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Ep. 16: Dr. Kenjarski – Optimizing Case Scheduling for All Stakeholders | This Week in Surgery Centers
Here’s what to expect on this week’s episode. 🎙️
Pop Quiz!
✋ Do you consider your anesthesia group a stakeholder of your surgery center?
✋ Do you consider your anesthesia group when scheduling cases?
✋ Do you understand how anesthesia groups receive reimbursement?
Results:
If you answered no to any of the above – you might be leaving money on the table that could be yours.
Dr. Thomas Kenjarski is the Founder & Managing Partner of Noble Anesthesia Partners. He joins us on this week’s episode to share why it is critical surgery centers start forming a more meaningful and proactive relationship with their outsourced anesthesia teams.
Right now, when it comes to scheduling cases, most ASC schedulers are hyper-focused on what the surgeon prefers. But, by considering what is best for your anesthesia team in addition to the surgeon, your ASC will see an increase in revenue and smoother workflows.
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 if you’re in the ASC industry then
0:06
you’re in the right place every week we’ll start the episode off by sharing an interesting conversation we had with
0:11
our featured guests and then we’ll close the episode by recapping the latest news impacting surgery centers we’re excited
0:18
to share with you what we have so let’s get started and see what the industry’s been up to [Music]
0:27
hi everyone here’s what you can expect on today’s episode Dr Tom kenjarski is
0:34
the founder and managing partner of noble anesthesia partners and he is also
0:39
the first anesthesiologist we’ve had on the podcast which is exciting and on
0:45
today’s episode our host Nick Latz is chatting with Dr kanjarski about how surgery centers can optimize case
0:52
scheduling for all stakeholders which of course includes your anesthesia partners
0:57
in our news recap we’ll cover virtual nurses the demand for anesthesia providers ask us ASC administrator
1:06
development program and of course end the new segment with a positive story about a nurse who is using her artistic
1:13
skills to help her peers reduce job-related anxiety hope everyone enjoys the episode and
1:20
here’s what’s going on this week in surgery centers good night
1:27
Dr konjarski welcome to the show thank you thanks for having me thanks
1:32
for joining us today and you’re our first anesthesiologist on the podcast that excited to to have you on and
1:39
before we dig in uh was hoping Dr conjures you could tell me a little bit about yourself and your professional
1:45
background sure sure uh I was raised in uh Buffalo
1:50
New York uh went to college and medical school at the University of Rochester moved down to Texas in 1998 for
1:58
residency at UT Southwestern and never left uh after training uh worked for two
2:05
different groups uh as an employed anesthesiologist and then started my own group Noble anesthesia Partners back in
2:12
October of 2011. um since that time I brought practice management or business operations in the
2:19
house in 2014 and had the opportunity to acquire another practice management company that
2:27
takes care of any type of office based physician you might go see primary care doctor surgeons or specialists
2:35
um and then from there uh just grew the anesthesia group um you know we’ve been practicing in
2:41
Dallas and very soon after uh moved over to our neighboring Town Fort Worth have a very heavy presence there uh we’ve
2:48
been in Houston Texas for over eight years El Paso Texas for over two and then just started uh Corpus Christi
2:55
Texas last month um along with that as as we were growing
3:01
we entered into a partnership with ambulatory Management Solutions out of Chicago Illinois uh at the end of 2021
3:10
so they’ve given us um a lot of insight on how to be able to
3:17
to grow the practice and also to add another service line to our anesthesia group namely office-based anesthesia
3:25
thanks thanks for sharing that and I did did want to ask a couple questions about your anesthesia group
3:31
Noble anesthesia partners and one of the things that makes you unique and you touched on the relationship with
3:36
ambulatory Management Solutions but I understand you guys are 100 focused on
3:42
the ASC Market from a client perspective is that right
3:47
um just about uh we’re focused on ambulatory anesthesia so we work in
3:53
Ambulatory Surgery centers like you mentioned but also acute care Surgical Hospitals smaller Community Hospitals with an
4:00
outpatient focus and then as I mentioned with with AMS we have entered into
4:07
office-based anesthesia over the course of the last year and both the Dallas Fort Worth and Houston markets so
4:14
um we we will go to any centers but primarily our focus is on ambulatory
4:19
anesthesia Services outpatient anesthesia gotcha and and how did you decide to focus on those segments of the
4:28
market and specifically kind of the outpatient side oh it kind of chose us
4:34
um you know the uh uh level one tertiary care Trauma Center Market is highly
4:40
saturated um those are the contracts that a lot of the national groups compete for
4:46
primarily because uh there is a stipend or a revenue guarantee associated with
4:51
them and what we found uh is in ambulatory centers such as the acute
4:57
care Surgical Hospitals surgery centers of course uh surgeons offices there’s there’s no stipend to be had so we found
5:04
a lot of the larger groups were neglecting those outpatient centers they were sending people there who were post
5:10
call because they could offer them the shortest days in order to get back home to their families uh they were sending
5:16
providers especially in rural communities that didn’t have the same level of training in Regional anesthesia that our providers did so uh having
5:25
focused on that um we developed our brand and Ward got
5:30
out that wow this this is a totally different approach to ambulatory anesthesia and Noble became a known
5:38
entity and then became recommended between facility administrators and then the larger Surgery Center organizations
5:43
like uspi and SCA fantastic um and in focusing on those segments
5:50
that the ASC segments and just your business in general one of the things that comes up a lot
5:56
these days is Staffing Staffing at the ASC level Staffing at you know from an anesthesiologist perspective how is that
6:03
impacting your business and and what are you seeing specifically at Noble oh the market is crazy right now for
6:10
providers um and again uh these these kind of go hand in hand the larger uh centers the
6:17
tertiary Care Center is level one centers um because they usually have entered into contracts with the groups that have
6:24
some type of Revenue guarantee or stipend um you know absorb those costs uh when
6:31
either the market is going up for employed anesthesiologists or they have to resort towards Locum tenants coverage
6:38
so in those situations uh yes the anesthesia group is having to pay more
6:45
in order to recruit the providers they need but they’re able to pass those costs on for the most part to those
6:52
larger centers and then subsequently the local state and federal governments and you know that’s that’s our you know
6:59
that’s you and me so when you have a practice like noble anesthesia Partners which is totally
7:05
dependent on the revenue generated from the anesthesia services at those ASCS and
7:12
um uh acute care Surgical Hospitals your your hands are really tied
7:17
um there is there’s only so much that you can offer those providers because uh a lot of times those centers aren’t
7:23
interested in paying any type of stipend or financial support whatsoever so
7:30
um the market is has kind of been really crazy for for all anesthesia groups but specifically for us it’s been a lot
7:36
harder because we we don’t have that blank check to write sure so um that’s
7:42
presented quite a challenge for us yeah and and on that front uh are you doing
7:47
anything different from a recruiting perspective or from a a coverage model perspective how are you how are you
7:54
thinking about changing the business model accordingly
7:59
um well um that’s a great question
8:04
um we have uh tried to work collaboratively with with those centers in order to
8:11
explain to them the the financial constraints that we’re under and how the way that they schedule cases really
