Image courtesy of Solara Surgical PartnersLeadership turnover within medical settings has been a hot topic in 2025.
Hospitals and ambulatory surgical centers (ASCs) have faced high turnover this year, driven by such stressors as economic pressures, technological demands and a changing workforce culture.
ASC News recently interviewed Steve Hockert, chief development officer at Southlake, Texas-based Solara Surgical, an ASC development and operations management organization, to gain his insights on why this trend has emerged and his outlook for its future.
The conversation below has been edited for length and clarity.
ASC News: How would you describe the current level of leadership turnover in ASCs compared to hospitals?
Hockert: Turnover pressures exist in both settings, but they can manifest differently.
Hospitals appear to have mostly stabilized after years of volatility, while ASCs continue to experience intense leadership pressure because their teams are smaller and each role directly affects operations.
In an ASC, a single administrator’s departure can instantly impact case flow, vendor relationships and surgeon satisfaction.
In hospitals, the turnover might be distributed across management levels, but the ripple effects in surgery centers are far more immediate and personal.
What trends have you observed in the past five to 10 years?
We’ve seen the ASC administrator role evolve into a more sophisticated leadership position.
A decade ago, many ASC leaders learned through experience; now they’re expected to bring some level of financial, regulatory and strategic expertise from Day 1.
There’s also been a significant shift toward early retention — centers are investing in mentorship, structured onboarding and compensation adjustments to retain talent before burnout occurs.
Meanwhile, hospitals have become more data-driven in workforce planning, using analytics to understand staffing patterns and turnover triggers.
What are the main factors contributing to leadership turnover in ASCs, and how do these compare to hospital settings?
In ASCs, turnover is often related to bandwidth and role concentration.
Administrators frequently directly support contracting, supply chain, scheduling, accreditation and physician relations — often with little redundancy. This constant multitasking can lead to fatigue.
Growth also influences turnover: When centers add service lines like spine or cardiology, managing vendors and credentialing becomes significantly more complex.
Hospitals, on the other hand, tend to struggle more with scale-driven stress — spanning much larger control and community service areas, 24/7 operations and complex layers of organizational accountability. Even when a hospital has more resources, the demands on middle management can be relentless. So, while ASCs face concentrated pressure, hospitals deal with systemic fatigue.
How do the size and complexity of an organization influence leadership stability?
Smaller ASCs tend to have strong cultures and agile teams, but they’re structurally fragile — one departure can disrupt the rhythm of the entire operation.
Larger hospitals or systems can handle turnover more easily, but the complexity of implementing change across multiple departments increases stress on managers.
Ultimately, it’s not just about size; it’s about how effectively the organization maintains continuity and supports its leaders through predictable playbooks, resources and mentorship.
Are demographic shifts in generations or the workforce influencing turnover rates in both ASCs and hospitals?
Absolutely. We’re observing younger leaders stepping into these roles with very different expectations around work-life balance, flexibility and professional growth. They want to feel aligned with the mission, not just the metrics. That presents an opportunity for ASCs, which can provide a more personal, physician-led culture and quicker decision-making.
However, it also means we need to rethink succession planning — mentoring early-career administrators before they burn out or move on.
Hospitals are facing similar generational changes, especially among first- and second-year nurse leaders who often lack the support systems needed for long-term engagement.
How does Solara Surgical Partners approach leadership retention and development?
At Solara, we create centers where people, partnerships and performance strengthen each other. That begins with designing manageable leadership structures — ensuring administrators have the resources, autonomy and mentorship needed to succeed.
We standardize the operational foundation so our leaders can focus on relationships and growth instead of constant firefighting. The goal isn’t just to fill a vacancy; it’s to build a bench of capable leaders who can grow alongside the organization.
