1 00:00:00,240 --> 00:00:03,220 Imagine this. You're at the Hyatt Regency Chicago 2 00:00:03,439 --> 00:00:05,859 surrounded by the top minds in the ambulatory 3 00:00:06,160 --> 00:00:07,540 surgery center industry. 4 00:00:07,919 --> 00:00:10,960 Welcome to the Becker's 30th annual meeting, the 5 00:00:10,960 --> 00:00:14,259 business and operations of ASCs from October 30th 6 00:00:14,400 --> 00:00:15,705 to November 2nd 7 00:00:16,324 --> 00:00:19,285 2024. Picture the excitement as you collect business 8 00:00:19,285 --> 00:00:22,184 cards from over a 1000 executive level attendees 9 00:00:22,404 --> 00:00:23,945 forging priceless connections. 10 00:00:24,404 --> 00:00:27,064 Feel the buzz of conversations as you participate 11 00:00:27,204 --> 00:00:29,969 in more than 60 sessions led by over 12 00:00:30,849 --> 00:00:33,030 225 elite ASC speakers. 13 00:00:33,649 --> 00:00:37,090 Envision yourself gaining actionable insights on topics like 14 00:00:37,090 --> 00:00:38,390 private equity strategies, 15 00:00:38,929 --> 00:00:43,030 ASC business growth, and innovations in spine, orthopedics, 16 00:00:43,635 --> 00:00:45,734 GI, ophthalmology, and cardiology. 17 00:00:46,354 --> 00:00:49,954 Now imagine yourself listening to inspiring keynotes from 18 00:00:49,954 --> 00:00:53,094 Hall of Fame boxing world champion, Lila Ali, 19 00:00:53,155 --> 00:00:56,879 and professional basketball player, Caitlin Clark. Their stories 20 00:00:56,879 --> 00:00:59,199 will motivate you to take your business to 21 00:00:59,199 --> 00:01:01,600 new heights. You'll leave with a wealth of 22 00:01:01,600 --> 00:01:03,920 knowledge and a network of connections to help 23 00:01:03,920 --> 00:01:06,719 lead your ASC into the next year. Don't 24 00:01:06,719 --> 00:01:09,619 miss out. Get registered today. Visit beckershospitalreviewdot 25 00:01:10,834 --> 00:01:12,754 com and click on the events page to 26 00:01:12,754 --> 00:01:15,094 find the conference website. That's the beckershospitalreview.com 27 00:01:17,075 --> 00:01:19,174 events page. See you in Chicago. 28 00:01:20,594 --> 00:01:22,834 This is Laura Dirda with the Becker's Healthcare 29 00:01:22,834 --> 00:01:23,334 podcast. 30 00:01:23,670 --> 00:01:25,349 I'm thrilled today to be joined by April 31 00:01:25,349 --> 00:01:27,989 Ernst, chief operating officer at Orlando Health Jewett 32 00:01:27,989 --> 00:01:30,390 Orthopedic Institute. April, it's a pleasure to have 33 00:01:30,390 --> 00:01:31,609 you on the podcast today. 34 00:01:32,229 --> 00:01:34,869 Thank you, Laura. It is really a pleasure 35 00:01:34,869 --> 00:01:36,170 to be here with you today. 36 00:01:37,215 --> 00:01:39,295 Now I'm looking forward to our conversation and 37 00:01:39,295 --> 00:01:40,894 really digging into some of the great things 38 00:01:40,894 --> 00:01:42,754 that you've been doing at the Jewett Orthopedic 39 00:01:42,814 --> 00:01:44,894 Institute. But before we dive in, can you 40 00:01:44,894 --> 00:01:46,334 tell me a little bit more about yourself 41 00:01:46,334 --> 00:01:47,155 and your background? 