8:17
affects the way that we’re able to staff them um if they want to you know have X
8:24
number of rooms worth of cases but in each of those rooms they don’t book enough cases in order for us to cover
8:29
the cost of a provider we’re losing money we’re we’re subsidizing that center for the day sure yeah
8:36
um you know that that becomes a challenge especially for for some centers which are just getting started
8:42
and all centers are you know really interested in in taking care of the surgeons and patients and just accepting
8:47
the case whenever the surgeon wants to post it whatever time they want to post it um for us we’ve had to educate them
8:53
about you know if you are able to stack the cases in one room have a surgeon have a morning block and another one and
9:00
an afternoon block or instead of a surgeon booking three cases on three different days saying hey is there any
9:06
chance that the surgeon could do all three of those on the same day boy that would really help us those are the types
9:12
of things that that we’ve had to do in order to kind of ensure that we can continue to find and pay for the types
9:18
of providers that are are um necessary for those types of facilities
9:25
um there there’s there’s a higher customer service back there in those types of facilities because a lot of them are open staff F and you’re only as
9:32
good as your last case so you know you really have to do your best as as the owner of an anesthesia group to find you
9:40
know kind of the the best and the brightest and then people who are not necessarily focused on shift work
9:45
um you know we we don’t hire providers from seven to three seven to seven or whatever so it’s different but in
9:51
general we accentuate the fact that it is a lifestyle practice when you’re in ASC they close for the day and then they
9:58
don’t open until the next morning so there’s there’s no bring backs there’s no call uh elective cases on the
10:04
weekends are just that and usually are done by mutual agreement with us so um our biggest selling point is the fact
10:10
that you know they’re not going to be taking in-house overnight call they’re not going to be working on weekends and if they do offer uh to do that they are
10:18
going to be rewarded on top of whatever their their base compensation packages sure and and you touched on something
10:24
there that I think is pretty interesting which is uh the Staffing challenge is forcing more conversations and
10:32
collaborations with the ASCS on on scheduling and stacking and how do you get more efficient with the case volumes
10:39
right and the case mix and the times um yes how how collaborative are your
10:45
customers with you on on those requests and those needs
10:50
boy is that a loaded question um I would say at first blush not very
10:56
collaborative but I’ve always felt that the most important question anybody could ask is why
11:03
um for the first time in in at least my memory um I I am hearing that anesthesia groups
11:09
are asking for subsidies from the Ambulatory Surgery centers in order to support um their their Staffing costs
11:16
um they’re also refusing cases they’re they’re having trouble finding coverage or whatever yeah and as administrator I
11:22
would think the most important question to ask is why um so
11:28
uh what we’re finding is as um ASCS are becoming more sophisticated and
11:35
able to draw um higher Acuity cases from the hospitals um you know for example we’re now doing
11:42
total joint Replacements on an outpatient basis as you’re moving those cases from the you know larger centers
11:48
into an ASC the demographic changes as well you you do have a higher incidence
11:53
of governmental payers um you know who require those higher Acuity services so we’ve tried to
11:59
explain that saying hey this might be a financial Boom for you as an ASC because you get to do a bigger case but we don’t
12:06
share that same benefit our Medicare rate is the same no matter if we do that case at a hospital or an ASE or you know
12:13
anywhere else so um again I I think that uh we have tried and we
12:20
have been fairly successful with with our administrators just saying here’s the challenges we’re facing
12:26
um we’ve shown them our you know data um to say Hey you know this might look like a great day but you know based on
12:33
the number of cases and what they are and whatever the uh the payer mix is for those patients that day we’re not
12:39
covering the cost of our provider and you know in the past you know we’ve had centers come up to us and say well we’ve
12:45
always had two anesthesiologists and I was like your case volume and demographics won’t cover the case of
12:50
just two crnas so you know again it becomes a discussion
12:57
um but I think the most important question that they could ask having seen these Staffing challenges or or requests
13:03
for stipends or other things is is to ask why and to enter into discussion with the anesthesia group and uh we have
13:09
no trouble being forthcoming with with those uh types of data points for them showing them that what might be a great
13:15
day for them and you know great day for the surgeon is actually going to be operating at a loss for their anesthesia
13:21
provider yeah it’s it’s super interesting right because in the long term the business model has to make
13:27
sense for all stakeholders right so to your point on on the more acute cases
13:33
and maybe the increased case profitability from those cases um yeah it seems like there’s some
13:40
interesting doesn’t translate to Anesthesia Services there’s some interesting conversations there on how you potentially spread the economics do
13:46
you do you foresee any you know kind of major changes the anesthesia care if you’re putting in your your five-year
13:53
hat and lens looking in the future well I do and you know again you you
14:00
asked some great questions um you know um
14:06
what I started and I’ve reached that age where I can say fun things like you know I’ve been in practice for over 20 years or my anesthesia group has been in
14:13
practice for over a decade I mean that that’s really cool but 20 years ago when I when I was starting my career down at
14:18
a level one Center in Dallas Texas uh that was kind of the
14:24
um uh Fertile Crescent for for a lot of different things including one now International uh
14:31
um Surgery Center company and they were building a location on the campus of that Center and I remember being in the
14:36
doctor’s lounge and the surgeons were having a discussion along the lines of gosh who would want to have their
14:42
gallbladder out and go home the same day um the answer is everybody and it’s it’s
14:48
troubling that they didn’t foresee that that hey the technology was getting to a certain point where you know not only
14:54
could we have the equipment but you know we had advances in anesthesia and Regional anesthesia to the point where
14:59
yeah you can do those cases at an outpatient facility and send those appropriately screened patients home you
15:05
know within an hour or so of their surgery I see that Trend continuing as it is
15:11
really booming right now uh from taking higher Acuity cases from hospitals to
15:16
Ambulatory Surgery centers for the next move to be from Ambulatory Surgery centers to appropriate surgeons offices
15:23
interesting I really see that happening and we’ve seen some evidence at least from the governmental payers uh with
15:28
pain management Physicians where they’re being guided to do a certain percent of say epidural steroid injections in their
15:35
office they they don’t want them taking all those patients especially the ones who don’t need to be there uh to
15:40
generate a facility fee and an ASC just for an epidural steroid injection so I think that the the patient certainly
15:47
would appreciate that uh I I know that the payers are certainly trying to direct it there I know a lot of Surgeons
15:54
have been proactive about this and I really see that as as the next Trend um you know and this is coming from from
16:00
the guy who with Noble anesthesia Partners I mean we’ve done outpatient craniotomies uh you know same-day brain
16:07
surgery yes so um yeah um and again you know those those not all those cases have to be
16:13
done at a level one Center uh we’re doing you know like I said you know total joint Replacements and
