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78 | EYEWORLD | WINTER 2025
the same language. There's consistency from start to finish,
and so the entire process is better," Dr. Kugler said.
Dr. Melendez said in his case, OBS lowered staffing
costs because he uses the same staff in clinic and for the
OBS. Cost savings also come from not having a separate
facility. He likes the control over the atmosphere that OBS
provides.
"When you see a surgeon taking a selfie with a patient
after surgery in an ASC versus an OBS, the ASC always
looks like they're in the hospital. The OBS feels like a spa,"
he said.
OBS expanding access
Dr. Kugler emphasized that there is a role for both ASCs
and OBS, with each making sense in certain geographies
and climates. In his view, OBS is expanding access to care.
"I get a lot of calls from surgeons in states that are cer-
tificate of need states, and they simply don't have a way to
start a surgery center. And they're being pushed out of the
ASCs that they've been going to because ophthalmology
isn't a great investment for a lot of open access ASCs com-
pared to other specialties," he said, adding that hospitals
are also limiting OR space to ophthalmology because "it's
not working from a profitability standpoint."
This coupled with a shortage of anesthesiologists and
nurse anesthetists, which are often required by ASCs,
is posing a problem for ophthalmologists. "I have some
friends who cannot get cases on at ASCs because they
don't have the anesthesia coverage that they're required to
have," he said.
"OBS offers another way for people to provide
high-level surgery when access to ASCs and hospitals
is limited," Dr. Kugler said. "In a lot of these areas, OBS
is a way that they can open access to more patients who
need surgery."
continued from page 76
" When you see a surgeon taking a
selfie with a patient after surgery
in an ASC versus an OBS, the ASC
always looks like they're in the
hospital. The OBS feels like a spa."
—Rob Melendez, MD, MBA
