Becker's ASC Review

20 Thought Leadership Staffing & supply chain: ASC leader's key winter concerns By Patsy Newitt S taffing shortages amid COVID-19 surges and supply chain disruptions are two of the biggest upcoming concerns for ASCs. Nine ASC leaders spoke with Becker's on their big- gest concerns for the upcoming winter season. Jason Sugar, MD. Washington Gastroenterol- ogy (Tacoma): e pandemic will continue to be a major source of strain on the healthcare system. Staffing shortages may be exacerbated by vaccine mandates and vaccine hesitancy. Delay in routine care may continue to occur with the backlog in elective cases. A possible COVID-19 surge related to schools being back in session, colder weather and the holiday season may be amplified by flu season, with some states already reporting moderate flu activity. is has the po- tential to put additional stress on ERs and ICUs. Caryn Fink, RN, BSN, CASC. Director of ASC Clinical Operations at IU Health (Indianapolis): Staffing is our biggest concern right now. is is second only to the contin- ued absences due to COVID-19. Robert Nelson. Executive Director of Island Eye Surgicenter (Westbury, N.Y.): Obviously, COVID-19 had an enormous impact on ASCs in the winter and spring of 2020 — essentially shutting the industry down. I am hopeful that the delta variant or another variant doesn't have a similar impact this winter. But another concern I have is the cost and availability of medications and supplies. Now more than ever, ASCs must have a laser focus on their supply costs. Review every contract, and if you are not taking advan- tage of prices available through a group purchas- ing option, you must do so. More specifically, there are specialty-specific group purchasing organizations that are experts at working with vendors within their specialty. With proposed cuts to reimbursement, managing costs becomes imperative. Aravind Sankar, MD. General Surgery Special- ist at Westlake Hospital (West Lake Hills, Texas): Uncertainties regarding new COVID-19 variants and possible severe flu season may be the most difficult challenge of the winter season. Craig Gold, PsyD. Administrator of Virginia Center for Eye Surgery (Virginia Beach): My biggest concerns are regarding COVID-19. Virginia hasn't seen the dramatic delta variant spike seen in other states yet, and I am wor- ried that if our hospitals get too full, they will start to discourage or even restrict nonemer- gency surgeries at ASCs due to the potential for hospital transfers, despite that being a rare occurrence for ophthalmologic surgery. Brandon Hollis. Administrator of Bone and Joint Institute of Tennessee Surgery Center (Franklin): Our biggest concern for the winter season will be to maintain a healthy workforce during a pandemic and fierce com- petition for all healthcare workers. We will also continue to focus on treating each patient individually and making sure our patients are safely taken care of. Our expectations carry a very high level of patient satisfaction, and this doesn't change, regardless of season. Melissa Hermanson, RN, CASC. Adminis- trator of Ambulatory Care Center (Vine- land, N.J.): COVID-19 and vaccinations are my biggest worries. It is concerning to see the positive case numbers continue to increase while vaccinations are dropping off. We, as an industry, have been leaders in providing safe, high-quality care, but it is very draining on our resources to have to continue test- ing, screening and increasing environmental services — especially to our most valuable resource: our committed staff. I'm also worried about the supply chain. We have already begun to experience backlogs and shortages of essential supplies again. Many manufacturers are down across the country and globally. is, too, will impact us over the winter season. Jamal Otula. COO of HRMD Management (Dallas, Texas): My biggest concerns include COVID-19 and the flu season, tight labor market with increased staffing costs and pend- ing reduction of reimbursement by CMS. Curtis Collins. COO of Palmetto Surgery Center (Columbia, S.C.): My biggest concern with the winter months is the resurgence of CO- VID-19 with the two additional and more ag- gressive variants being transmitted. At Palmetto Surgery Center, we relaxed our visitor policy for a very short time until the delta COVID-19 variant started spreading in South Carolina. We will be maintaining very stringent protocols as developed by our COVID-19 task force. n Insurers are taking decisions out of the hands of physicians, says ortho surgeon By Marcus Robertson A utonomy is an important factor in where physicians choose to practice medicine, and Grant Shifflett, MD, of Disc Sports & Spine Center in Newport Beach, Calif., told Becker's ASC Review that he sees a potentially concerning trajectory. Question: What is a top trend you're following in healthcare? Dr. Grant Shifflett: I don't want to paint a bleak picture, but I look at this in terms of the voice we have as physi- cians. And it seems like every day that voice is getting stripped away more and more by insurers denying care, determining what we can and can't do and taking away decisions from us. … I'm in a private practice. I work for my- self and I make my own decisions, but I still have to answer to the insurance companies. Not a day goes by that I [don't] tell patients, "Unfortunately ... insurance companies make medi- cal decisions, doctors don't." That's a pretty sad state of affairs. So I think we're not going on a great tra- jectory in medicine, where we're giving up autonomy and decisions are being made for us. We're becoming more just worker bees. And not only is that not good for us as a profession, but I worry about patients. I had a guy who was a clear-as-day disc replacement candidate, and the insur- ance company wouldn't approve it and would rather him have a fusion. He's 28 years old. That's pretty sad when I'm supposedly the expert, telling a young guy an operation will give him the rest of his life, a big benefit, and they want him to have something else done to him. So I think that picture of what is going to happen in medicine, where we are going and what level of control we have, hopefully that pendulum swings the other direction. n

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