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Imagine this, you're at the Hyatt Regency Chicago

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surrounded by the top minds in the ambulatory

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surgery center industry.

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Welcome to the Becker's 30th annual meeting, the

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business and operations of ASCs from October 30th

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to November 2, 2024.

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Picture the excitement as you collect business cards

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from over a 1000 executive level attendees forging

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priceless connections.

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Feel the buzz of conversations as you participate

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in more than 60 sessions led by over

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225 elite ASC speakers.

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Envision yourself gaining actionable insights on topics like

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private equity strategies,

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ASC business growth, and innovations in spine, orthopedics,

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GI, ophthalmology, and cardiology.

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Now imagine yourself listening to inspiring keynotes from

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hall of fame boxing world champion, Lila Ali,

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and professional basketball player, Caitlin Clark. Their stories

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will motivate you to take your business to

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new heights. You'll leave with a wealth of

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knowledge and a network of connections to help

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lead your ASC into the next year. Don't

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miss out. Get registered today. Visit beckershospitalreviewdot

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com and click on the events page to

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find the conference website. That's the beckershospitalreview.com

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events page. See you in Chicago.

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This is Laura Dierda with the Becker's Healthcare

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podcast.

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I'm thrilled today to be joined by doctor

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Mahdi Schnur, who is the neuromuscular

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skeletal dyad leader and interventional pain physician at

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Aspirus

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St. Luke's Hospital. Doctor Schnur, it's a pleasure

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to have you on the podcast today.

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Yes. Great to be here.

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Now I'm really looking forward to our conversation.

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I know there's a lot, that you're doing

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at Aspirus St. Luke's and really looking forward

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to learning more about,

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how you can really galvanize a physician team's

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productivity.

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But before we dive in, I was wondering

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if you could tell us a little bit

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more about yourself and your background.

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Sure. So as, everyone heard, I'm doctor Mady

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Schnur. I'm an interventional pain physician

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with a background of anesthesia.

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I work in a small Midwest city at

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a hospital based practice, and I have an

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administrative role at my hospital. And I'm quite

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involved in several professional societies in my field,

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including WIPA, which is the Society of Women

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Innovators and Team Management, of which I'm one

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of the founding members,

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as well as a current board member and

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treasurer.

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I have my MBA from Cornell, and I'm

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about 5 years post fellowship training,

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which I did at Mayo Rochester.

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And in my free time, I really enjoy

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archery and running.

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Well, it's fantastic. And, you know,

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really cool to have those passions of archery

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and running. I can imagine, you know, it

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is really helpful after

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a lot of, the clinical and administrative work

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that you do.

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Yes. I'm so excited

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to watch the Olympics.

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Really rooting for team USA.

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Absolutely. It's going to be a a fun

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summer here coming up. So,

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from your perspective, what do you see as

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being some of the biggest challenges for physician

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productivity in 2024?

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Yeah. So one of the biggest challenges is

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honestly maintaining a consistent team around you. And

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what I mean by that is it always

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helps to have rad techs, nurses, medical assistants,

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fillers

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that really

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know

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your

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practice

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and can do their jobs well. And so

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having this team and really convincing them to

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stay with you for long time periods, I

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think, is super important.

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And second to this,

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I think

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also important, is really finding out what others

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in the field are doing in terms of,

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timing and number of procedures and clinic visits.

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It's

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really helped me so much to

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really be able to go to, multiple conferences

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a year

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and to be part of,

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professional societies.

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When

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I came from fellowship, it was easy to

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kind of continue that routine that I had,

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but I soon realized that if I did

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that,

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I wasn't going to make really my personal

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productivity goals, and I wasn't gonna have good

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patient access in my practice, particularly,

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because I I live in a a small

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town, and,

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there aren't as many physicians as there would

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be in really bigger cities.

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That makes a lot of sense. And, certainly,

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I can imagine a lot of,

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physicians and organizations are in a similar situation.

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So when you look at

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the idea around productivity and how you can,

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boost that within

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the different hospitals and systems,

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what do you do to design your productivity

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targets?

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Yeah. So, I use one of the big

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databases, so NGMA,

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really, as a guide.

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I think not all of the databases are

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correct in every aspect of, the data that

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they use, but they're certainly quite useful.

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Additionally, I have found it super helpful to

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ask my close colleagues

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and friends really what their goals are and,

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you know, what are the number of procedures

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they're doing in a day, and what are

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the number of patients they're seeing in clinic

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important to this? And something that I think

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has taken me,

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a bit of time to find out is,

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you know, what what are the numbers of

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ancillary staff, they use and the resources that

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they have available.

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I think we all know that if we

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had an infinite team and infinite resources,

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you know, we could all be quite productive.

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But knowing the resources that you have and

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what's feasible with that,

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I think, is is good and then seeing

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what other people are doing with similar resources.

