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visit carecredit.comforward/beckerspodcast.

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Cast. This is Chanel Banger with the Becker's

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Healthcare podcast, and I'm recording live at the

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21st annual Spine Orthopedic and Pain Management Driven

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ASC

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and the Future of Spine Conference in Chicago.

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Right now, I'm sitting down with doctor Brett

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Shore, an orthopedic surgeon at DISC Sports and

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Spine. Doctor Shore, thank you so much for

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joining me today. Thank you for having me.

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Perfect. Well, to get us started, could you

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please tell us a bit about your background

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and organization?

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Yeah. So a little bit about myself.

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I did my training mostly on the East

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Coast. I attended Columbia University for medical school.

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I did my residency at the Harvard combined,

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orthopedic residency in Boston.

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Then completed a sports medicine fellowship with doctor

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James Andrews in Birmingham, Alabama.

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And then

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I moved out to California

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to,

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join Kaiser Permanente,

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where I was a sports medicine specialist

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for about 11 and a half years.

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And for 10 of those, I was their

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head of hip preservation

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for the Southern California region.

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While I was with Kaiser,

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I was

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the referral person for most of the complex

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hip preservation problems that were encountered for the

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Southern California region.

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And then

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near the end of my time there, I

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took a sabbatical to Switzerland

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where I spent approximately two and a half

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months in Zurich learning advanced hip preservation from

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some of the world's experts

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in hip preservation.

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I then continue to practice with Kaiser for

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about a year and a half after my

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sabbatical,

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after which time I ended up leaving

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Kaiser and joining DISC Sports and Spine,

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to come on as a hip and orthopedic

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specialist.

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Got it. Thank you so much for that

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introduction. Now moving forward, based on your experience,

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how has the patient provider dynamic changed over

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time?

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Well,

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in general, due to decreased reimbursements and increased

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health care costs,

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one of the things we've seen is that

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the overall amount of time that the patients

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have with providers has gone down.

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And as a result, the use of physician

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extenders has increased. Now, in some ways, this

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is not necessarily a bad thing,

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but it does decrease the amount of sort

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of trust and relationship that has developed

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between patients and doctors.

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And, unfortunately,

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as reimbursements continue to go down

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and

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the

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volume of patients required

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to maintain a thriving and efficient practice

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increases,

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this will only continue to become a problem.

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Got it. And in recent years, people have

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become more interested in improving their overall health.

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But

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it seems like with social media and the

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likes, people are feeling more comfortable taking matters

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into their own hands rather than seeking out

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professional

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opinions. What do you think that is?

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Thanks for this. This is a very good

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question, I think. And it actually gets at

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the heart of some of the struggles with

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medicine in general.

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So one of the things that I recall

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as a medical student, and I think this

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experience is true for a lot of doctors,

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is that

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areas of wellness,

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specifically exercise,

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diet, sleep, these sorts of things were not

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really taught or emphasized in medical school.

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Additionally,

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the development of our modern field of medicine

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is really a disease based model,

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and reimbursement

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and patient care is really structured based on

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the illness injury model. We have ICD codes

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for illness and injury. We have CPT codes

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for treatments and procedures,

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but there really isn't a straightforward way to

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bill or to maintain a thriving practice

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by focusing on maintaining patients' health and wellness.

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And I think patients realize this, and they

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realize that doctors both don't necessarily have the

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training or time, and also the structure of

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medicine is really not set up in such

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a way that doc that we are always

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the best people

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to

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focus on patients' health and wellness. And as

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the

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there's an increase in the amount of literature

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that has been published in the last 15,

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20 years

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on the importance of sleep, diet, exercise, and

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whatnot in patients' health and longevity.

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Patients are aware of this and are not

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getting this information from their physicians.

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So as a result, I think they're

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understandably seeking it out on their own.

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Got it. That makes a lot of sense.

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Now from an organization standpoint,

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do you have any strategies in place aimed

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at helping to bring in new patients or

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to improve retention?

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Yes. So,

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within our organization,

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within DISC, Sports and Spine, there are some

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standard

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ways that we,

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work to bring in patients.

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Basic things like, utilizing social media, search engine

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optimization,

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targeted marketing campaigns.

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We also, do some events that help bring

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together different types of providers,

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physicians and surgeons with physical therapists, chiropractors,

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acupuncture,

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and other,

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types of providers

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to sort of

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let everyone know what it is that we

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do

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and to facilitate

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referrals.

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With respect to retention,

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one of the things that DISC has done

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is expansion into all areas of orthopedics and

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spine

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with the intention of keeping patient referrals

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in house, so to speak.

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Got it. And kind of building off of

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that, why is that retention so important?

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Well, there are there are a couple of

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reasons. And retention is one of those ideas

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that has always been present in

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marketing and business in general,

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with the sort of old adage that it

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is more expensive to get a new customer

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than to maintain a current one. And I

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think that's some element of why retention is

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important in medicine as well.

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Additionally, an exist an existing patient

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is going to likely come back for additional

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procedures, is gonna come back for pain in

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additional body parts,

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and

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we won't the the overall cost of onboarding

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them is lower.

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The other reason why retention is so important,

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I think, and why just seeing the patients

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in the moment really isn't a win is

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because

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a lot of our best sources for referrals

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are our former and current patients. And so

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if we can maintain a patient within our

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practice

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who is satisfied and happy with the care

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that they're receiving, that's likely going to lead

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to more referrals in the future.

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Absolutely. Well, I wanna thank you for your

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time today, but I have one more question

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for you.

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Looking ahead, if the macroeconomic

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challenges of health care do not change, how

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do you anticipate the industry will evolve? Do

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you think it'll turn more into a consumer

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based service rather than a personal one? Or

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what do you think?

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So this is really what I think one

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of the one of the big questions that

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I think everyone's trying to sort out in

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the health care space.

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I think there will probably be a trend

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towards larger organizations, which we've already seen because

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larger organizations have the ability to spread out

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the costs

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of

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the bureau of the bureaucratic, like, maintenance of

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health care practices.

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And, ultimately,

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that will

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likely advantage larger groups over individual practices, but

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will open the door potentially

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for some sorts of hybrid models

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that allow for some physician autonomy within the

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group,

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but they also

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have some element of sort of back office

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staff that allows for

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dealing with the increased amount of paperwork and

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other things associated with

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the macroeconomic

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challenges. Additionally,

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one of the things that has also been

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happening already is that there's been a greater

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shift of cost

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to patients.

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More and more of the costs are being

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shifted to sort of out of pocket things

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and to the consumers themselves rather than to

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either the insurance companies or to the other

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health care organizations.

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Got it. Well, doctor Shore, I wanna thank

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you once again for your time today and

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for joining me on the Becker's Healthcare podcast.

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Thank you. Thank you for having me.