Background Understanding trends in surgical volumes can help Ambulatory Surgery Centers (ASCs) prevent clinician burnout and provide adequate staffing while maintaining the quality of patient care throughout the year. Health insurance deductibles reset in January each year and may contribute to an annual rhythm where the levee of year-end deductibles is breached in the last few months of every year, resulting in a flood of cases and several accompanying challenges. This study aims to identify and analyze monthly and yearly surgical volume patterns in ASCs and explore a relationship with the deductible reset. Methods De-identified, aggregate visit data for 2016–2019 were obtained retrospectively from 14 ambulatory surgery centers within the same benchmarking consortium in the Southeast. The ASCs subspecialty types consisted of orthopedics, urology, otolaryngology, and multispecialty. Kaiser Family Foundation survey data from 2016 to 2019 was used to inform deductible trends. Augmented Dickey-Fuller tests, linear regressions, and two-sample T-tests were conducted to explore and establish patterns in surgical volume between 2016 and 2019. Results Overall, average orthopedic surgical volume increased 38.04% from January to December in 2016–2019 with an average difference of 64 cases (95% CI: 47–80), while that of all ASCs combined increased 19.24% within the same timeframe with an average difference of 37 cases (95% CI: 21–52). Average health insurance deductibles rose 12% from $1476 to $1655 within the same timeframe. Regression analysis showed a stronger association between year and volume for orthopedic ASCs (R (Claxton et al., 2019) [2] = 0.796) than for all ASCs combined (R (Claxton et al., 2019) [2] = 0.645). Regression analysis also showed a stronger association between month and volume for orthopedic ASCs (R (Claxton et al., 2019) [2] = 0.488–0.805) than for all ASCs combined (R (Claxton et al., 2019) [2] = 0.115–0.493). Conclusion This study is first to identify regular and predictable yearly and monthly increases in orthopedic ASCs surgical volume. The study also identifies yearly increases in surgical volume for all ASCs. The combination of increasing yearly demand for orthopedic surgery and growing association between month and volume leads to an unnecessary year-end rush. The study aims to inform future policy decisions as well as help ASCs better manage resources throughout the year.

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The development of effective managers and good management practices begins with proper education and training. Innovative teaching strategies are needed in management education to more effectively engage students in the classroom. Several innovative strategies, such as the flipped classroom approach, are quickly gaining popularity in higher education. Such approaches can help students understand how to apply theoretical information regarding concepts such as conflict resolution, teamwork, and communication in realworld settings. Role play is one technique used in innovative teaching strategies, such as the flipped classroom method, that is essential for practicing proper application of concepts in the management classroom. This article will discuss the concepts of the flipped classroom and role-play, and their use in management education. The purpose of this article is to provide management educators with an overview of innovative strategies that can be utilized to enhance management education. This information will have implications for the management workforce in providing knowledge that can lead to the development of good management practices.

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A common perception exists that extroverts are better communicators than introverts, and thus make the best leaders. Research studies throughout time have consistently resulted in the belief that extroverts are more likely to emerge as leaders and are more likely to be perceived as effective. The Trait Theory of Leadership and the Personality Type Theory have been used in research to suggest that theories support that extraversion is key to professional leadership communication and success. The purpose of this article was to conduct a thorough review of leadership communication from a personality perspective. Leadership and personality theories were examined in depth through review of current and past research studies. There is a growing body of research adding to the newfound belief that introverts possess traits that can contribute to their success in leadership roles. According to a review of recent research, organizations may benefit immensely from the inclusion of introverts in leadership positions. Thus, the field of healthcare would benefit from further research regarding how best to utilize introverts within leadership of organizations. Since introverts communicate in different ways than extroverts, organizations should look at their current methods of communication and ensure that the channels of communication are effective for all types of leaders.