'We have to adjust': 5 ASC leaders on meeting workforce expectations

Five ASC administrators joined Becker's to share their predictions on what the future holds for the outpatient surgery workforce.

Editor's note: Responses have been lightly edited for length and clarity. If you would like to contribute to our next question, please email Paige Haeffele at phaeffele@beckershealthcare.com.

Question: How do you see the ASC workforce changing in the next two to three years?

Les Jebson. Regional Administrator at Prisma Health (Greenville, S.C.). I would submit that the ASC arena has historically enjoyed a modest human resource advantage. Specifically, this advantage is the result of predictability in work hours and perceived associated overall quality of professional life. Barring regional market variations, I do believe that the ASC labor market will continue to be progressively more strained over the next 24 to 36 months. Inflationary salary creep resulting from limited labor pools should be a real area of focus on the immediate horizon for ASC leaders. Keeping an eye on employee turnover rates in frequency and by position and semi-annual market analyses on market compensation is key.

I believe the greatest workforce ASC challenges will reside in the following positions, in the following order of staffing shortages:

  • Nurse anesthetists
  • Surgical technologists
  • Sterile processing technologists
  • Registered nurses

Omar Khokhar, MD. Gastroenterologist and Partner at Illinois GastroHealth, Medical Director, Eastland Surgicenter (Bloomington, Ill.): We have to meet our employees where they are, just like our patients. Previously, we could say "hours 8-5, M-F." But in the Uber/Instacart economy, we have to adjust. That means early-morning hours and evening hours. For our employees, they need both routines and flexibility. If we adapt, we'll be able to recruit and retain the best staff. Otherwise, there are opportunities in the market that are a better fit for their lifestyles.

Matthew Reeder, MSN, RN. Administrator at Harris Health Outpatient Center (Houston): My answer is a bit of an echo from my colleagues around the nation in regards to how I see the ASC workforce changing in the next two to three years. It’ll continue to be diverse in regards to age in that we will continue to see a larger group of “younger” individuals finishing up their university studies and entering into the perioperative arena. Especially as we continue to see challenges with a non-mobile “older” workforce staying at their current employers for longer periods. I think we will continue to see a decent amount of second career individuals entering into the clinical side of ASCs as we continue to see the nursing workforce compensation rise relative to other workforce areas. I think we will continue to see a rise in the diversity of gender in general within ASCs from all sides as traditional gender roles become more fluid. Lastly, I see the ASC workforce asking for more flexibility in schedules such as part-time status or supplemental status as different generations prioritize life events differently.

Ken Schaff. Administrator at Brentwood (Tenn.) Surgery Center: Due to staffing shortages — whether related to early retirement decisions, burnout, or career changes — ASC workforce changes have been dramatic and the effects are long lasting. Over the next two to three years, the ASC industry will see growing staffing costs due to increased wage demand and longer surgical days. While demand for higher pay has catapulted for most industries in this country, we have and will continue to see drastic pay changes (increases) and longer days due to demand in the ASCs. Unfortunately, this will be bad news for independent ASCs, as the centers that are consolidated with large ASC partners and/or hospital systems will have the advantage of deeper pockets and larger pools of staff.

As we are bouncing back from the COVID staffing issues, we are seeing the demand for this higher pay to match the hospital systems. Prior to the epidemic, we were able to stave off this pay increase with plenty of qualified candidates in the market pool. Now with this reduced workforce and demand for more outpatient business, we find ourselves having to come to the table. ASCs will have to increase pay and/or bonus structures to match the hospital systems in order to get and maintain the skilled staff necessary to compete in the market. Long gone are the days where we were able to offset lower pay at ASCs with a shorter workday due to lower-acuity cases. With an increased demand on highly-skilled staff at higher pay, it is the ASCs that can hire and maintain these individuals that will be successful.

Andrew Weiss. Administrator at Summit Surgical Center (Voorhees, N.J.): It seems that our workforce in ASCs, like other healthcare facilities, has become more competitive not just with salaries and benefits but also with flexibility of scheduling. I’m seeing more of our full-time employees requesting to go to part-time hours or per diem shifts. I think work-life balance is a driving factor for many. This isn't necessarily a bad thing for ASCs, but it does make scheduling more complicated. Retention of employees is more important now than ever; managers need to consider strategies that keep employees satisfied. Otherwise they will be recruiting in a fiercely competitive environment or paying a premium for agency staffing.

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