Staten Island’s First Multi-Specialty Surgery Center Opens in Annadale, Promises Shorter Waits

Staten Island’s first dedicated ambulatory surgery center may offer a preview of how outpatient healthcare could evolve in urban America.

The sheer number of New Yorkers awaiting procedures has long been the stuff of municipal myth: in 2023, the average wait for non-urgent surgery at the city’s public hospitals hovered near four and a half months. On Staten Island, the situation had reached an impasse—patients were often compelled to traverse boroughs or venture into New Jersey for outpatient procedures that could just as easily have occurred closer to home. Now, the ribbon-cutting of the Empire Center for Special Surgery in Annadale, the borough’s first independent facility of its kind, portends a modest but meaningful change for this perennially underserved corner of Gotham.

The opening ceremony, held in April, drew an array of city leaders, from the Empire Center’s clinical team to Dr. James McDonald, commissioner of the New York State Department of Health. The fanfare reflects a broader institutional bet: that cutting-edge, patient-focused design can relieve pressure on hospitals by siphoning routine surgical cases into purpose-built ambulatory centers. The new facility touts such virtues: operating rooms brimming with digital dashboards and workflow software, patient suites designed for privacy and efficiency, and (if its architects are to be believed) a “seamless” experience for physicians, nurses, and clients alike.

For Staten Islanders, the implications are unusually practical. This is a borough perpetually wrestling with medical access—long the only part of New York without a major academic medical centre; hemmed in by ferry and bridge tolls; and, in a health-economic paradox, sicker and older on average than its metropolitan siblings. For years, local patients faced a paltry menu of options: join the well-heeled for care in Manhattan or Brooklyn, or accept lengthy waits at the borough’s few existing hospital campuses. In theory, a locally grounded ambulatory surgery centre could shrink these waitlists while sparing patients the logistical ordeal that is a two-hour trek via public transit.

The ambitions do not stop at logistics. Proponents of the $30 million Empire Center argue that bringing more elective surgery offsite delivers measurable benefits: fewer surgical-site infections, lower costs, shorter recovery times, and greater patient satisfaction. According to industry surveys, ambulatory surgical centers (ASCs) can perform standard procedures—hernias, cataract removals, joint repairs—for as much as 40% less than hospitals, owing to leaner operations and the absence of in-house acute care. Over the past decade, New York State has gingerly expanded its licensing regime for such facilities, seeking to balance efficiency with oversight.

The secondary effects call for a measure of cautious optimism. For one, the rise of outpatient surgery sites has the potential to ease the burden on overtaxed hospital ERs, freeing beds and clinicians for cases that cannot be scheduled or anticipated. In a city still reckoning with hospital closures in poorer districts—and periodic system-wide strain, as during the height of the COVID-19 pandemic—such incremental relief is not to be sneezed at. There are caveats: ASCs, by necessity, serve only those healthy enough to be routed out of hospital, and critics worry that the migration of profitable procedures from traditional hospitals could undermine the stability of legacy providers.

Politically, the arrival of the Empire Center is a tonic for an oft-neglected constituency whose grievances have animated Staten Island politics for decades. The opening will doubtless be cited by state and city officials eager to burnish their records on healthcare access. Yet, as the burgeoning national debate over outpatient care attests, such projects tend to evoke more questions than answers about urban health equity. ASCs may deliver more frictionless care for the insured and the mobile, but where does this leave the uninsured, the frail elderly, or those with complicated medical needs beyond their remit?

Hospitals, for their part, have greeted the proliferation of ASCs with a mixture of weary resignation and proprietary caution. In many states, including New York, hospital networks have attempted to buy stakes in these facilities, hoping both to capture revenue and shape referral patterns. That the Empire Center is independently owned, helmed by CEO Dr. George Kofinas and a consortium of physician-entrepreneurs, marks a departure from the typical pattern elsewhere in the city, where hospital consolidation has left little room for entrepreneurial medicine.

Comparison with other cities spotlights both the promise and the limits of the model. Outpatient surgical care has become standard in mid-sized American cities, where over half of all surgeries are now performed in non-hospital settings. New York, slow to follow, has lagged behind states like Texas or California in approving and regulating these centers, often citing the complex tangle of hospital finance, union power, and insurance arrangements. The Empire Center is emblematic, then, not so much of a revolution as a catch-up to national norms.

Globally, too, urban health systems have chased similar efficiencies. In the United Kingdom, the National Health Service has ramped up investment in “surgical hubs” to mitigate ever-lengthening waitlists. Singapore, ever the paragon of efficient medicine, has tried to combine ambulatory care with digital health to compress care pathways further. Yet, the nuances of American insurance and licensure render direct importation of these models a Sisyphean task.

A step forward, but not a panacea

For all the congratulatory rhetoric, some scepticism is in order. The much-advertised technological “seamlessness” remains unproven in practice, and health outcomes data specific to the centre—and to Staten Island’s population—remain scant. As ever, care quality will hinge as much on human capital as on digital dashboards. Moreover, the tension between efficiency and inclusivity is alive and well; if incentive structures are misaligned, ASCs could, in theory, widen rather than bridge existing gaps in health access.

Yet the broad direction is sensible. Diverting predictable, low-acuity surgical cases from hospitals, while maintaining hospital capacity for emergencies and complex care, is both cost-conscious and patient-friendly. As the city’s demographic profile ages and the fiscal screws continue to tighten, such incremental adaptations look less like innovation and more like overdue common sense.

Whether the Empire Center merely trims waitlists or catalyses a broader modernisation of medicine in New York will depend on regulatory nimbleness and the willingness to measure, and act on, robust outcome data. If the facility achieves its promise, it may—quietly, competently—poke a hole in the myth that healthcare efficiency and accessibility cannot coexist in the five boroughs. For Staten Island, that would be progress of the unflashy yet welcome variety. ■