An ambulatory surgery center administrator traditionally wears many hats, overseeing the financial, clinical and operational processes of a facility. Coming into this role can be a challenge, especially from a hospital or health system environment.
Maria Freed, MHSA, is currently the administrator of Miami-based Coral Gables Surgery Center. She transitioned into this role in February 2014, prior to which she served as director of international services at the University of Miami, Miller School of Medicine. Her previous roles have included administrator of Cyberknife of Miami & Palm Beach, a radiation/oncology center, and assistant administrator at Doctors Hospital in Coral Gables.
"As an administrator in the inpatient space, your authority is functional," says Ms. Freed. "You get to be an expert in one or two areas. Your duties are more concentrated. In an ASC, you are a generalist and are expected to know a little bit about everything. Every decision you make affects all areas."
The unique aspects of running an ASC
Ms. Freed quickly discovered some of the differences of running an ASC, as compared to leading in an inpatient setting. One of the most apparent differences was that ASCs run more autonomously than hospitals.
"I don't have many layers of decision-making to move through," she says. "We can explore new programs and services, even though we are part of a corporation. We can try new things and we aren't static."
Additionally, on a personal level, Ms. Freed found that the ASC industry did not interact as much as the hospital/health system community in the Miami-Dade area. Hospital administrators tend to be more collegial and know each other better even if they are from competing organizations. There are lots of opportunities to meet hospital leadership counterparts.
In the Miami-Dade ASC industry however, opportunities for interaction are limited. This is something Ms. Freed says she would like to work to change. She wants to reach out to her colleagues to create more opportunities for them to get to know each other and share best practices.
Using inpatient skills in the outpatient arena
While there are many differences between serving as an administrator in an inpatient setting versus an outpatient one, Ms. Freed discovered that she could transfer certain skills and processes from her previous experiences to the ASC setting.
For example, in the hospital setting vendor representatives and payers are extremely important, and as an administrator, having a strong relationship with them is paramount.
"When I came on board, this ASC hadn't previously placed a focus on this," says Ms. Freed. "That was something new for our staff, a new way of looking at things. I made it a priority to start building relationships with our payers."
Ms. Freed also implemented continuous staff education and training in her ASC. Hospitals are constantly providing in-service programs and educational opportunities. Ms. Freed began offering programs, such as CME events for physicians and training for staff members at Coral Gables Surgery Center.
Areas of success
Ms. Freed has been successful in achieving what she was tasked with when she first assumed the role of administrator — growing the center.
"I recruited approximately 37 percent of the physicians currently practicing at the ASC," she says. "There has been good physician retention in the last few years. I asked the physicians to come try us out and they came, had positive experiences and continued to perform procedures here.. I am also so proud of the staff members who adjusted to the new physicians quickly and efficiently. They have handled it all beautifully."
At ASC-focused conferences and meetings, Ms. Freed has sensed reluctance among administrators to share the good things they are doing at their centers. She feels that administrators can be more confident talking about their center in positive terms.
ASCs can now offer more complex surgeries and are using more state-of-the-art technologies. This lends itself to a great deal of opportunity in terms of growth.
"You have to be comfortable talking about your strengths" says Ms. Freed. "Whether you are interacting with a physician or your colleagues, it's important to verbalize the benefits your center provides."
"The thing I enjoy most about being in an ASC setting is that I am much closer to my patients," says Ms. Freed. "As an administrator in a larger setting you may not be able to interface everyday with patients and physicians. In an ASC, I can greet my patients and my surgeons daily. I really like that. There are no boring days at an ASC."