The 61% system average is not a uniform problem. It is driven by a small number of specialties with significant underutilization relative to their block allocations.

Orthopedics and General Surgery are both running above 85% and are almost certainly capacity constrained given the waitlist. Neurosurgery and GYN are well below 70% while holding large block allocations. ENT is similarly lagging.

The core implication is that Meridian does not need more OR time overall. It needs to move blocks from low-utilization specialties to high-demand ones. The key follow-on question is whether underuse in Neurosurgery and GYN is structural (genuinely low case volume, or long case times that limit how many procedures fit in a block) or behavioral (surgeons holding blocks they are not filling). That distinction determines whether the fix is reallocation, scheduling policy, or a direct conversation with department chairs.