Jeff Pfaff: Technology, Culture & the Future of ASC Operations

The Surgeon Shortage Nobody Is Talking About - And What You Can Do About It

A landmark study just tracked 224,629 surgeons over a decade, and the findings are a wake-up call for every surgery center administrator in the country. Nearly 10% of surgeons left clinical practice within an eight-year period — and in some specialties, the numbers are far worse. Oral and maxillofacial surgery lost 1 in 4 surgeons within just five years. OB/GYN wasn't far behind. In this episode, we break down the data, reveal which specialties face the highest attrition risk, and explain why mid-career surgeons - those with 5 to 9 years of practice - are the most vulnerable group. We also cover the American College of Surgeons' newly released national workplace standards framework - the first of its kind in the organization's 113-year history - and what its six key domains mean for how you structure schedules, allocate OR time, and support the surgeons affiliated with your center. Whether you're managing a single-specialty ASC or a multi-specialty center, this episode gives you the data and the framework to have more informed conversations with your medical staff, your board, and your recruitment partners - before a staffing gap becomes a crisis. In this episode: * The attrition rates by surgical subspecialty you need to know * Why the mid-career danger zone matters for your retention strategy * What the ACS workplace standards framework actually requires * Five practical steps ASC administrators can take right now SHOW NOTES / SOURCES 1. ACS Press Release — Nearly 10% of Surgeons Are Leaving the Profession Within 8 Years (May 20, 2026) https://www.facs.org/media-center/press-releases/2026/nearly-10-percent-of-surgeons-are-leaving-the-profession-within-8-years/ [https://www.facs.org/media-center/press-releases/2026/nearly-10-percent-of-surgeons-are-leaving-the-profession-within-8-years/] 2. ACS Press Release — American College of Surgeons Releases First-Ever Workplace Standards Framework (March 4, 2026) https://www.facs.org/media-center/press-releases/2026/american-college-of-surgeons-releases-first-ever-workplace-standards-framework/ [https://www.facs.org/media-center/press-releases/2026/american-college-of-surgeons-releases-first-ever-workplace-standards-framework/] 3. Primary Research — Elemosho A, et al. A National Analysis of Trends and Factors Associated with Surgeon Attrition in the United States. Journal of the American College of Surgeons, 2026. DOI: 10.1097/XCS.0000000000001905 https://journals.lww.com/journalacs/abstract/9900/national_analysis_of_trends_and_factors_associated.1680.aspx [https://journals.lww.com/journalacs/abstract/9900/national_analysis_of_trends_and_factors_associated.1680.aspx]

Stop Treating Old Workflows Like the Status Quo

If your surgery center is still relying on transcription services, freehand dictation, or rigid EHR templates for operative reports, this episode of the DocBuddy Journal is worth your time. Host Erik Sunset makes the case that what many ASCs treat as standard practice is actually just the old way and there's a measurable cost to staying there. Drawing from Doc Buddy's own onboarding process, Erik explains how Op Note transforms surgeon dictation into standardized, EHR-integrated operative reports in real time, without changing how surgeons work or burdening the business office with setup. The result is documentation that's cleaner, faster, and more revenue cycle friendly — with less rework, fewer denied claims, and a direct impact on days to bill and days AR. Plus, Erik shares highlights from the Surgery Partners Leadership Conference and what to expect from DocBuddy at ASCA 2026 in Washington, DC. Links from the show: ASCA [https://www.ascassociation.org/home] DocBuddy's Op Note [https://docbuddy.com/solutions/op-note/] Connect with DocBuddy on LinkedIn [https://www.linkedin.com/company/docbuddy/?viewAsMember=true].

Michael McClain: How to Expand Your ASC

Michael McClain, founder of Left Coast Healthcare Advisors, returns to the DocBuddy Journal with Erik Sunset for a practical conversation about ASC expansion. Before jumping to blueprints and construction budgets, Michael argues that most surgery centers need to get honest about what problem they're actually trying to solve. More often than not, the answer isn't more square footage. From maximizing revenue cycle performance and payer contract management to block time utilization and physician alignment, Michael walks through the foundational work that should happen before any expansion conversation begins. The episode also covers the five key questions every feasibility study should answer, why physician volume estimates are almost always optimistic, and how to build a realistic financial model that accounts for ramp time, regulatory costs, and operating capital. If you're thinking about growing your ASC, this episode is required listening before you break ground. Connect with Michael McClain [https://www.linkedin.com/in/michaelmcclainpac/] and follow LeftCoast Healthcare Advisors [https://www.linkedin.com/company/lcha/] on LinkedIn. Check out the LeftCoast Healthcare Advisors Website [https://lchadvisors.com/]. Follow DocBuddy on LinkedIn [https://www.linkedin.com/company/docbuddy/?viewAsMember=true].

Jeff Pfaff: Technology, Culture & the Future of ASC Operations

Jeff Pfaff, Senior Director of Business Operations at Inova Health Systems, joins host Erik Sunset to share hard-won lessons from scaling one of Northern Virginia's most active ASC networks — from a single center to five thriving multi-specialty locations with a additional growth planned. Jeff breaks down how Inova approaches the relentless pace of digital transformation, why throwing FTEs at operational problems is no longer an option, and how his team vets and implements new technology without burning out the people who actually have to use it every day. They dig into the real barriers to technology adoption — resistant physicians, stretched administrators, and the hidden time cost of implementation — and why building a "we" culture is the foundation everything else has to sit on. Jeff also shares his candid take on AI in the ASC space: what's genuinely exciting, what's being wildly oversold, and why a site visit in a live production environment is worth more than any demo. He wraps with glowing feedback for DocBuddy's team and solution! Connect with Jeff Pfaff on LinkedIn. [https://www.linkedin.com/in/jeffrey-pfaff-mba-61219869/] Follow DocBuddy On LinkedIn. [https://www.linkedin.com/company/docbuddy/?viewAsMember=true]

Marc Ryan: Big News, Bigger Stakes

Marc Ryan, Chief Solutions Officer at Lilac Software, returns to the DocBuddy Journal with big news: Lilac Software has been acquired by Medisolv, combining payer and agentic AI expertise with Medisolv's established provider and quality measurement platform. From there, Marc and host Erik Sunset break down the most important trends shaping healthcare in 2026 — the Trump administration's technology-first agenda, value-based care expansion, and the slow but real progress on interoperability. They also dig into the financial fallout from the One Big Beautiful Bill on state Medicaid programs, the turbulence hitting health plans across every line of business, and what landmark PBM reforms and Most Favored Nation drug pricing could mean for American consumers. Medisolv's acquisition of Lilac [https://www.prnewswire.com/news-releases/medisolv-expands-ai-capabilities-for-value-based-care-with-acquisition-of-lilac-software-302709559.html] See Marc's work at Lilac Software [https://lilacsoftware.com/]. As always, be sure to follow DocBuddy on LinkedIn [https://www.linkedin.com/company/docbuddy].