42 00:01:47,774 --> 00:01:48,274 Sure. 43 00:01:49,215 --> 00:01:50,744 Interestingly enough, I, 44 00:01:51,709 --> 00:01:54,030 started my career as a respiratory therapist. So 45 00:01:54,030 --> 00:01:56,849 something very far from orthopedics and spine 46 00:01:57,310 --> 00:01:59,729 care, but, I have spent 47 00:02:00,269 --> 00:02:02,049 27 years in, 48 00:02:02,909 --> 00:02:04,369 in hospital operations 49 00:02:04,670 --> 00:02:05,729 and health care, 50 00:02:06,704 --> 00:02:10,224 at Orlando Health in Orlando. Most of my 51 00:02:10,224 --> 00:02:13,125 career has been at Orlando Regional Medical Center, 52 00:02:13,344 --> 00:02:15,525 which was the or is the flagship 53 00:02:16,305 --> 00:02:19,525 for Orlando Health. Started as a respiratory therapist 54 00:02:19,905 --> 00:02:22,520 fresh out of out of school and, 55 00:02:23,140 --> 00:02:25,159 and remained in that field 56 00:02:25,700 --> 00:02:27,400 for the better part of 57 00:02:27,700 --> 00:02:29,000 24 years 58 00:02:29,460 --> 00:02:30,840 before I transitioned 59 00:02:31,219 --> 00:02:33,640 at the the same hospital over into, 60 00:02:35,145 --> 00:02:36,044 project operations. 61 00:02:36,504 --> 00:02:39,564 We were seeing such significant growth at 62 00:02:40,025 --> 00:02:41,965 at our hospital and, 63 00:02:42,664 --> 00:02:43,724 really embracing 64 00:02:44,344 --> 00:02:46,525 institutes and specialized care, 65 00:02:47,224 --> 00:02:49,564 for patients with with different conditions. 66 00:02:50,000 --> 00:02:50,500 And 67 00:02:50,800 --> 00:02:53,060 so we were growing those programs 68 00:02:53,680 --> 00:02:57,379 and, really required someone with a clinical background 69 00:02:58,000 --> 00:02:58,500 to, 70 00:02:59,039 --> 00:02:59,539 facilitate 71 00:03:00,239 --> 00:03:00,719 that, 72 00:03:01,360 --> 00:03:02,900 that growth in those projects 73 00:03:03,199 --> 00:03:06,105 and to ensure that we had clinical team 74 00:03:06,105 --> 00:03:08,284 members at the table as we were, 75 00:03:08,825 --> 00:03:10,365 creating these spaces, 76 00:03:11,224 --> 00:03:12,044 for patients 77 00:03:12,344 --> 00:03:15,245 and that would allow them to work efficiently 78 00:03:15,385 --> 00:03:17,564 and deliver the best care possible. 79 00:03:18,585 --> 00:03:20,099 So, after that, 80 00:03:20,500 --> 00:03:21,000 we, 81 00:03:21,460 --> 00:03:23,319 after that transition into that role, 82 00:03:23,700 --> 00:03:24,840 Orlando Health, 83 00:03:25,460 --> 00:03:28,340 began to build the Orlando Health Jewett Orthopedic 84 00:03:28,340 --> 00:03:28,840 Institute, 85 00:03:29,379 --> 00:03:31,000 and that was right across the street 86 00:03:31,540 --> 00:03:33,879 from the hospital that I was working in. 87 00:03:34,020 --> 00:03:35,319 So I had 88 00:03:36,165 --> 00:03:38,724 a great opportunity to to work on this 89 00:03:38,724 --> 00:03:39,224 project 90 00:03:40,245 --> 00:03:43,284 and really see it started from the ground 91 00:03:43,284 --> 00:03:44,905 up, and this was 92 00:03:45,284 --> 00:03:46,425 pretty much in 93 00:03:47,205 --> 00:03:47,705 early 94 00:03:49,009 --> 00:03:49,509 2021 95 00:03:49,889 --> 00:03:51,030 when we started. 96 00:03:51,490 --> 00:03:54,930 And, then as the facility went up and 97 00:03:54,930 --> 00:03:55,669 the programs, 98 00:03:56,689 --> 00:03:59,430 were being developed, I was given an opportunity 99 00:03:59,569 --> 00:04:01,030 to transfer over 100 00:04:02,115 --> 00:04:03,655 to the Orthopedic Institute, 101 00:04:03,955 --> 00:04:06,455 and so that's where I am today. 102 00:04:07,395 --> 00:04:09,314 That's amazing to hear, and what a great 103 00:04:09,314 --> 00:04:12,435 journey, from a respiratory therapist into more of 104 00:04:12,435 --> 00:04:14,854 administrative and leadership roles and really, 105 00:04:15,360 --> 00:04:16,959 leaning into spaces where you can make a 106 00:04:16,959 --> 00:04:19,279 big impact on the community. So that's great 107 00:04:19,279 --> 00:04:19,860 to hear. 108 00:04:20,639 --> 00:04:22,399 From your position and vantage point, 109 00:04:22,879 --> 00:04:24,720 at the Orthopedic Institute, what are some of 