16:20
um other types of big bigger cases um staple bariatric procedures and sending those patients home the same day so
16:26
again you have to look at what the current cases are in the ASC and say how many of them could be done in a properly
16:32
equipped and staffed uh surgeon’s office that makes sense for that shift to continue yeah
16:38
I want to go back um and talk about one of the things that you touched on earlier which is
16:44
scheduling and you talked about kind of the need or or opportunity for different
16:49
scheduling mixes to become more efficient to help with the staffing issues what have are there any best practices
16:56
that you guys have seen at you know your practice or with your clients around
17:01
uh tools and process around scheduling because it seems like
17:06
flexibility and communication is becoming even even more important right
17:11
for the for the ASC to be able to communicate with all stakeholders around scheduling and flexibility and taking
17:17
input have you seen any good tools or best practices that have that have helped you guys in that communication
17:25
yes and um unfortunately I think that those are kind of uh falling into the category of the difficult discussions
17:32
that they want to have the surgery centers want to be accommodating they they it’s like especially if they um are
17:39
just opening or trying to establish business or have expanded recently or whatever they they really want to be
17:46
able to let the surgeon to more than likely are surgeon investors in the facility do any case they want any day
17:52
of the week at any time and um I I you know would love in a perfect
17:59
world to be able to accommodate all of that but um I don’t think that a
18:05
um they know how anesthesia is reimbursed and I think that
18:11
um we’ve had discussions with with administrators and some surgeons just saying Hey look you know I want to show
18:17
you like why we’re asking you to either start cases or for you to pick an afternoon Block in front of some others
18:24
or whatever so that we can generate or enough Revenue to have the appropriate amount of providers that you want at
18:29
that facility that day but the other thing is I think that there’s there’s certainly a discussion to be had between
18:34
the administrators and the the surgeons and especially surgeon investors saying hey look when you book one case on a day
18:42
where we’re not doing anything else we have to bring in this many staff members
18:47
we have to turn the lights on we have to generate all of these other things and then anesthesia has to come out here and
18:53
they’re doing it a lost leader um over time you know annualized or
19:00
whatever saying if we had done these types of things we would have generated another million dollars of ibita for the
19:06
center had we not booked cases like that and we’re just starting to see the administrator sitting down at their
19:13
meetings and start having those discussions uh saying that hey look you know
19:19
just because you can doesn’t mean you should and if we were to do this your
19:24
distribution checks as a physician investor would have each increased by X those are usually eye-popping numbers
19:31
those are usually things that I think would motivate everybody but again to your point it requires a discussion it
19:38
requires some collaboration the other thing is recognizing some things that are kind of inherent that
19:44
people don’t think about you know the surgery center cases should be done earlier in the day most of those
19:50
centers hire people for their you know seven to five chefs or or or you know the anesthesia providers certainly
19:56
expect to be kind of working during day hours or whatever you know the surgeon should always keep that in mind in the facilitate or administrators should be
20:03
um keeping that in mind when they accept those cases as well Surgery Center cases should be done at the beginning of the
20:08
day um the other cases that they need to do at the hospital those again are either
20:14
stipend or Revenue guaranteed contracts with the other anesthesia group they have second shifts they they have
20:20
another crew that that’s working three to elevens or 7p to 7A or whatever they they have those providers in place and
20:27
and they’re there in order to take on those later cases so the timing of the
20:32
day in which when do I do my surgery center block whereas when do I go do my one or two inpatient cases to follow is
20:38
huge um you know some of the cases at the hospitals are are bigger and run over
20:43
and it is not uncommon for a surgeon to the case at say 11 A.M thinking they can
20:48
sneak a case in at a hospital and then not showing up for one two three hours
20:53
after their posting time at the surgery center that’s just not a good use of their resources for a facility which
20:59
does not you know run 24 7 365. so it’s some of those bigger considerations and
21:06
then some of the others like hey could you you know just put these cases all on the same day could we establish a block
21:11
time for you um could one of you you know take an AM block and then follow with an afternoon block just just doing things like that
21:19
so having those types of proactive collaborative conversations further in advance as those schedules start to
21:24
materialize for the weeks after is is key yeah yeah and and you you kind of
21:31
touched on this theme of hey the the scheduling and the efficiency is important for us and our teams
21:38
um what about changing cases I gotta imagine that can kind of throw a wrench and things too if the if the time of the
21:46
cases change around on you is that is that an issue for you guys and your customers
21:51
are you talking like start times or durations of the cases yeah when cases get scheduled or rescheduled on
21:57
different days and and you kind of get late notifications on that is that much of an issue
22:02
that not that not so much I would say the the bigger uh issue is is something
22:08
that I like to refer to as truth in posting um I think if if you ask any surgeon and
22:14
you know it’s just the way it is and they say hey how long do you need for this case an hour I need two hours or
22:20
whatever um usually those are woefully inaccurate um and with the adoption of electronic
22:27
health records and all of the the times that we record in the rooms or whatever I really think that that every facility
22:33
surgery centers acute care Surgical Hospitals you know tertiary Care Centers should utilize that data and say hey
22:39
we’re going to take an average duration from that surgeon’s last 10 or 20 cases and regardless if he or she thinks it’s
22:44
going to take an hour we know it’s going to take them three and a half that is that is um more important to to
22:52
everybody not not only that the staff and the other surgeons who may be posting cases that they thought were
22:57
going to be able to start on time or the anesthesia providers then hey I just got to reschedule this case something came
23:02
up can we do it on Friday so I really think the truth in posting is is something that they everyone should pay
23:09
more attention to it’s not just what the surgeon or the surgeon scheduler put down it’s hey the last time you did a
23:15
total knee here last 10 times last 20 times it took you three hours so we’re going to post that for three hours and
23:21
we’re not going to let you put it on another case before then or tell another surgeon hey that room will be ready you
23:26
know until after that three hour window uh so that that that’s that’s one of the
23:32
things that is is one of my causes and I I try to get everybody to drink that Kool-Aid but it’s it’s been really
23:37
challenging sure the the difference between what what it should take or what you’d like to take right versus what it
23:43
actually does right and a lot of anesthesiologists Will Roll their eyes when they see
23:48
whatever the procedure is posted and then see what they’re requesting to go yeah that’s not going to happen so yeah
23:54
Dr kanjarski one one final question for you and we do this with with all of our guests every week
24:00
what’s one thing our listeners can do this week to improve their surgery centers
24:07
um really look at all of the stakeholders involved I love doing the stakeholder exercise and
24:12
um you know uh not assuming um anything
