This is Rosie Talaga with the Becker's Healthcare podcast. Today, I'm thrilled to be joined by Bruce Feldman, administrator of Eastern Orange Ambulatory Surgery Center, to talk about some of the biggest trends in the ASC industry. Bruce, it's a pleasure to have you on the podcast today. Thank you very much. Pleasure to be here. Can you please take a moment to introduce yourself and your work in the industry? Sure. My name is Bruce Feldman. I am in the ASC administrator for Easton Auditorium Military Surgery Center. We're a 4 operating room, 2 endoscopy suite, freestanding ASC located in Cornwall, New York. I've been in the ASC industry now for about 30 years, running a number of freestanding ambulatory surgery centers as well as ASCs that are joint ventures with large academic hospital centers predominantly in the New York and New Jersey area. Great. Thank you so much. Sure. So our first question surrounds the prediction that ASC volume across the country is expected to increase by 16% by 2032. With this growth, what are the most pressing challenges to maintaining a positive patient experience? Well, I think the most, challenge is gonna really going to be to keep up with the acuity level of these cases. More and more of these cases that are shifting from a hospital setting are of a higher level acuity. And, not always ASCs have, you know, appropriate, staff that have the educational training to deal with some of these more complex cases. You know, ASCs many years ago were basically mostly very simple straightforward cases, you know, ophthalmology, GI. Now we're getting into complex cardiac cases, complex orthopedic cases. So, I think the biggest, challenge is really to make sure that you have the your staff have the educational training to be able to meet the, the clinical needs of the patients. Mhmm. And when you talk about the the staff training for complex cases and keeping up with the high acuity cases, what strategies have worked for your organization to tackle these challenges? Well, I think we've done a lot of partnering with some of the vendors like Smith and Nephew and Stryker. You know, they provide people to come in house, and do in service educational sessions and training. That has helped a great deal. I think you have to really get all your physicians involved as well when you're bringing in a new clinical service line to make sure that, you know, your staffing has the appropriate educational knowledge. So it's really a partnership between your vendors, your doctors, and making sure that everybody is kind of on board with what you're trying to accomplish. Got it. So thank you so much for sharing those strategies. Sure. And I'd also like to hear your thoughts on another prevalent issue which is the cost of care. So how do you think leaders can ensure that their staff are well equipped to help patients navigate the financial aspects of their care? Well, that that's where the difficulty lies, you know, lies because as these higher acuity cases shift from the hospital into the ASC environment, reimbursement has not met up with that. So it's very difficult to provide, you know, high quality of care at a higher cost, when your staff are not necessarily used to being so cost conscious, so to speak. So I think, again, it comes back to making your staff aware that a lot of these cases are higher acuity level, but we still have our costs that we have to keep in mind. So we one of the things we do like orthopedics is we develop PACS for certain procedures. So you're not opening up an entire tray and going through a ton of instruments. You have set instruments specific for that procedure. So that's a strategy that we've used, and I know other centers have used to keep your costs down, and, you know, maintain, the same quality of, of care. Got it. In these packs, how do you see that benefiting the patient to provide a relationship? Well, I I think it's better because you're not you're not wasting, supplies and equipment. The patients are getting, their procedures done in a quicker period of time, because it can be faster. You know, staff don't have to go out of the room to look for instrumentation because it's not in the tray. So everything just moves along more efficiently. Mhmm. The pay the patient gets done with their procedure quicker, quicker recovery time, and they're home. Great. Lastly, are there any additional challenges, innovations, or anything else on top of your mind for the industry that you'd like to talk about? Well, I think one of the biggest challenges is obviously the anesthesia shortage. And, I've attended some sessions here earlier, and everybody has the same concerns. You know, we're trying to develop innovative strategies with our anesthesia providers to see how we can benefit on both sides of the equation. So that that's, I think, is gonna be the greatest challenge for ASCs moving forward is how do we handle this huge shortage of anesthesiologists, and how can we continue to provide appropriate anesthesia services to our patients when reimbursement all around continues to decline. Absolutely. Well, thank you so much for joining us today and for speaking at Becker's 30th annual ASC meeting. It's been a pleasure. Sure. And I look forward to connecting with you soon. Thank you very much. Appreciate it. Thank you.