110 00:04:24,720 --> 00:04:27,199 the big headwinds that you're looking at and 111 00:04:27,199 --> 00:04:28,879 planning on for this year? What's top of 112 00:04:28,879 --> 00:04:29,779 mind for you? 113 00:04:31,024 --> 00:04:33,925 So, you know, we we have multiple factors 114 00:04:33,985 --> 00:04:37,024 that create a pretty complex landscape in health 115 00:04:37,024 --> 00:04:38,564 care. Right? No matter what 116 00:04:38,944 --> 00:04:41,125 what the specialty is, the environment 117 00:04:41,504 --> 00:04:43,925 is evolving and changing rapidly. 118 00:04:45,050 --> 00:04:47,550 What we have done is to actually embrace 119 00:04:48,410 --> 00:04:49,230 those headwinds 120 00:04:49,769 --> 00:04:51,709 and treat them as if they are tailwinds, 121 00:04:52,569 --> 00:04:55,290 that push us to be creative in our 122 00:04:55,290 --> 00:04:55,790 strategies 123 00:04:56,889 --> 00:04:58,029 and to be adaptable 124 00:04:58,730 --> 00:04:59,870 and really, 125 00:05:00,774 --> 00:05:01,274 just 126 00:05:01,654 --> 00:05:03,595 encourage us to solve for them, 127 00:05:04,294 --> 00:05:06,854 before they get in front of us, and 128 00:05:06,854 --> 00:05:08,794 and and we're too far behind. 129 00:05:09,175 --> 00:05:11,595 But but some of those things are really 130 00:05:11,894 --> 00:05:12,954 quite an opportunity 131 00:05:13,930 --> 00:05:16,029 in Central Florida where we live. 132 00:05:16,649 --> 00:05:18,509 We have an aging population 133 00:05:18,889 --> 00:05:20,750 here that we're seeing 134 00:05:21,129 --> 00:05:22,110 across the country, 135 00:05:22,410 --> 00:05:26,045 but, also, we're seeing a huge migration of 136 00:05:26,145 --> 00:05:28,817 people to Central Florida moving here. So what 137 00:05:28,817 --> 00:05:29,145 this is creating for us, really is, 138 00:05:30,025 --> 00:05:31,085 a tailwind that's 139 00:05:31,545 --> 00:05:32,444 pushing us. Okay. 140 00:05:33,384 --> 00:05:35,545 We've got to grow, and we've gotta grow 141 00:05:35,545 --> 00:05:36,045 faster. 142 00:05:39,170 --> 00:05:40,790 And what can we do, 143 00:05:41,889 --> 00:05:44,050 in order to to take care of these 144 00:05:44,050 --> 00:05:46,449 patients that are coming into our community? So 145 00:05:46,449 --> 00:05:47,189 real estate, 146 00:05:48,050 --> 00:05:50,370 is something that we are continually look at 147 00:05:50,689 --> 00:05:52,935 looking at. Where are people going in the 148 00:05:52,935 --> 00:05:55,115 market? Where do we need to provide orthopedic 149 00:05:55,175 --> 00:05:57,115 spine care for these patients? 150 00:05:58,055 --> 00:05:59,814 And where do we need to set up 151 00:05:59,814 --> 00:06:02,774 shop? So this is something that our team 152 00:06:02,774 --> 00:06:06,060 is is doing on a a consistent basis. 153 00:06:06,199 --> 00:06:09,100 We're consistently reviewing that market and determining 154 00:06:09,560 --> 00:06:12,060 where the best locations are for us, 155 00:06:12,680 --> 00:06:15,819 in our region. We do have a hub, 156 00:06:16,680 --> 00:06:19,019 on our downtown campus in Orlando 157 00:06:19,384 --> 00:06:22,365 where we have the institute, which is our, 158 00:06:23,384 --> 00:06:25,725 complex that takes care of patients 159 00:06:26,345 --> 00:06:27,725 outpatient and inpatient 160 00:06:28,264 --> 00:06:30,104 all under the same roof. We have a 161 00:06:30,104 --> 00:06:31,084 surgery center, 162 00:06:32,060 --> 00:06:33,259 on one side of our building, and then 163 00:06:33,259 --> 00:06:34,960 we have a hospital on the other side. 164 00:06:35,020 --> 00:06:37,020 So we do see the majority of our 165 00:06:37,020 --> 00:06:38,879 patients that will come downtown 166 00:06:39,420 --> 00:06:41,920 to receive their services on our downtown campus, 167 00:06:42,060 --> 00:06:43,980 but we also, you know, need to solve 168 00:06:43,980 --> 00:06:46,699 for patients that want to receive care in 169 00:06:46,699 --> 00:06:47,199 their 170 00:06:47,564 --> 00:06:50,625 in their communities close to home. So that's 171 00:06:50,685 --> 00:06:54,125 something that we are working through is growth. 