After more than 16 years at Houston-based Mann Eye Institute, administrator Kayla Schneeweiss-Keene says physician trust in administrators and nursing teams is key to the organization’s stability.
Friction between ASC administrators and physician owners isn’t unusual, she told Becker’s. But at Mann Eye, leadership has deliberately built a culture that prioritizes autonomy, and the result is mutual respect.
That culture starts at the top, she said, with owner Mike Mann, MD, and CEO Dana Ondrias.
“Our doctors are down to earth,” she said. “Dr. Mann is a huge contributor to just the culture of the company. He pushes me. Whenever somebody compliments him and tells him that he has a great team, he says, ‘Well, I’m only great because I have a great team.’ He always puts the onus back on his team, and he always gives praise to everybody else.”
That mindset keeps staff invested, she said, and often draws employees back even after they leave. Just as importantly, surgeons and board leaders allow administrators to run the center without constant interference.
“They trust what I do and trust the results,” she said. “I’ve been very blessed that they allow me to run the center, and I give that autonomy to my directors of nursing. It kind of snowballs down.”
Autonomy also strengthens alignment, she added. When everyone feels ownership over their role, the team stays focused on shared goals, which are organization growth and excellent patient care.
Without that trust, performance suffers, she said.
“When the doctors micromanage, it ties the administrator’s hands behind their back,” she said. “When that surgeon has their thumb on top of everything, nobody can move, nobody can do anything.”
Autonomy doesn’t mean administrators operate separately from clinical leadership. Instead, it creates a true partnership, allowing administrators to bring operational and financial insights to surgeons. Ms. Schneeweiss-Keene described reviewing case combinations that don’t reimburse well and suggesting adjustments, such as avoiding cataract surgery paired with multiple MIGS procedures in a single sitting.
“I feel like it’s a partnership with the surgeons,” she said. “They listen.”
On the workforce side, Ms. Schneeweiss-Keene said the biggest challenge is compensation. Ophthalmology reimbursement runs lower than higher-margin specialties, making it harder to match hospital nursing wages.
At the same time, many employees are returning to school, which she supports but says adds training costs and churn. Her approach is to protect culture and flexibility so staff see Mann Eye as a place worth returning to.
