What many ASC leaders once viewed as a short-term, post-pandemic workforce disruption now looks like a permanent reset.
Seven ASC leaders joined Becker’s to discuss how shifting expectations around flexibility, pay, predictability and staffing pipelines are redefining how ASCs recruit and retain talent.
Question: What’s one workforce issue you thought was temporary that now feels permanent?
Lisa Fagan. CEO of Smith Medical Denver ASC: I initially believed post-COVID staffing instability was a short-term disruption. It now feels like a structural shift.
Clinical staff are prioritizing flexibility, predictable schedules and workplaces where they feel respected and not consistently stretched thin. Burnout has changed what people are willing to tolerate. The traditional ASC advantages, lower acuity and more predictable hours still matter, but they are no longer enough on their own.
Organizations that succeed with workforce challenges will be those that redesign roles, invest in culture, and operate efficiently enough that staff are not expected to carry system-level dysfunction. Retention is no longer just an HR issue; it’s an operational strategy.
Megan Friedman, DO, Chair and Medical Director at Pacific Coast Anesthesia: The expectation that anesthesiologists will tolerate highly variable schedules and unpredictable days is permanently broken. The workforce has reset around predictability, with defined hours, reliable start times and transparent expectations. Practices and ASCs that do not adapt to this reality are already struggling to recruit and retain talent.
Tracy Hoeft-Hoffman, RN. Administrator of Heartland Surgery Center (Kearney, Nev.):: The change in workforce expectations is permanent. Flexibility, balance and meaningful engagement are no longer perks — they are baseline requirements and expectations of our workforce. ASCs that proactively redesign schedules, roles and leadership practices to meet these expectations will stabilize their workforce; those that don’t will continue to cycle through talent, regardless of pay and to the cost of turnover is high.
Thomas Jeneby, MD, CEO of Palm Tree Surgicenters, Chrysalis Cosmetic Surgicenter and Maximus Plastic Surgicenter (San Antonio, Texas): Higher-than-average nursing rates, which are based on hospital rates. That is unsustainable!
Carrie Marut. Administrator of Mentor (Ohio) Surgery Center: One workforce issue I thought was temporary that now feels permanent is the decline in certified surgical technicians. It seemed after the COVID-19 pandemic, the industry was falling short of surgical techs but now that we are well out of the pandemic surgical technicians are still a dime a dozen. It feels like we are fighting against each other to employ certified techs because the market is so bare. One disadvantage of a surgery center is that the students do not come to them for their clinical experience, so it is difficult to hire them when they graduate. When we put out ads for surgical techs to apply, we often get a wide variety of applicants and none of them with any surgical experience. I hope shortly there will be a turn in the market and surgical techs will be plenty to support the hospitals and surgery centers.
Gary John Mullen, MD. Principal of Sovereign Anesthesiology Partners (Raleigh, N.C.): The workforce shortage of healthcare professionals in general, now appears to be permanent. After the COVID-19 pandemic, the urgency in the shortage of healthcare providers seems to be only slowly addressed by Accreditation Council for Graduate Medical Education
and Health Care Financing Administration. Given the aging population in the U.S., we are not training physicians and mid-levels at a pace to keep up with the needs of our population. Training programs in most disciplines need to be expanded to meet these needs; and that requires funding, which (due to healthcare policy) is slow to occur.
Lisa York, RN. Executive Director of the Hunterdon Center for Surgery (Flemington, N.J.): The workforce issue that I thought was temporary was the shortage of OR nurses and scrub techs. I thought it would improve after COVID-19 but it has not and I have had two open positions for scrub technicians for over two years. We are using travelers and having RNs who are able to scrub help out. It is tough to get help!
