ASC leaders’ approaches vary with respect to the functions they outsource and those they keep local, with the split coming down to what can be standardized and what cannot.
Megan Friedman, DO, anesthesiologist and director of Pacific Coast Anesthesia Consultants in Los Angeles, said operational management is the one function she believes should stay in house, even as outsourcing spreads across other administrative functions.
“Effective management depends on understanding the unique culture, physicians, staff, and patient population of each ASC,” Dr. Friedman said. “Every surgery center is different. Trying to manage every ASC with the same playbook is like trying to fit a square peg into a round hole.”
Case mix, staffing models, surgeon expectations and local market dynamics vary enough that a one-size-fits-all management approach tends to break down, she said. The strongest teams, in her view, have the flexibility to adapt rather than apply a standard template across every site.
“Local leaders who are present, engaged and empowered to make decisions are often in the best position to improve efficiency, build physician relationships and create a culture of accountability,” she said.
Not every ASC leader is convinced local customization is the only way to get there, however. Neil Parikh, MD, chief innovation officer of Rocky Hill-based Connecticut GI, has made close to the opposite case. For him, shared standards across sites, not site-by-site judgment calls, are what produce consistency.
“It starts with prioritizing patient safety by creating an environment of transparent standardization and shared accountability,” Dr. Parikh told Becker’s.
Because every location in his multisite GI network is focused on the same specialty, staff and physicians work from a single playbook rather than each site training its own nurses and technicians in its own way.
“It is a team sport and we all have the same playbook,” he said. “In an [ambulatory endoscopy center], we are all aligned. This allows for high quality and consistency.”
The question of outsourcing comes amid rising administrative strain that makes “local judgment” harder to execute than it sounds. A March 2026 survey of 360 independent practice leaders by healthcare technology company Veradigm found that more than half rated administrative workload as very or extremely challenging. Sixty-five percent of physicians reported spending at least an hour a day on documentation outside of scheduled patient visits, and 26% reported two or more hours daily. Every staffing category in the same survey was flagged as difficult to recruit or retain by at least 31% of respondents.
On the other end, Thomas Hutchinson, administrator of the Surgery Center of Central Florida in Ocala, told Becker’s about a switch he does not regret: moving to disposable instruments for cardiac rhythm management device implants instead of processing them in house.
“The cost savings outweighs the cost of running the SPD equipment and staff time,” Mr. Hutchinson said. “We had to make some adjustments and get custom instrument packages, but it has been a cost-effective switch.”
The same standardize-or-localize debate shows up in sterile processing, just with different stakes. Outsourcing all or part of a sterile processing department, whether fully off site or through a contracted on-site team, shifts the burden of training, certification and staffing to a specialized partner.
ASCs already lean on tighter infection control than hospitals as a competitive advantage, and a specialized SPD partner’s focused expertise can extend that edge further, particularly as compounded sterile preparation standards and value-based care pressures have made in-house sterile processing a heavier lift than it once was. Mr. Hutchinson’s move cuts the other way: It isolates the swap to a single high-cost device category rather than restructuring the whole department, which keeps the trade-off contained and easy to measure.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.