24:18
um if if we look at a surgery center for example we have we have our patients uh you know surgeons uh anesthesia
24:25
providers we have our or staff we have our administrative staff we have you
24:31
know the administrators who are both at the facility and then the the others and and to look at everybody’s goals and
24:37
incentives and really make sure that those are in alignment and if there are ongoing issues or if they have had
24:43
trouble with anesthesia coverage or retaining anesthesia staff or canceling cases or whatever ask that most
24:48
important question why is this happening don’t don’t assume anything but just say
24:54
hey why weren’t you able to show up or you know um why did you not want to do the case at this time or you know you’ve
25:01
been talking about you know wanting to meet with our scheduler maybe it’s time for us to do that so that everybody can express their concerns uh really just
25:08
taking a look at something that may have been in existence for 10 15 20 years for the first time as I mentioned I think
25:15
that what’s going on in 2023 is great being able to tell people you can have a
25:21
total hip replacement at a Surgery Center with you know your family close by and
25:28
be able to get home and sleep in your own bed that same night is is amazing and I’m so glad we have had all the
25:34
advances in in every aspect in order to get to that but we need to have an understanding that those types of cases
25:40
done in that type of facility present new challenges and that we really need to make sure that we’re on the same page
25:46
in order for it to not only make clinical sense but Financial sense for everybody as well
25:51
fantastic I appreciate the advice and thanks so much for joining us today
25:57
great yeah and you know if if anybody would uh like to connect uh again we have a great presence in in Texas but as
26:04
I mentioned we have uh our partners ambulatory Management Solutions in Chicago and their group their anesthesia
26:10
group mobile anesthesiologists there we also have M2 anesthesia and Washington State and Oregon uh we are you know
26:17
um you know preaching this this gospel to everyone and we have local resources if anybody would like to talk or or even
26:23
in states that that we aren’t yet I I I’d love to do this I I really have a passion for it and it’s what drove me
26:30
from leaving an employed model to to starting my own group back in 2011. fantastic
26:36
all right cool that’s a wrap
26:42
[Music] as always it has been a busy week in healthcare so let’s Jump Right In
26:49
michigan-based Health System Trinity Health is rolling out a new program called the virtual connected Care
26:56
Program this initiative changes up the healthcare delivery model by weaving in
27:02
a virtual nurse to help care for patients and reduce the workload for in-person nurses
27:09
so under this new model A patient’s care team would consist of three people two that are in person the direct care nurse
27:16
and the licensed practical nurse and then the third would be the virtual nurse
27:21
according to Doug disenzo who’s the regional Chief nursing officer the hope
27:26
for this program is that it will help health care facilities find a way to decrease the demand for registered
27:32
Nursing nursing Services while still delivering high quality care that
27:37
patients require so the virtual nurse will be on camera so they’ll still have some face-to-face
27:44
element with the patient and the virtual nurse can provide a number of benefits
27:49
they can answer questions Provide support or check Patients Out On Demand
27:55
they can connect with the families therapists and social workers they can
28:00
help prep the patient for discharge and again answer any questions and just help ease the burden that is on our health
28:07
care workers right now so if a patient needs something they press the call button the you know the nurse is doing a
28:14
million other things has so many other patients they’re caring for by the time they have to kind of drop everything go
28:20
back to the patient the virtual nurse could have answered all of their questions and then some so that’s kind
28:26
of the vision and when I first read this headline I was very skeptical but after
28:32
reading the vision of the program and knowing how much everyone is struggling right now with Staffing I actually think
28:38
it’s pretty Innovative way to use technology to help solve some of these staffing issues since you know you
28:44
obviously can never replace a nurse entirely but this might be a good way to
28:49
kind of help ease the burden that our healthcare workers are experiencing right now
28:55
so the health the health system intends to launch the virtual connected Care Program across 88 hospitals and 26
29:03
States over the next 12 to 17 months so I’m interested to see how it’s received
29:08
and how it goes our next story is from Becker’s ASC and
29:14
it’s a pertinent story considering the discussion we just had with our guests this week Dr kanjarski from Noble
29:21
anesthesia partners in a discussion with Adam Spiegel who’s the CEO of Northstar anesthesia Adam
29:28
shared that the demand for anesthesia providers in ASCS is growing right now which is great but unfortunately at the
29:36
same time reimbursement rates are shrinking and they’re also experiencing some staffing shortages
29:43
since Medicare and insurance companies are reducing reimbursement anesthesia costs are being subsidized by hospitals
29:49
and ASCS you know depending on the case and to add one more layer to it with
29:55
certified nurses being able to perform as anesthetists in many states
30:00
it is becoming more cost effective to hire multiple crnas as opposed to multiple anesthesiologists
30:08
so that’s kind of the state of things right now but what do we do my biggest takeaway from reading this is that it is
30:15
vital that surgery centers partner and work closely with their anesthesia providers
30:21
gone are the days where you can kind of semi ignore your anesthesia provider and
30:27
not really know who they are and how you know the ins and outs of how the relationship works you really need to
30:33
bring them into the fold consider them a stakeholder and kind of hunker down
30:38
together and create solutions that work for you both so super important that
30:43
asc’s this year and moving forward kind of tighten that relationship with
30:49
the with their anesthesia providers our third story is not so much a story
30:56
but I wanted to take a minute to share a program that ask us offering that I think is so important to the industry
31:02
right now in 2023 ASCA is offering two classes for what they call their ASC
31:09
administrator development program they have two programs that start this year and the first is a hybrid class
31:17
that starts in May and it’s a mix of in-person content at the ask a conference in Louisville and then
31:24
monthly virtual content after that and then the second is an all virtual class
31:29
but that doesn’t start until October of 2023. so enrollment right now is open for the hybrid class and prospective
31:36
mentors and mentees should submit their applications prior to February 28th
31:43
um you know due to Staffing shortages and the shake up from covid there are so many administrators who were promoted
31:49
without the experience that former administrators have typically had in the past
31:55
um so this program is hugely important and matches up those mentors and mentees to help provide guidance education and
32:03
moral support as these newer admins get acclimated so if this sounds like something you’re
32:09
interested in or know someone who would be a good fit please check out ask us website and we’ll provide the link
32:14
directly in our show notes as well and to end our new segment on a positive
32:20
note Amy um Avila amyavilla is a student registered nurse anesthetist and she’s
32:27
using her creativity and love for drawing to help her co-workers and peers reduce job-related anxiety
32:35
Amy is an extremely talented artist and she uses human anatomy medical equipment
32:40
and health care in general as inspiration for her drawings her peers use her drawings to color and
32:47
it’s a way for them to both learn and relax at the same time as we all know the toll that working in healthcare can
32:54
take on someone’s Mental Health so to see Amy’s drawings you can search
