Since the administering of safe and effective anesthesia is such an essential component of the procedures performed in your ASC, you should approach the decision of who will provide anesthesia to your patients with due diligence. Here are three best practices offered by Robert Welti, MD, medical director and administrator of the Santa Barbara (Calif.) Surgery Center, to help you identify and attract the right anesthesia provider to your ASC.

1. Make your ASC an appealing setting for anesthesiologists. Your ASC will likely compete with hospitals for the service of anesthesia groups. If these groups use a salary system based on anesthesia unit production, they may look for reasons to stay with “big unit” cases such as cardiac procedures or neurosurgery performed in the hospital even if they find working at your facility more enjoyable. You must make sure your ASC remains an attractive setting for anesthesia providers or risk overpaying for services.

“If your cases are scheduled back to back with little down time and volume is consistent, your ASC will be a very attractive location,” Welti says. “Conversely, lots of down time between cases, slow days, and a shortage of anesthesia practitioners in the area could render the center subject to demands for anesthesia stipends.” 

2. Find anesthesia care fit for your ASC. Despite the advances in anesthesia pharmacology, the skills and attitudes of successful hospital-based anesthesiologists may not always transfer to the ASC setting, Welti says. If practitioners cannot adapt their services to your setting, do not hesitate to find an option that better suits the efficiency of your ASC.

“Whereas the number one priority in both hospital and ASC setting is patient safety, the ASC anesthesia practitioner must provide this safety in a highly efficient setting where turnover time, cost effectiveness, and a more personalized service to both patient and surgeon play a much larger role,” he says.  

3. Don’t overlook the service provided by your anesthesiologists. As ASCs perform new and more complex procedures, ASC anesthesia providers must also adapt and tackle this new challenge. It is important to recognize their efforts in maintaining the high quality of care offered by your center.

“As ASC administrators, we must not lose sight of the incredible job that our anesthesia practitioners do with respect to handling the increasingly aging and physically challenged patient population that we now accept into our facilities,” Welti says.

Although you may struggle to secure an optimum small, core group of anesthesia practitioners who limit themselves to the ambulatory setting and understand the priorities of ASCs, you can make small or large gestures to keep your ASC as an attractive source of business for anesthesiologists.

“In the ideal world, the ASC would … provide to the practitioners some sort of incentive to ‘sign-on’ to the mission of the center and align their common interests,” Welti says. “Such incentive could range from the very simple, such as the all too often missing expression of appreciation for the services provided, to the more complicated, such as ownership positions when permitted by state or federal law.”  

Contact Rob at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Note: This article shares some of the thoughts and insights from a larger article discussing clinical and
business issues in ambulatory anesthesia that will appear in the May/June issue of the Becker’s ASC Review.