172 00:06:54,125 --> 00:06:55,824 It's it's, you know, it's really, 173 00:06:57,245 --> 00:06:59,725 something that is a great opportunity for us 174 00:06:59,725 --> 00:07:00,625 in in expansion. 175 00:07:01,650 --> 00:07:03,029 Also, we're we're looking 176 00:07:03,490 --> 00:07:05,430 constantly at reimbursement pressure. 177 00:07:06,290 --> 00:07:09,170 I think everyone feels that. Health care payment 178 00:07:09,170 --> 00:07:09,670 models, 179 00:07:10,050 --> 00:07:13,490 value based care, that puts pressure on on 180 00:07:13,490 --> 00:07:14,230 our organization. 181 00:07:15,365 --> 00:07:17,705 But but it's good pressure. It's pressure that 182 00:07:17,764 --> 00:07:18,904 reduces cost. 183 00:07:19,605 --> 00:07:20,745 It's pressure that, 184 00:07:22,165 --> 00:07:23,625 makes us do better 185 00:07:24,245 --> 00:07:25,384 in quality, 186 00:07:25,925 --> 00:07:28,584 providing quality care for our patients. 187 00:07:30,084 --> 00:07:33,210 So we have to always have our eye 188 00:07:33,210 --> 00:07:33,790 on that 189 00:07:34,330 --> 00:07:36,730 as we look towards the future. How do 190 00:07:36,730 --> 00:07:38,810 we provide quality care? How do we set 191 00:07:38,810 --> 00:07:39,550 up programs 192 00:07:40,170 --> 00:07:40,670 that, 193 00:07:41,129 --> 00:07:43,310 make it easy for patients to navigate? 194 00:07:44,595 --> 00:07:47,254 How do we ensure that 195 00:07:47,555 --> 00:07:49,335 patients have access 196 00:07:49,955 --> 00:07:52,535 to our team anytime that they need it 197 00:07:52,595 --> 00:07:55,235 in order to provide that quality care, to 198 00:07:55,235 --> 00:07:56,855 have those outcomes recorded, 199 00:07:57,379 --> 00:07:58,839 to have that track record, 200 00:07:59,379 --> 00:08:01,720 with insurance companies, with Medicare. 201 00:08:02,180 --> 00:08:03,639 So that reimbursement 202 00:08:03,939 --> 00:08:06,039 pressure is is not necessarily 203 00:08:06,339 --> 00:08:07,560 as heavy for us. 204 00:08:08,740 --> 00:08:11,544 So always have our eye on that. Also, 205 00:08:11,544 --> 00:08:13,785 the shift towards outpatient care. We know in 206 00:08:13,785 --> 00:08:16,285 orthopedics and spine, we're seeing that flip. 207 00:08:17,144 --> 00:08:17,644 Inpatient, 208 00:08:19,064 --> 00:08:21,305 procedures are now being done in the outpatient 209 00:08:21,305 --> 00:08:21,805 setting. 210 00:08:22,185 --> 00:08:25,419 So we have to look towards the future 211 00:08:25,560 --> 00:08:27,959 where patients going to receive this care. They're 212 00:08:27,959 --> 00:08:30,220 probably going to receive them in surgery centers 213 00:08:30,279 --> 00:08:33,559 and ambulatory surgery centers. So, again, we have 214 00:08:33,559 --> 00:08:35,480 to look at the market, assess the market, 215 00:08:35,480 --> 00:08:38,039 determine where patients are moving to, where they 216 00:08:38,039 --> 00:08:40,315 live, where do we need to invest in 217 00:08:40,315 --> 00:08:41,214 surgery centers, 218 00:08:42,315 --> 00:08:44,794 in their communities so they can receive that 219 00:08:44,794 --> 00:08:45,615 that care. 220 00:08:46,714 --> 00:08:50,154 Rising cost. There's there's always supply chain, and, 221 00:08:50,714 --> 00:08:54,190 we have experienced rising cross rising cost across 222 00:08:54,190 --> 00:08:54,690 the 223 00:08:56,110 --> 00:08:58,129 the country and almost everything. 