32:59
for her on Pinterest and we’ll also include the link directly in our show notes but you can go ahead and download
33:05
them give her feedback um they’re they’re really well done
33:10
and that news story officially wraps up this week’s podcast thank you as always for spending a few minutes of your week
33:17
with us make sure you subscribe or leave a review on whichever platform you’re listening from I hope you have a great
33:24
day and we’ll see you again next week please
33:29
[Music]
welcome to this week in surgery centers if you’re in the ASC industry then
0:06
you’re in the right place every week we’ll start the episode off by sharing an interesting conversation we had with
0:11
our featured guests and then we’ll close the episode by recapping the latest news impacting surgery centers we’re excited
0:18
to share with you what we have so let’s get started and see what the industry’s been up to [Music]
0:27
hi everyone here’s what you can expect on today’s episode Dr Tom kenjarski is
0:34
the founder and managing partner of noble anesthesia partners and he is also
0:39
the first anesthesiologist we’ve had on the podcast which is exciting and on
0:45
today’s episode our host Nick Latz is chatting with Dr kanjarski about how surgery centers can optimize case
0:52
scheduling for all stakeholders which of course includes your anesthesia partners
0:57
in our news recap we’ll cover virtual nurses the demand for anesthesia providers ask us ASC administrator
1:06
development program and of course end the new segment with a positive story about a nurse who is using her artistic
1:13
skills to help her peers reduce job-related anxiety hope everyone enjoys the episode and
1:20
here’s what’s going on this week in surgery centers good night
1:27
Dr konjarski welcome to the show thank you thanks for having me thanks
1:32
for joining us today and you’re our first anesthesiologist on the podcast that excited to to have you on and
1:39
before we dig in uh was hoping Dr conjures you could tell me a little bit about yourself and your professional
1:45
background sure sure uh I was raised in uh Buffalo
1:50
New York uh went to college and medical school at the University of Rochester moved down to Texas in 1998 for
1:58
residency at UT Southwestern and never left uh after training uh worked for two
2:05
different groups uh as an employed anesthesiologist and then started my own group Noble anesthesia Partners back in
2:12
October of 2011. um since that time I brought practice management or business operations in the
2:19
house in 2014 and had the opportunity to acquire another practice management company that
2:27
takes care of any type of office based physician you might go see primary care doctor surgeons or specialists
2:35
um and then from there uh just grew the anesthesia group um you know we’ve been practicing in
2:41
Dallas and very soon after uh moved over to our neighboring Town Fort Worth have a very heavy presence there uh we’ve
2:48
been in Houston Texas for over eight years El Paso Texas for over two and then just started uh Corpus Christi
2:55
Texas last month um along with that as as we were growing
3:01
we entered into a partnership with ambulatory Management Solutions out of Chicago Illinois uh at the end of 2021
3:10
so they’ve given us um a lot of insight on how to be able to
3:17
to grow the practice and also to add another service line to our anesthesia group namely office-based anesthesia
3:25
thanks thanks for sharing that and I did did want to ask a couple questions about your anesthesia group
3:31
Noble anesthesia partners and one of the things that makes you unique and you touched on the relationship with
3:36
ambulatory Management Solutions but I understand you guys are 100 focused on
3:42
the ASC Market from a client perspective is that right
3:47
um just about uh we’re focused on ambulatory anesthesia so we work in
3:53
Ambulatory Surgery centers like you mentioned but also acute care Surgical Hospitals smaller Community Hospitals with an
4:00
outpatient focus and then as I mentioned with with AMS we have entered into
4:07
office-based anesthesia over the course of the last year and both the Dallas Fort Worth and Houston markets so
4:14
um we we will go to any centers but primarily our focus is on ambulatory
4:19
anesthesia Services outpatient anesthesia gotcha and and how did you decide to focus on those segments of the
4:28
market and specifically kind of the outpatient side oh it kind of chose us
4:34
um you know the uh uh level one tertiary care Trauma Center Market is highly
4:40
saturated um those are the contracts that a lot of the national groups compete for
4:46
primarily because uh there is a stipend or a revenue guarantee associated with
4:51
them and what we found uh is in ambulatory centers such as the acute
4:57
care Surgical Hospitals surgery centers of course uh surgeons offices there’s there’s no stipend to be had so we found
5:04
a lot of the larger groups were neglecting those outpatient centers they were sending people there who were post
5:10
call because they could offer them the shortest days in order to get back home to their families uh they were sending
5:16
providers especially in rural communities that didn’t have the same level of training in Regional anesthesia that our providers did so uh having
5:25
focused on that um we developed our brand and Ward got
5:30
out that wow this this is a totally different approach to ambulatory anesthesia and Noble became a known
5:38
entity and then became recommended between facility administrators and then the larger Surgery Center organizations
5:43
like uspi and SCA fantastic um and in focusing on those segments
5:50
that the ASC segments and just your business in general one of the things that comes up a lot
5:56
these days is Staffing Staffing at the ASC level Staffing at you know from an anesthesiologist perspective how is that
6:03
impacting your business and and what are you seeing specifically at Noble oh the market is crazy right now for
6:10
providers um and again uh these these kind of go hand in hand the larger uh centers the
6:17
tertiary Care Center is level one centers um because they usually have entered into contracts with the groups that have
6:24
some type of Revenue guarantee or stipend um you know absorb those costs uh when
6:31
either the market is going up for employed anesthesiologists or they have to resort towards Locum tenants coverage
6:38
so in those situations uh yes the anesthesia group is having to pay more
6:45
in order to recruit the providers they need but they’re able to pass those costs on for the most part to those
6:52
larger centers and then subsequently the local state and federal governments and you know that’s that’s our you know
6:59
that’s you and me so when you have a practice like noble anesthesia Partners which is totally
7:05
dependent on the revenue generated from the anesthesia services at those ASCS and
7:12
um uh acute care Surgical Hospitals your your hands are really tied
7:17
um there is there’s only so much that you can offer those providers because uh a lot of times those centers aren’t
7:23
interested in paying any type of stipend or financial support whatsoever so
7:30
um the market is has kind of been really crazy for for all anesthesia groups but specifically for us it’s been a lot
7:36
harder because we we don’t have that blank check to write sure so um that’s
7:42
presented quite a challenge for us yeah and and on that front uh are you doing
7:47
anything different from a recruiting perspective or from a a coverage model perspective how are you how are you
7:54
thinking about changing the business model accordingly
7:59
um well um that’s a great question
8:04
um we have uh tried to work collaboratively with with those centers in order to
8:11
explain to them the the financial constraints that we’re under and how the way that they schedule cases really
8:17
affects the way that we’re able to staff them um if they want to you know have X
8:24
number of rooms worth of cases but in each of those rooms they don’t book enough cases in order for us to cover
8:29
the cost of a provider we’re losing money we’re we’re subsidizing that center for the day sure yeah
8:36
um you know that that becomes a challenge especially for for some centers which are just getting started
8:42
and all centers are you know really interested in in taking care of the surgeons and patients and just accepting
