4 Best Practices for ASC Anesthesia: Roanoke Orthopaedic Center

Roanoke (Va.) Orthopaedic Center has three ORs and 18 physician-investors. T.K. Miller, MD, president and medical director of the facility, offers four best practices for ASCs working with anesthesiologists.

1. Don't hire; contract out. Rather than hire anesthesiologists, Roanoke's physician-investors preferred to contract with a large independent anesthesiology group because it provided more flexibility. "An employee is on a fixed schedule," Dr. Miller says. "When there is no more work, you still have to pay him for the rest of the day." In contrast, when an anesthesiologist from the group is done at the ASC, he or she can go back to the hospital and do add-on cases there.

2. Form a pool of anesthesiologists. Not everyone in the contracted anesthesiology group will be comfortable in an ASC, so it is important to designate a pool of available anesthesiologists within the group. Roanoke wanted anesthesiologists who would work at a faster pace than in the hospital and be comfortable using regional anesthesia. "We sat down with each member, explained the challenges of working in an ASC and asked them to decide," Dr. Miller says. About 60 percent of them joined the pool. Using this tactful approach, "I don't think we hurt anyone's feelings," he says.

3. Don't request individual anesthesiologists. The ASC takes whoever is available from the pool and does not ask for a particular anesthesiologist, even though some surgeons have favorites. "We do not want to tell them how to run their business," Dr Miller says, adding, "We want to be able to say to patients, any anesthesiologist you get here is good."

4. Weed out slow anesthesiologists. Show the slow anesthesiologists their production times and ask them, "Is there something we need to know about?" Usually they will voluntarily decide drop out of the available pool for ASCs.

Contact Dr. Miller at tkmiller@carilionclinic.org.

Thank you to ASD Management for arranging this interview.

Read more best practices for ASCs:

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