Becker’s Healthcare Podcast: Megan Friedman, DO, Chair and Medical Director at Pacific Coast Anesthesia

Date: November 9, 2025
Host: Grace Lynn Keller
Guest: Dr. Megan Friedman
Recorded at: 31st Annual Business and Operations of ASCs

Episode Overview

This episode features Dr. Megan Friedman, Chair and Medical Director at Pacific Coast Anesthesia, who provides insights into the rapid growth and operational evolution of the Ambulatory Surgery Center (ASC) market. Dr. Friedman discusses market trends, the transformative role of technology in perioperative care, and the significance of anesthesia leadership in driving patient and operational outcomes.

Key Discussion Points & Insights

1. Growth in the ASC Market

• Market Projection:
  • The ASC market in the US is projected to reach $60.8 billion annually by 2030, experiencing strong year-over-year growth. (01:41)
• Driving Trends:
  • Shift of Higher Acuity Cases: More complex cases are being transferred from hospitals to ASCs.
  • Payer Incentives: Insurance payers increasingly push care to lower-cost ASC settings.
  • Surgeon Preferences: Surgeons seek more control and efficiency, prompting shifts toward ASC practice models.
  • Rising Costs: Labor and supply costs have risen, requiring leaders to rethink traditional scheduling and staffing models.
  • Need for Data-Driven Decisions:

    “ASC leaders really need to rethink staffing and scheduling. They need to use real-time data to make decisions that prioritize case efficiency and resource allocation, not just surgeon preference as typically done in the past.”
    — Dr. Megan Friedman (02:29)

2. The Role of Technology in Operations

• Leading Technologies:

  • AI, robotic surgeries, and advanced EHR systems are crucial in scaling efficient ASC operations.

• Scheduling and Resource Optimization:

  • Technology must provide insights into cost-per-case, staffing patterns, case delays, and room utilization in real time.

• Smart Scheduling Platforms:

  • Dr. Friedman highlights the use of a platform called Equina, which allows:
    • Clocking in/out and shift swapping for anesthesia providers
    • Real-time visibility into coverage needs
    • Data presentation for administrators to optimize staffing
  • Quote:

    "AI and analytics can show us inefficiencies in real time so we can act on them, not just report them later… This kind of visibility changes everything. It improves transparency, fairness and helps leadership find the right size staffing based on actual need, not just assumptions."
    — Dr. Megan Friedman (03:35 / 03:46)

• Satisfaction and Data Transparency:

  • Providers gain more control and satisfaction with their scheduling, and ASC administrators can track trends to identify whether observed overtime reflects volume demand or operational inefficiency.

    “It’s led to anesthesia provider increased satisfaction. They feel like they have more control over their schedule... It allows us to provide a lot of data to our hospital and ASC administrators.”
    — Dr. Megan Friedman (04:25)

3. Collaboration and Joint Ventures

• Changing Landscape:
  • 60% of health systems are considering ASC joint ventures; many ASCs already collaborate locally.
• Opportunity Areas:
  • Aligning stakeholders around metrics like throughput, staffing efficiency, and financial sustainability—not just volume or revenue.

    "Collaboration is going to be key, especially as more ASCs enter joint ventures with health systems. The opportunity lies in aligning around shared metrics: throughput, staffing efficiency, and financial sustainability, not just volume."
    — Dr. Megan Friedman (05:36)

  • Deep partnership with anesthesia services across planning, scheduling, and strategic discussions improves outcomes and cost control.

4. The Imperative Role of Anesthesia Leadership

• Anesthesia as Strategic Partner:

  "Anesthesia needs to be at the table. We see everything—every surgeon, every room, every staff member, every delay, every inefficiency. In today's margin tight environment, you can't afford to ignore that perspective.… Real partnership with anesthesia teams is not a luxury. It's your competitive edge."
  — Dr. Megan Friedman (06:16)

Memorable Quotes

• “ASC leaders really need to rethink staffing and scheduling. They need to use real-time data to make decisions that prioritize case efficiency and resource allocation, not just surgeon preference as typically done in the past.”
  — Dr. Megan Friedman (02:29)

• "AI and analytics can show us inefficiencies in real time so we can act on them, not just report them later... This kind of visibility changes everything."
  — Dr. Megan Friedman (03:35)

• "Collaboration is going to be key, especially as more ASCs enter joint ventures with health systems... The anesthesia groups that are fully integrated into scheduling, case planning and strategic conversations will deliver better outcomes, lower cost per case, and help reduce friction across key players."
  — Dr. Megan Friedman (05:36)

• "Anesthesia needs to be at the table... Real partnership with anesthesia teams is not a luxury. It's your competitive edge."
  — Dr. Megan Friedman (06:16)

Timestamps of Key Segments

• 00:54: Dr. Friedman’s introduction and Pacific Coast Anesthesia’s scope
• 01:41: Major market trends driving ASC growth
• 02:57: The impact and critical role of technology and AI in operations
• 04:22: Equina scheduling platform—transformation in staffing and data transparency
• 05:21: ASC joint ventures, opportunities for collaboration
• 06:16: Final insights: strategic necessity of anesthesia leadership

Summary Flow & Takeaways

Dr. Megan Friedman paints a detailed and actionable picture of the ASC landscape. She urges leaders to:

• Embrace shifting case acuity and payer incentives as drivers for ASC expansion.
• Prioritize smart technology adoption to optimize operations, transparency, and provider satisfaction.
• Adopt integrated, collaborative models with anesthesia teams to ensure data-driven, efficient, and patient-focused care.
• Recognize that anesthesia leadership offers comprehensive operational insight and must be involved in strategy for ASCs to thrive in a challenging healthcare environment.

Listeners gain a practical, ground-level perspective on the intersection of clinical care, operations, and innovation in the ASC sector—directly from an expert at the forefront of change.