8:47
the case whenever the surgeon wants to post it whatever time they want to post it um for us we’ve had to educate them
8:53
about you know if you are able to stack the cases in one room have a surgeon have a morning block and another one and
9:00
an afternoon block or instead of a surgeon booking three cases on three different days saying hey is there any
9:06
chance that the surgeon could do all three of those on the same day boy that would really help us those are the types
9:12
of things that that we’ve had to do in order to kind of ensure that we can continue to find and pay for the types
9:18
of providers that are are um necessary for those types of facilities
9:25
um there there’s there’s a higher customer service back there in those types of facilities because a lot of them are open staff F and you’re only as
9:32
good as your last case so you know you really have to do your best as as the owner of an anesthesia group to find you
9:40
know kind of the the best and the brightest and then people who are not necessarily focused on shift work
9:45
um you know we we don’t hire providers from seven to three seven to seven or whatever so it’s different but in
9:51
general we accentuate the fact that it is a lifestyle practice when you’re in ASC they close for the day and then they
9:58
don’t open until the next morning so there’s there’s no bring backs there’s no call uh elective cases on the
10:04
weekends are just that and usually are done by mutual agreement with us so um our biggest selling point is the fact
10:10
that you know they’re not going to be taking in-house overnight call they’re not going to be working on weekends and if they do offer uh to do that they are
10:18
going to be rewarded on top of whatever their their base compensation packages sure and and you touched on something
10:24
there that I think is pretty interesting which is uh the Staffing challenge is forcing more conversations and
10:32
collaborations with the ASCS on on scheduling and stacking and how do you get more efficient with the case volumes
10:39
right and the case mix and the times um yes how how collaborative are your
10:45
customers with you on on those requests and those needs
10:50
boy is that a loaded question um I would say at first blush not very
10:56
collaborative but I’ve always felt that the most important question anybody could ask is why
11:03
um for the first time in in at least my memory um I I am hearing that anesthesia groups
11:09
are asking for subsidies from the Ambulatory Surgery centers in order to support um their their Staffing costs
11:16
um they’re also refusing cases they’re they’re having trouble finding coverage or whatever yeah and as administrator I
11:22
would think the most important question to ask is why um so
11:28
uh what we’re finding is as um ASCS are becoming more sophisticated and
11:35
able to draw um higher Acuity cases from the hospitals um you know for example we’re now doing
11:42
total joint Replacements on an outpatient basis as you’re moving those cases from the you know larger centers
11:48
into an ASC the demographic changes as well you you do have a higher incidence
11:53
of governmental payers um you know who require those higher Acuity services so we’ve tried to
11:59
explain that saying hey this might be a financial Boom for you as an ASC because you get to do a bigger case but we don’t
12:06
share that same benefit our Medicare rate is the same no matter if we do that case at a hospital or an ASE or you know
12:13
anywhere else so um again I I think that uh we have tried and we
12:20
have been fairly successful with with our administrators just saying here’s the challenges we’re facing
12:26
um we’ve shown them our you know data um to say Hey you know this might look like a great day but you know based on
12:33
the number of cases and what they are and whatever the uh the payer mix is for those patients that day we’re not
12:39
covering the cost of our provider and you know in the past you know we’ve had centers come up to us and say well we’ve
12:45
always had two anesthesiologists and I was like your case volume and demographics won’t cover the case of
12:50
just two crnas so you know again it becomes a discussion
12:57
um but I think the most important question that they could ask having seen these Staffing challenges or or requests
13:03
for stipends or other things is is to ask why and to enter into discussion with the anesthesia group and uh we have
13:09
no trouble being forthcoming with with those uh types of data points for them showing them that what might be a great
13:15
day for them and you know great day for the surgeon is actually going to be operating at a loss for their anesthesia
13:21
provider yeah it’s it’s super interesting right because in the long term the business model has to make
13:27
sense for all stakeholders right so to your point on on the more acute cases
13:33
and maybe the increased case profitability from those cases um yeah it seems like there’s some
13:40
interesting doesn’t translate to Anesthesia Services there’s some interesting conversations there on how you potentially spread the economics do
13:46
you do you foresee any you know kind of major changes the anesthesia care if you’re putting in your your five-year
13:53
hat and lens looking in the future well I do and you know again you you
14:00
asked some great questions um you know um
14:06
what I started and I’ve reached that age where I can say fun things like you know I’ve been in practice for over 20 years or my anesthesia group has been in
14:13
practice for over a decade I mean that that’s really cool but 20 years ago when I when I was starting my career down at
14:18
a level one Center in Dallas Texas uh that was kind of the
14:24
um uh Fertile Crescent for for a lot of different things including one now International uh
14:31
um Surgery Center company and they were building a location on the campus of that Center and I remember being in the
14:36
doctor’s lounge and the surgeons were having a discussion along the lines of gosh who would want to have their
14:42
gallbladder out and go home the same day um the answer is everybody and it’s it’s
14:48
troubling that they didn’t foresee that that hey the technology was getting to a certain point where you know not only
14:54
could we have the equipment but you know we had advances in anesthesia and Regional anesthesia to the point where
14:59
yeah you can do those cases at an outpatient facility and send those appropriately screened patients home you
15:05
know within an hour or so of their surgery I see that Trend continuing as it is
15:11
really booming right now uh from taking higher Acuity cases from hospitals to
15:16
Ambulatory Surgery centers for the next move to be from Ambulatory Surgery centers to appropriate surgeons offices
15:23
interesting I really see that happening and we’ve seen some evidence at least from the governmental payers uh with
15:28
pain management Physicians where they’re being guided to do a certain percent of say epidural steroid injections in their
15:35
office they they don’t want them taking all those patients especially the ones who don’t need to be there uh to
15:40
generate a facility fee and an ASC just for an epidural steroid injection so I think that the the patient certainly
15:47
would appreciate that uh I I know that the payers are certainly trying to direct it there I know a lot of Surgeons
15:54
have been proactive about this and I really see that as as the next Trend um you know and this is coming from from
16:00
the guy who with Noble anesthesia Partners I mean we’ve done outpatient craniotomies uh you know same-day brain
16:07
surgery yes so um yeah um and again you know those those not all those cases have to be
16:13
done at a level one Center uh we’re doing you know like I said you know total joint Replacements and
16:20
um other types of big bigger cases um staple bariatric procedures and sending those patients home the same day so
16:26
again you have to look at what the current cases are in the ASC and say how many of them could be done in a properly
16:32
equipped and staffed uh surgeon’s office that makes sense for that shift to continue yeah
16:38
I want to go back um and talk about one of the things that you touched on earlier which is
16:44
scheduling and you talked about kind of the need or or opportunity for different
16:49
