on
16:55
gas and other offerings will give you a
16:58
big advantage over those around you that
16:59
don’t offer things like that
17:01
so the moral of the story is that
17:03
tapping into the talent pool of gig
17:05
workers might help ease Staffing
17:09
shortages and retain and motivate your
17:11
team and then also get you set up for
17:14
success for kind of the next generation
17:16
of healthcare workers that are coming
ASCA submits comments
17:19
Switching gears ASCA officially
17:22
submitted their comments in response to
17:24
medicare’s 2024 proposed payment rule
17:27
for ASCS and hopdees so their final
17:31
comments ended up being 22 pages long so
17:33
I’m just going to give you some of the
17:35
highlights here but I will link their
17:37
full comments in the episode notes as
17:39
well so you can easily check those out
17:41
they really went to bat for the industry
17:44
as expected and I was really impressed
17:47
because like they just presented their
17:48
arguments extremely well lots of
17:50
detailed reports and data points so a
17:52
lot of the stuff they were sharing
17:53
didn’t come off as opinion it came off
17:55
as fact so here’s a quick recap
17:58
Asuka commented on ongoing payment
18:01
issues such as the need for alignment of
18:04
inflation update factors between ases
18:06
and hospitals
18:07
the removal of secondary adjustments
18:10
that depress ASE reimbursement rates and
18:13
issues with medicare’s process for
18:15
moving procedures to the ASC covered
18:17
procedures list as you probably remember
18:20
they only accepted one I know I think
18:23
aska is 60 something that they had
18:25
submitted and they only took one so
18:29
hopefully when the proposed rule comes
18:31
out we’ll see a lot more on there
18:34
ASCA also commented on proposed updates
18:37
to the ASC Quality Reporting program
18:39
including opposing the newly proposed
18:43
ASC 7 volume measure and continuing to
18:46
request removal of the ASC 11 cataract
18:49
measure and lastly continuing to request
18:53
the removal of the ASC 20 covid-19
18:56
vaccination measure
18:58
and last but not least ASCA also
19:01
submitted comments in response to the
19:04
2024 updates to the Medicare physician
19:07
fee schedule now these policies don’t
19:10
always or rarely directly impact ASCS
19:13
but they do impact the clinicians who
19:15
work in surgery centers
19:17
so thank you to aska for advocating on
19:20
behalf of the industry and we can expect
19:22
the final rule to be released around
19:24
November 1st
New Jersey nurses strike
19:26
our third story is from Healthcare dive
19:29
more than 1700 nurses have been on
19:33
strike in New Jersey since the beginning
19:35
of August at Robert Wood Johnson
19:38
University Hospital
19:40
the strike just hit its 40th day last
19:43
week but the parties were expected to
19:45
meet on September 14th so hopefully by
19:48
the time you are listening to this there
19:50
has been some resolution or progress
19:52
made in the right direction
19:54
if you haven’t been following the story
19:56
the nurse’s first authorized a strike in
20:00
July after failing to negotiate a new
20:03
contract so nurses walked off the job on
20:06
August 4th citing unsafe Staffing levels
20:09
and insufficient pay as primary concerns
20:12
in addition to reining in health
20:14
insurance costs so the parties have
20:17
remained at an impasse since August 16th
20:20
despite even bringing in federal
20:21
mediators
20:23
and as with all strikes both parties are
20:27
suffering ultimately the 965 bed
20:30
hospital said it spent 45 million
20:33
dollars on a team of a thousand
20:35
contracted replacement nurses and of
20:38
course the 1700 nurses who are on strike
20:41
just lost their health insurance amongst
20:43
experiencing other Financial losses so
20:47
again hopefully the hospital will commit
20:49
to enforceable nurse to Patient ratios
20:52
which seems to be the biggest hold up
20:54
here and of course
20:56
staff safety and pay and just other
20:59
Staffing agreements and I hope they can
21:01
come to a resolution so life can resume
21:03
back to normal as much as possible
New treatment for prostate cancer
21:07
and to end our new segment on a positive
21:10
note a revolutionary Search and Destroy
21:13
drug for treating Advanced prostate
21:15
cancer could improve the quality of life
21:18
for thousands of men each year psma acts
21:22
like a guided missile by hunting down
21:24
cancerous cells and delivering a
21:26
targeted dose of radiation leaving
21:28
healthy tissue untouched
21:31
a total of 617 patients took part in a
21:35
trial led by The Institute of cancer
21:37
research in London and it found that men
21:40
treated with the drug lived for longer
21:42
before their pain levels increased for
21:45
patients taking psma it took 9.7 months
21:49
for quality of life to worsen compared
21:51
to 2.4 months amongst men who were
21:54
receiving standard care
21:56
so hopefully this could pave the way for
22:00
a new era of these nuclear treatments
22:02
for other cancers as well
Outro
22:04
and that news story officially wraps up
22:07
this week’s podcast thank you as always
22:09
for spending a few minutes of your week
22:11
with us make sure to subscribe or leave
22:14
a review on whichever platform you’re
22:15
listening from I hope you have a great
22:17
day and we will see you again next week
22:25
why are you keeping me
22:27
[Music]
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