Smart patient selection anchors DISC’s high-acuity spine ASC model

Editor's Note

Ambulatory surgery center (ASC) leaders elevate safety by treating patient selection as a clinical gatekeeper, then prop that rigor with data-driven workflows, advanced monitoring, and targeted robotics to bring complex spine cases safely into the outpatient space. An interview with Glenn Snyders Jr, MD, medical director and head of anesthesiology at DISC Surgery Center in Carlsbad, California, published on April 18 by Ambulatory Surgery Center News, unpacks the effects of proper patient selection for ASCs.

According to Dr Snyders, patient selection is “one of the most important parts of creating a safe and effective surgical experience” in an ASC, where ICUs and cath labs are absent. The article notes that DISC accepts mainly ASA I–II adults—those with well-controlled hypertension or diabetes—while borderline patients with severe sleep apnea or uncontrolled comorbidities trigger joint deliberations among surgeons, anesthesia, and nurses, plus thorough patient counseling. Consensus hinges on clinical judgment rather than rigid rules, though teams lean on SAMBA guidance for issues like sleep apnea.

The outlet reports that DISC’s three-OR ASC in Carlsbad was built for throughput, pairing the theaters with 10 preop/recovery bays and real-time tracking from Ospitek and HST to flag bottlenecks and measure mobilization times. DISC already performs high-acuity spine procedures with “minimal blood loss and incredibly low infection rates—zero for spine,” and bolsters safety by deploying hospital-style telemetry for overnight observation (up to 23 hours) without repeated vital checks. Surgeons also employ Mako and Rosa robotics and will pilot Pixee augmented-reality navigation, technologies, which the outlet says cut radiation, shrink incisions, and speed recovery.

While staffing remains tight amid the anesthesia shortage, DISC’s predictable hours and reputation attract anesthesiologists who value outpatient practice. In the interview, Dr Snyders championed a team model in which CRNAs and, where permissible, anesthesiologist assistants extend coverage while physicians retain leadership—essential, he argued, when emergency back-up is limited. The article concludes that DISC’s narrow focus on orthopedic and complex spine care embodies the specialized “subunit” playbook championed in The Innovator’s Prescription, proving that disciplined patient selection plus targeted innovation can safely expand outpatient boundaries.