scheduling mixes to become more efficient to help with the staffing issues what have are there any best practices
16:56
that you guys have seen at you know your practice or with your clients around
17:01
uh tools and process around scheduling because it seems like
17:06
flexibility and communication is becoming even even more important right
17:11
for the for the ASC to be able to communicate with all stakeholders around scheduling and flexibility and taking
17:17
input have you seen any good tools or best practices that have that have helped you guys in that communication
17:25
yes and um unfortunately I think that those are kind of uh falling into the category of the difficult discussions
17:32
that they want to have the surgery centers want to be accommodating they they it’s like especially if they um are
17:39
just opening or trying to establish business or have expanded recently or whatever they they really want to be
17:46
able to let the surgeon to more than likely are surgeon investors in the facility do any case they want any day
17:52
of the week at any time and um I I you know would love in a perfect
17:59
world to be able to accommodate all of that but um I don’t think that a
18:05
um they know how anesthesia is reimbursed and I think that
18:11
um we’ve had discussions with with administrators and some surgeons just saying Hey look you know I want to show
18:17
you like why we’re asking you to either start cases or for you to pick an afternoon Block in front of some others
18:24
or whatever so that we can generate or enough Revenue to have the appropriate amount of providers that you want at
18:29
that facility that day but the other thing is I think that there’s there’s certainly a discussion to be had between
18:34
the administrators and the the surgeons and especially surgeon investors saying hey look when you book one case on a day
18:42
where we’re not doing anything else we have to bring in this many staff members
18:47
we have to turn the lights on we have to generate all of these other things and then anesthesia has to come out here and
18:53
they’re doing it a lost leader um over time you know annualized or
19:00
whatever saying if we had done these types of things we would have generated another million dollars of ibita for the
19:06
center had we not booked cases like that and we’re just starting to see the administrator sitting down at their
19:13
meetings and start having those discussions uh saying that hey look you know
19:19
just because you can doesn’t mean you should and if we were to do this your
19:24
distribution checks as a physician investor would have each increased by X those are usually eye-popping numbers
19:31
those are usually things that I think would motivate everybody but again to your point it requires a discussion it
19:38
requires some collaboration the other thing is recognizing some things that are kind of inherent that
19:44
people don’t think about you know the surgery center cases should be done earlier in the day most of those
19:50
centers hire people for their you know seven to five chefs or or or you know the anesthesia providers certainly
19:56
expect to be kind of working during day hours or whatever you know the surgeon should always keep that in mind in the facilitate or administrators should be
20:03
um keeping that in mind when they accept those cases as well Surgery Center cases should be done at the beginning of the
20:08
day um the other cases that they need to do at the hospital those again are either
20:14
stipend or Revenue guaranteed contracts with the other anesthesia group they have second shifts they they have
20:20
another crew that that’s working three to elevens or 7p to 7A or whatever they they have those providers in place and
20:27
and they’re there in order to take on those later cases so the timing of the
20:32
day in which when do I do my surgery center block whereas when do I go do my one or two inpatient cases to follow is
20:38
huge um you know some of the cases at the hospitals are are bigger and run over
20:43
and it is not uncommon for a surgeon to the case at say 11 A.M thinking they can
20:48
sneak a case in at a hospital and then not showing up for one two three hours
20:53
after their posting time at the surgery center that’s just not a good use of their resources for a facility which
20:59
does not you know run 24 7 365. so it’s some of those bigger considerations and
21:06
then some of the others like hey could you you know just put these cases all on the same day could we establish a block
21:11
time for you um could one of you you know take an AM block and then follow with an afternoon block just just doing things like that
21:19
so having those types of proactive collaborative conversations further in advance as those schedules start to
21:24
materialize for the weeks after is is key yeah yeah and and you you kind of
21:31
touched on this theme of hey the the scheduling and the efficiency is important for us and our teams
21:38
um what about changing cases I gotta imagine that can kind of throw a wrench and things too if the if the time of the
21:46
cases change around on you is that is that an issue for you guys and your customers
21:51
are you talking like start times or durations of the cases yeah when cases get scheduled or rescheduled on
21:57
different days and and you kind of get late notifications on that is that much of an issue
22:02
that not that not so much I would say the the bigger uh issue is is something
22:08
that I like to refer to as truth in posting um I think if if you ask any surgeon and
22:14
you know it’s just the way it is and they say hey how long do you need for this case an hour I need two hours or
22:20
whatever um usually those are woefully inaccurate um and with the adoption of electronic
22:27
health records and all of the the times that we record in the rooms or whatever I really think that that every facility
22:33
surgery centers acute care Surgical Hospitals you know tertiary Care Centers should utilize that data and say hey
22:39
we’re going to take an average duration from that surgeon’s last 10 or 20 cases and regardless if he or she thinks it’s
22:44
going to take an hour we know it’s going to take them three and a half that is that is um more important to to
22:52
everybody not not only that the staff and the other surgeons who may be posting cases that they thought were
22:57
going to be able to start on time or the anesthesia providers then hey I just got to reschedule this case something came
23:02
up can we do it on Friday so I really think the truth in posting is is something that they everyone should pay
23:09
more attention to it’s not just what the surgeon or the surgeon scheduler put down it’s hey the last time you did a
23:15
total knee here last 10 times last 20 times it took you three hours so we’re going to post that for three hours and
23:21
we’re not going to let you put it on another case before then or tell another surgeon hey that room will be ready you
23:26
know until after that three hour window uh so that that that’s that’s one of the
23:32
things that is is one of my causes and I I try to get everybody to drink that Kool-Aid but it’s it’s been really
23:37
challenging sure the the difference between what what it should take or what you’d like to take right versus what it
23:43
actually does right and a lot of anesthesiologists Will Roll their eyes when they see
23:48
whatever the procedure is posted and then see what they’re requesting to go yeah that’s not going to happen so yeah
23:54
Dr kanjarski one one final question for you and we do this with with all of our guests every week
24:00
what’s one thing our listeners can do this week to improve their surgery centers
24:07
um really look at all of the stakeholders involved I love doing the stakeholder exercise and
24:12
um you know uh not assuming um anything
24:18
um if if we look at a surgery center for example we have we have our patients uh you know surgeons uh anesthesia
24:25
providers we have our or staff we have our administrative staff we have you
24:31
know the administrators who are both at the facility and then the the others and and to look at everybody’s goals and
24:37
incentives and really make sure that those are in alignment and if there are ongoing issues or if they have had
24:43
trouble with anesthesia coverage or retaining anesthesia staff or canceling cases or whatever ask that most
24:48
