ASC Leaders Embrace 'Farm Mentality' for Financial Success

Balancing revenue generation and cost-savings requires a holistic, hands-on approach, says veteran ASC administrator.

Mar. 10, 2026 at 9:51pm

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Thomas Durick, MD, an experienced anesthesiologist and ASC administrator, emphasizes the importance of ASC leaders having a deep, multifaceted understanding of their facility's operations and finances. He likens this approach to a 'farm mentality' - looking at the entire ecosystem of costs and revenue rather than siloed metrics. Dr. Durick stresses the need for leaders to be embedded in the day-to-day of the operating room, billing processes, and supply chain to make informed decisions about case profitability and overall financial health.

Why it matters

ASCs face a complex equation of revenue generation and cost-savings, and leaders who take a holistic, 'boots-on-the-ground' approach tend to be more successful. This 'farm mentality' allows them to optimize each aspect of the business, from OR efficiency to billing and supply chain management.

The details

Dr. Durick, who has over 30 years of experience in anesthesia and ASC administration, emphasizes the importance of leaders being deeply embedded in the day-to-day operations of their facility. By actively participating in the OR, overseeing billing processes, and closely monitoring supply chain, leaders can develop a granular understanding of case costs and revenue. This allows them to make informed decisions about case profitability and strategically manage their facility's financial health.

  • Dr. Durick has worked in anesthesia and ASCs for over 30 years, including 21 spent as an ASC administrator and medical director.

The players

Thomas Durick, MD

An associate professor of anesthesiology at The Ohio State University Wexner Medical Center in Columbus, with over 30 years of experience in anesthesia and ASC administration, including 21 years as an ASC administrator and medical director.

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What they’re saying

“I have that tripod of experience because I'm in the [operating room] doing anesthesia. I'm seeing what's going on. I'm seeing what the surgeon is using, what implants, what supplies, what they're opening, what's necessary, what's not necessary … if you don't have those boots-on-the-ground kind of attitude, you really don't know what's going on in the OR.”

— Thomas Durick, MD, Associate Professor of Anesthesiology (Becker's ASC Review)

“My deep involvement in the in the billing side for the facility really opened my eyes as to how we get paid, what we get paid, when we get paid, how the claims have to go out, how you have to really stay on top of that and know what you're going to get paid before you ever take the case.”

— Thomas Durick, MD, Associate Professor of Anesthesiology (Becker's ASC Review)

What’s next

Dr. Durick's insights on the 'farm mentality' approach to ASC management are expected to be further discussed at the upcoming American Society of Anesthesiologists conference in October.

The takeaway

Successful ASC leaders adopt a holistic, hands-on mindset that allows them to deeply understand the operational and financial intricacies of their facility. This 'farm mentality' enables them to make informed decisions about case profitability and overall financial sustainability.