Meet the Board: Brian Cohen

Digital Debut

Brian Cohen, MD

Administrative Chief

Miami Anesthesia Services

Aventura, Florida

Interviewed by Sahely Mukerji
Brian Cohen, MD

Get to know your officers through these short interviews

We are running a series of Q&As with ASCA’s board of directors to help our members get to know them better. Meet Brian Cohen, MD, administrative chief at Miami Anesthesia Services in Aventura, Florida.

How did you get into the ASC space?

Brian Cohen (BC): In 2015, eight years into my anesthesia career at a local hospital, I was presented an opportunity to start an anesthesia company for a startup physician-owned hospital in Miami, Florida. With optimism — and, admittedly, naivety — I accepted. That decision led to the founding of Miami Anesthesia Services. Twenty months later, we found ourselves sitting in our gorgeous office in the brand-new hospital, having just received the news that the hospital was closing. Tomorrow.

This was in late 2017 and we observed a shift in south Florida — the complex orthopedic and surgical cases were increasingly moving to ASCs. But we also noticed a serious gap: The anesthesia teams being placed in these centers were not equipped for the complexity of the cases. The skill sets, motivation and performance levels did not match the needs of the patients or the facilities. We realized we had something valuable to offer — ASC-focused anesthesia care that could scale with complexity. And, as luck (or timing) would have it, we had an entire team ready to deploy.

From that minute forward, we remained fully focused on fulfilling our mission in the ASC anesthesia space. We signed our first surgery center contract in December 2017. Now, Miami Anesthesia Services is contracted at 21 ASCs in south Florida, while managing anesthesia services at another 12 centers throughout the rest of the Southeast. Our team of 220-plus clinicians have joined us in this adventure — remaining dedicated to continuing to find ways to drive value and success across this unique, niche space in healthcare. One door closed. Thirty-three opened. And we could not be more grateful.

What are your aspirations for ASCA?

BC: ASCA has successfully built a reputation on trust, education and advocacy in the ASC world. My aspiration is to build on that legacy — expanding ASCA's influence not only in operations and policy, but also in clinical education and best practices.

One area I feel strongly about is patient selection and preoperative assessment. As ASCs take on more complex cases, there has been a lag in evolving preop clearance standards to reflect the ambulatory setting. More specifically, current guidelines often overlook the impact of the surgical environment on patient risk.

ASCA is uniquely positioned to lead this conversation. With input and internal leadership from specialty societies, anesthesiologists, surgeons and ASC administrators, we can strive to develop consensus statements that facilitate a safer, more efficient and more transparent perioperative process tailored specifically to ASCs.

In joining the ASCA board, I am committed to helping ASCA become not just the operational voice of ASCs, but the clinical compass as well.

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Who was a great mentor for you?

BC: As a cofounder of an anesthesia company with no previous business training, every conversation that I have had over the years involved some level of mentorship. I have been lucky enough to have partners with different strengths than myself, allowing us to learn from each other. I have strived to operate without an ego — always willing to be a mentee, with the hope of one day being able to share my knowledge as a mentor.

What are you most proud of in your ASC work?

BC: I am most proud of the employment platform that our company has been able to provide to local anesthesiologists, CRNAs and anesthesiologist assistants to work in the ASC environment. The ambulatory space is such a unique place to practice anesthesia. Historically, it was something one had to earn through years of hospital work and on-call nights. Our career path should allow us to find the space in which we can fit and provide quality care for our patients in a setting that we love. I am proud that our company has allowed hundreds of anesthesia providers the opportunity to experience this and thrive.

If you could change one thing about the ASC community, what would it be?

BC: I have worked in large academic hospitals, community settings and ASCs — and the greatest differentiator across all of them is culture. It is the human factor. If you do not account for this intangible, the entire system will break down.

So, while I firmly believe in data, models and systems, I also believe this: The most successful ASCs are the ones that invest in people. That is how you build sustainable, resilient care models — not just for the next 10 years but for the next generation. When this success is achieved, it should not be punished by payers — it should be rewarded and replicated by the rest of the ASC and healthcare community.

What excites you most about the future of ASCs?

BC: The ASC setting is nimble. It is open to change and innovation. It is responsive. It is less talking and more doing. This is what I love about working in the ambulatory setting. As an anesthesiologist in this space, I get to lead in real time. Safety and efficiency are not abstract goals — they are daily imperatives. In ASCs you can truly make a difference — quickly and meaningfully.

What legacy do you hope to leave in the ASC space?

BC: I am not concerned about leaving a legacy — I am more concerned about creating a positive impact each day. Healthcare is very much about risk versus benefit. This is amplified in the ambulatory surgery space — in which we have an enormous opportunity to drive excellent care in a safe and efficient manner, while consciously controlling risk. If I can help define these guardrails and drive the success of patient outcomes in ASCs, then I am proud of my efforts.