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That's fascinating to to hear about. And, you

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know, I can imagine having those targets and

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looking at, you know, what is available to

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you. I I know a lot of organizations

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are are in a similar

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situation in in trying to understand, you know,

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what makes the most sense for them so

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they can continue to provide excellent patient care

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even if

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they're they're still trying to go through and

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figure out exactly,

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what that productivity looks like and how to

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strengthen their teams. And so,

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you know, what from your perspective, what are

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the challenges that you see, especially in the

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field of pain management over the next 2

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to 3 years, and what are you really

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focusing on?

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Yeah. I think every year, and and, you

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know, I'm only 5 years post fellowship, there

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seem to be so many new technology and

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procedures that,

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we see being introduced into

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the field of, pain management.

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And

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I personally have found it quite difficult to

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know which ones are appropriate and feasible to

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really bring into my everyday practice.

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When I go

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to conferences or when I, talk with my

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colleagues, I find it helpful to really have

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them talk about their experience with different

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products and new techniques,

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before I'm really able to to introduce that.

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The other thing

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is most companies

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will provide training for a lot of these

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procedures. And so,

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you know, going to the trainings, whether it,

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you know, be at a big conference like

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NAMS, Aspen, WIPA,

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or one of the the private trainings they

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provide has been

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quite helpful.

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The other thing is knowing what resources these

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companies have for you.

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So being in a,

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kind of small Woodwest town, I

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wanna know if, the companies have reps that

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can come out and be there when I

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introduce their products or

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be there for the patients if the patients

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have questions,

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you know, provide me with pamphlets

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or,

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guides, things like that.

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I I definitely see where that would be

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extremely helpful to have, you know, the the

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companies and and make sure there's support on

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their from the reps.

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When you think about some of the different

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technologies that you've seen and experiences that you've

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had, is there anything that you're really excited

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about?

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So when I came out of

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fellowship,

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peripheral nerve stimulation

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had

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kind of had a moment where it was

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starting to flourish,

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and I really

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took on to that and started using it

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in my everyday practice even though in fellowship

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I had really only done it a few

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times.

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One

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one company in particular I found, quite easy

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to use their

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devices,

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and,

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I really started offering it almost as a

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Hail Mary. And,

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my patients have really loved it. It's really

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given me something else I can offer to

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them when there really isn't much else,

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to be done.

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And, you know, probably 50% or greater of

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the time, I've had good success with it,

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which for me is a big win. I

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think my biggest worry when I'm

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using products,

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I worry that

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the research and the promises that they're giving

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to me just aren't

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true.

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And so if I'm using a product and

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I've given it,

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you know, several tries, I would say 5

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to 10, and I haven't seen

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the success that was touted, you know, I

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I start to think to myself maybe it's

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something that

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I don't wanna continue on.

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That's really helpful perspective and especially, you know,

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wanting to make sure that you're actually seeing

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the results as you said with your patients

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and it's making sense for you. Now is

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there anything else that you think about when

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you're trying to decide which new procedures to

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integrate into your practice?

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Yeah. I I think that when new exciting

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things come out, you're always in a rush

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to,

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you know, go do it. And I find

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that giving yourself a little bit of time

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before integrating into your practice is good.

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1, because oftentimes, companies will develop parts of

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their products that weren't there right at the

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beginning stages, but, also, it gives you time

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to see,

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how other people have used the product or

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the techniques

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and really,

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you know, kind of form a plan on

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how you're going to,

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integrate it in your everyday practice.

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If

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I feel like something looks feasible and I

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wanna add it in,

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one of the first things I do

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is

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I really get these sheets that the that

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the reps can, give to you. They're almost

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like pro little pro formas.

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And then I bring it to

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the value analysis committee at my hospital, which

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I think is a a pretty common,

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entity where you basically present the product you

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wanna use

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and talk about

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how it's new and helpful for your patients

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and, really, how it's

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it's going to, you know, make money and

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the value that you're gonna bring to your,

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either hospital

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or practice.

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That makes a lot of sense. And, you

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know, I'm glad you mentioned having that opportunity

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to

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show, the value

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for any of the new types of procedures

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you're trying to bring in. I can imagine

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everything comes with a cost. And so when

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you're you're looking at the value and thinking

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about the value of what you're doing both

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for the patient as well as, the organization

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overall,

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package that in a way that really resonates

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within,

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the committee leadership?

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Yeah. So, 1, I usually tell them, you

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know, these are the number of patients that

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I think I'll have every month, every year.

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And then oftentimes,

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I've gotten buy ins from my partners,

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as well as, some of the other services

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that I work very closely with. So, for

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example, neurosurgery

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or, PM and R.

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And, really, with their buy in, I have

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found it's quite easy to move forward in

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saying that,

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this product or this technique is gonna be

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useful

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in the practice.

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That's great advice. Doctor Cheniere, thank you so

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much for joining us on the podcast today.

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This has been a really fascinating conversation, and

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I look forward to connecting with you again

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soon.

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Yes. Thank you for having me.