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Cast. This is Chanel Banger with the Becker's
Healthcare podcast, and I'm recording live at the
21st annual Spine Orthopedic and Pain Management Driven
ASC
and the Future of Spine Conference in Chicago.
Right now, I'm sitting down with doctor Brett
Shore, an orthopedic surgeon at DISC Sports and
Spine. Doctor Shore, thank you so much for
joining me today. Thank you for having me.
Perfect. Well, to get us started, could you
please tell us a bit about your background
and organization?
Yeah. So a little bit about myself.
I did my training mostly on the East
Coast. I attended Columbia University for medical school.
I did my residency at the Harvard combined,
orthopedic residency in Boston.
Then completed a sports medicine fellowship with doctor
James Andrews in Birmingham, Alabama.
And then
I moved out to California
to,
join Kaiser Permanente,
where I was a sports medicine specialist
for about 11 and a half years.
And for 10 of those, I was their
head of hip preservation
for the Southern California region.
While I was with Kaiser,
I was
the referral person for most of the complex
hip preservation problems that were encountered for the
Southern California region.
And then
near the end of my time there, I
took a sabbatical to Switzerland
where I spent approximately two and a half
months in Zurich learning advanced hip preservation from
some of the world's experts
in hip preservation.
I then continue to practice with Kaiser for
about a year and a half after my
sabbatical,
after which time I ended up leaving
Kaiser and joining DISC Sports and Spine,
to come on as a hip and orthopedic
specialist.
Got it. Thank you so much for that
introduction. Now moving forward, based on your experience,
how has the patient provider dynamic changed over
time?
Well,
in general, due to decreased reimbursements and increased
health care costs,
one of the things we've seen is that
the overall amount of time that the patients
have with providers has gone down.
And as a result, the use of physician
extenders has increased. Now, in some ways, this
is not necessarily a bad thing,
but it does decrease the amount of sort
of trust and relationship that has developed
between patients and doctors.
And, unfortunately,
as reimbursements continue to go down
and
the
volume of patients required
to maintain a thriving and efficient practice
increases,
this will only continue to become a problem.
Got it. And in recent years, people have
become more interested in improving their overall health.
But
it seems like with social media and the
likes, people are feeling more comfortable taking matters
into their own hands rather than seeking out
professional
opinions. What do you think that is?
Thanks for this. This is a very good
question, I think. And it actually gets at
the heart of some of the struggles with
medicine in general.
So one of the things that I recall
as a medical student, and I think this
experience is true for a lot of doctors,
is that
areas of wellness,
specifically exercise,
diet, sleep, these sorts of things were not
really taught or emphasized in medical school.
Additionally,
the development of our modern field of medicine
is really a disease based model,
and reimbursement
and patient care is really structured based on
the illness injury model. We have ICD codes
for illness and injury. We have CPT codes
for treatments and procedures,
but there really isn't a straightforward way to
bill or to maintain a thriving practice
by focusing on maintaining patients' health and wellness.
And I think patients realize this, and they
realize that doctors both don't necessarily have the
training or time, and also the structure of
medicine is really not set up in such
a way that doc that we are always
the best people
to
focus on patients' health and wellness. And as
the
there's an increase in the amount of literature
that has been published in the last 15,
20 years
on the importance of sleep, diet, exercise, and
whatnot in patients' health and longevity.
Patients are aware of this and are not
getting this information from their physicians.
So as a result, I think they're
understandably seeking it out on their own.
Got it. That makes a lot of sense.
Now from an organization standpoint,
do you have any strategies in place aimed
at helping to bring in new patients or
to improve retention?
Yes. So,
within our organization,
within DISC, Sports and Spine, there are some
standard
ways that we,
work to bring in patients.
Basic things like, utilizing social media, search engine
optimization,
targeted marketing campaigns.
We also, do some events that help bring
together different types of providers,
physicians and surgeons with physical therapists, chiropractors,
acupuncture,
and other,
types of providers
to sort of
let everyone know what it is that we
do
and to facilitate
referrals.
With respect to retention,
one of the things that DISC has done
is expansion into all areas of orthopedics and
spine
with the intention of keeping patient referrals
in house, so to speak.
Got it. And kind of building off of
that, why is that retention so important?
Well, there are there are a couple of
reasons. And retention is one of those ideas
that has always been present in
marketing and business in general,
with the sort of old adage that it
is more expensive to get a new customer
than to maintain a current one. And I
think that's some element of why retention is
important in medicine as well.
Additionally, an exist an existing patient
is going to likely come back for additional
procedures, is gonna come back for pain in
additional body parts,
and
we won't the the overall cost of onboarding
them is lower.
The other reason why retention is so important,
I think, and why just seeing the patients
in the moment really isn't a win is
because
a lot of our best sources for referrals
are our former and current patients. And so
if we can maintain a patient within our
practice
who is satisfied and happy with the care
that they're receiving, that's likely going to lead
to more referrals in the future.
Absolutely. Well, I wanna thank you for your
time today, but I have one more question
for you.
Looking ahead, if the macroeconomic
challenges of health care do not change, how
do you anticipate the industry will evolve? Do
you think it'll turn more into a consumer
based service rather than a personal one? Or
what do you think?
So this is really what I think one
of the one of the big questions that
I think everyone's trying to sort out in
the health care space.
I think there will probably be a trend
towards larger organizations, which we've already seen because
larger organizations have the ability to spread out
the costs
of
the bureau of the bureaucratic, like, maintenance of
health care practices.
And, ultimately,
that will
likely advantage larger groups over individual practices, but
will open the door potentially
for some sorts of hybrid models
that allow for some physician autonomy within the
group,
but they also
have some element of sort of back office
staff that allows for
dealing with the increased amount of paperwork and
other things associated with
the macroeconomic
challenges. Additionally,
one of the things that has also been
happening already is that there's been a greater
shift of cost
to patients.
More and more of the costs are being
shifted to sort of out of pocket things
and to the consumers themselves rather than to
either the insurance companies or to the other
health care organizations.
Got it. Well, doctor Shore, I wanna thank
you once again for your time today and
for joining me on the Becker's Healthcare podcast.
Thank you. Thank you for having me.