important question why is this happening don’t don’t assume anything but just say
24:54
hey why weren’t you able to show up or you know um why did you not want to do the case at this time or you know you’ve
25:01
been talking about you know wanting to meet with our scheduler maybe it’s time for us to do that so that everybody can express their concerns uh really just
25:08
taking a look at something that may have been in existence for 10 15 20 years for the first time as I mentioned I think
25:15
that what’s going on in 2023 is great being able to tell people you can have a
25:21
total hip replacement at a Surgery Center with you know your family close by and
25:28
be able to get home and sleep in your own bed that same night is is amazing and I’m so glad we have had all the
25:34
advances in in every aspect in order to get to that but we need to have an understanding that those types of cases
25:40
done in that type of facility present new challenges and that we really need to make sure that we’re on the same page
25:46
in order for it to not only make clinical sense but Financial sense for everybody as well
25:51
fantastic I appreciate the advice and thanks so much for joining us today
25:57
great yeah and you know if if anybody would uh like to connect uh again we have a great presence in in Texas but as
26:04
I mentioned we have uh our partners ambulatory Management Solutions in Chicago and their group their anesthesia
26:10
group mobile anesthesiologists there we also have M2 anesthesia and Washington State and Oregon uh we are you know
26:17
um you know preaching this this gospel to everyone and we have local resources if anybody would like to talk or or even
26:23
in states that that we aren’t yet I I I’d love to do this I I really have a passion for it and it’s what drove me
26:30
from leaving an employed model to to starting my own group back in 2011. fantastic
26:36
all right cool that’s a wrap
26:42
[Music] as always it has been a busy week in healthcare so let’s Jump Right In
26:49
michigan-based Health System Trinity Health is rolling out a new program called the virtual connected Care
26:56
Program this initiative changes up the healthcare delivery model by weaving in
27:02
a virtual nurse to help care for patients and reduce the workload for in-person nurses
27:09
so under this new model A patient’s care team would consist of three people two that are in person the direct care nurse
27:16
and the licensed practical nurse and then the third would be the virtual nurse
27:21
according to Doug disenzo who’s the regional Chief nursing officer the hope
27:26
for this program is that it will help health care facilities find a way to decrease the demand for registered
27:32
Nursing nursing Services while still delivering high quality care that
27:37
patients require so the virtual nurse will be on camera so they’ll still have some face-to-face
27:44
element with the patient and the virtual nurse can provide a number of benefits
27:49
they can answer questions Provide support or check Patients Out On Demand
27:55
they can connect with the families therapists and social workers they can
28:00
help prep the patient for discharge and again answer any questions and just help ease the burden that is on our health
28:07
care workers right now so if a patient needs something they press the call button the you know the nurse is doing a
28:14
million other things has so many other patients they’re caring for by the time they have to kind of drop everything go
28:20
back to the patient the virtual nurse could have answered all of their questions and then some so that’s kind
28:26
of the vision and when I first read this headline I was very skeptical but after
28:32
reading the vision of the program and knowing how much everyone is struggling right now with Staffing I actually think
28:38
it’s pretty Innovative way to use technology to help solve some of these staffing issues since you know you
28:44
obviously can never replace a nurse entirely but this might be a good way to
28:49
kind of help ease the burden that our healthcare workers are experiencing right now
28:55
so the health the health system intends to launch the virtual connected Care Program across 88 hospitals and 26
29:03
States over the next 12 to 17 months so I’m interested to see how it’s received
29:08
and how it goes our next story is from Becker’s ASC and
29:14
it’s a pertinent story considering the discussion we just had with our guests this week Dr kanjarski from Noble
29:21
anesthesia partners in a discussion with Adam Spiegel who’s the CEO of Northstar anesthesia Adam
29:28
shared that the demand for anesthesia providers in ASCS is growing right now which is great but unfortunately at the
29:36
same time reimbursement rates are shrinking and they’re also experiencing some staffing shortages
29:43
since Medicare and insurance companies are reducing reimbursement anesthesia costs are being subsidized by hospitals
29:49
and ASCS you know depending on the case and to add one more layer to it with
29:55
certified nurses being able to perform as anesthetists in many states
30:00
it is becoming more cost effective to hire multiple crnas as opposed to multiple anesthesiologists
30:08
so that’s kind of the state of things right now but what do we do my biggest takeaway from reading this is that it is
30:15
vital that surgery centers partner and work closely with their anesthesia providers
30:21
gone are the days where you can kind of semi ignore your anesthesia provider and
30:27
not really know who they are and how you know the ins and outs of how the relationship works you really need to
30:33
bring them into the fold consider them a stakeholder and kind of hunker down
30:38
together and create solutions that work for you both so super important that
30:43
asc’s this year and moving forward kind of tighten that relationship with
30:49
the with their anesthesia providers our third story is not so much a story
30:56
but I wanted to take a minute to share a program that ask us offering that I think is so important to the industry
31:02
right now in 2023 ASCA is offering two classes for what they call their ASC
31:09
administrator development program they have two programs that start this year and the first is a hybrid class
31:17
that starts in May and it’s a mix of in-person content at the ask a conference in Louisville and then
31:24
monthly virtual content after that and then the second is an all virtual class
31:29
but that doesn’t start until October of 2023. so enrollment right now is open for the hybrid class and prospective
31:36
mentors and mentees should submit their applications prior to February 28th
31:43
um you know due to Staffing shortages and the shake up from covid there are so many administrators who were promoted
31:49
without the experience that former administrators have typically had in the past
31:55
um so this program is hugely important and matches up those mentors and mentees to help provide guidance education and
32:03
moral support as these newer admins get acclimated so if this sounds like something you’re
32:09
interested in or know someone who would be a good fit please check out ask us website and we’ll provide the link
32:14
directly in our show notes as well and to end our new segment on a positive
32:20
note Amy um Avila amyavilla is a student registered nurse anesthetist and she’s
32:27
using her creativity and love for drawing to help her co-workers and peers reduce job-related anxiety
32:35
Amy is an extremely talented artist and she uses human anatomy medical equipment
32:40
and health care in general as inspiration for her drawings her peers use her drawings to color and
32:47
it’s a way for them to both learn and relax at the same time as we all know the toll that working in healthcare can
32:54
take on someone’s Mental Health so to see Amy’s drawings you can search
32:59
for her on Pinterest and we’ll also include the link directly in our show notes but you can go ahead and download
33:05
them give her feedback um they’re they’re really well done
33:10
and that news story officially wraps up this week’s podcast thank you as always for spending a few minutes of your week
33:17
with us make sure you subscribe or leave a review on whichever platform you’re listening from I hope you have a great
33:24
day and we’ll see you again next week please
33:29
[Music]
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