Megan Friedman, DO, Chair and Medical Director at Pacific Coast Anesthesia

Summary

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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

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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.

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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)

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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)

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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

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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.

Transcript

[A]

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[B]

Is Grace Lynn Keller with the Beckers Healthcare Podcast and we are recording live at the 31st annual Business and Operations of ASCS. I'm currently joined by Megan Friedman who is the Chair and Medical Director of Pacific Coast Anesthesia. Megan, thanks for being here to kick us off. Can you please share a little bit more about yourself and your work in the ASC space?

[C]

Yes. Thank you for having me here. It's been a great conference so far. My name is Megan Friedman. I'm a double board certified anesthesiologist and Pediatric Anesthesiologist and also the Director of Pacific Coast Anesthesia. We're a large independent anesthesia group in Southern California. We staff multiple acute care hospitals and high volume surgery centers across the Los Angeles area. I work closely with ASC leadership or directors and system executives to optimize staffing, scheduling and throughput while keeping a pulse on payer dynamics, cost per case and the evolving role of anesthesia in outpatient care. My focus is bridging clinical care with operational strategy.

[B]

Wonderful. Well, let's start our conversation regarding the ASC market in the US. This is projected to reach $60.8 billion annually by 2030 and continues to experience strong year over year growth. So from your perspective, what are the most significant trends in market forces driving this expansion and how should ASC leaders be preparing today?

[C]

Yeah, so we're seeing three key trends. First, higher acuity cases are being moved from the hospitals to ASCs. Second, we're seeing payers pushing care towards these lower cost settings. And and then finally another thing driving cases to ASCs is we're seeing surgeons are increasingly seeking more control and efficiency in their practice. When you consider these and keep in mind that there's increased labor, the cost of labor has gone up substantially over the last few years as well as supply costs. 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. Underutilized rooms and fragmented schedules are no longer sustainable.

[B]

And from AI and robotic surgeries to advanced EHR systems, technology remains both a make or break factor and a critical driver of ASC operations at scale. How do you see deeper tech integration shaping the way ASCs deliver care and manage their businesses over the next few years?

[C]

So tech is going to be a make or break factor, especially in how we schedule staff and optimize resource use. It's not just about the or tech needs to help us see the full picture. Cost per case, staffing patterns, case delays and room utilization across service lines. AI and analytics can show us inefficiencies in real time so we can act on them, not just report them later. For me, it's about smart scheduling platforms. One tech that we've invested in and started adapting is a scheduling platform called Equina. Platforms such as these allow anesthesia teams to be able to clock in, swap shifts, see real time coverage needs, and then we can track patterns of staffing need across multiple sites and then present that to our ASC administrators. This kind of visibility changes everything. It improves transparency, fairness and helps leadership right find the right size staffing based on actual need, not just assumptions.

[B]

And a follow up to that. Is there one specific technology or innovation that stands out to you as especially transformative?

[C]

So as I mentioned, we started using the scheduling platform towards Equina and that's done a couple things for us. One, it's led to anesthesia provider increased satisfaction. They feel like they have more control over their schedule, putting in requests on an app, swapping shifts and then also it allows us to provide a lot of data to our hospital and ASC administrators so we can track. We have real time clock ins as I mentioned, so we can follow trends such as if a certain person who's always at a particular ASC is always staying over a few hours, it can really show that center. Either the volume in demand for staffing is much higher than they thought or on the flip side, is it because it's very inefficient. So these things have been very transformative and helping us with having data to show to people.

[B]

And with 60% of health systems considering ASC joint ventures and many ASCs already partnering with systems in their communities, what opportunities do you see for collaboration? Whether with other providers or vendors to strengthen the patient care and operational efficiency.

[C]

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. That means deeper partnerships with anesthesia and anesthesia teams. 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.

[B]

And is there anything else that we didn't touch on as we wrap up our conversation, or any final thoughts you'd like to share?

[C]

Yes, if there's one message I'd emphasize for executives. Anesthesia needs to be at the table. We see everything. Every surgeon, every room, every staff member, every delay, every inefficiency, every. In today's margin tight environment, you can't afford to ignore that perspective. If you're only focused on staffing costs but not looking at cost per case, case mix, scheduling dynamics and other things, you're going to fall behind. Real partnership with anesthesia teams is not a luxury. It's your competitive edge.

[B]

Wonderful. Well, Megan, thanks so much for joining me today on the Becker's Healthcare Podcast and sharing these insights again. We are recording live at the 31st annual business and operations of ASCS.

[C]

Thank you so.