224 00:08:58,669 --> 00:08:59,889 The same thing applies 225 00:09:00,429 --> 00:09:02,990 for to our implants, to the materials we 226 00:09:02,990 --> 00:09:03,490 use. 227 00:09:03,949 --> 00:09:06,929 Controlling cost is a significant challenge 228 00:09:07,684 --> 00:09:09,365 for for most of us, and this is 229 00:09:09,365 --> 00:09:12,184 something that we always have to have our 230 00:09:12,725 --> 00:09:15,684 eye on. We're also seeing patients. They they 231 00:09:15,684 --> 00:09:16,584 want nonsurgical 232 00:09:17,125 --> 00:09:17,625 alternatives. 233 00:09:18,404 --> 00:09:21,225 So while that may be in biologics, 234 00:09:22,419 --> 00:09:25,159 through physical therapy, through lifestyle modifications, 235 00:09:25,940 --> 00:09:28,279 those are not necessarily something that surgeons, 236 00:09:29,220 --> 00:09:32,019 are embedded in their practice, but we as 237 00:09:32,019 --> 00:09:32,759 an institute, 238 00:09:33,699 --> 00:09:35,220 are looking to that. We want to have 239 00:09:35,220 --> 00:09:36,644 a comprehensive approach 240 00:09:37,125 --> 00:09:37,625 that, 241 00:09:38,325 --> 00:09:38,825 satisfies 242 00:09:39,605 --> 00:09:40,665 patients' needs, 243 00:09:41,684 --> 00:09:43,764 where we can meet patients where they are. 244 00:09:43,764 --> 00:09:45,925 And if there's an opportunity for us to 245 00:09:45,925 --> 00:09:48,105 provide a nonsurgical opportunity, 246 00:09:49,285 --> 00:09:51,684 or or alternative, then then we want to 247 00:09:51,684 --> 00:09:53,490 be the ones that do that. 248 00:09:54,029 --> 00:09:57,149 Also, there's there are advancements in robotics. And 249 00:09:57,149 --> 00:09:58,129 so the technology 250 00:09:58,750 --> 00:09:59,250 advancement 251 00:09:59,950 --> 00:10:00,690 is something 252 00:10:00,990 --> 00:10:02,050 that is 253 00:10:02,750 --> 00:10:03,250 really 254 00:10:03,710 --> 00:10:04,210 abundant, 255 00:10:04,590 --> 00:10:06,514 and it's very rapid. 256 00:10:07,054 --> 00:10:10,334 So keeping up with the latest technology, ensuring 257 00:10:10,334 --> 00:10:12,514 that our our surgeons are trained, 258 00:10:13,134 --> 00:10:15,454 and able to utilize this technology is very 259 00:10:15,454 --> 00:10:18,735 important. We are very, very lucky to have 260 00:10:18,735 --> 00:10:20,194 a bioskills lab, 261 00:10:21,329 --> 00:10:22,470 in our institute, 262 00:10:23,169 --> 00:10:26,129 10 Station Cadaver Lab, that we are able 263 00:10:26,129 --> 00:10:27,990 to bring in our industry partners 264 00:10:28,610 --> 00:10:29,589 with their technology 265 00:10:30,129 --> 00:10:32,450 and train our surgeons right there in our 266 00:10:32,450 --> 00:10:34,450 building so they don't have to go out 267 00:10:34,450 --> 00:10:35,190 for training. 268 00:10:35,654 --> 00:10:38,214 So we do have that advantage that we 269 00:10:38,214 --> 00:10:39,754 can continue to keep our surgeons 270 00:10:40,214 --> 00:10:42,554 up on the the latest technology. 271 00:10:43,014 --> 00:10:44,774 So those are some of the things that 272 00:10:44,774 --> 00:10:46,634 we're looking at as opportunities 273 00:10:47,014 --> 00:10:49,674 as we move into to the next year. 274 00:10:50,919 --> 00:10:52,600 That's really amazing to hear, and thank you 275 00:10:52,600 --> 00:10:54,360 so much for the overview. As you mentioned, 276 00:10:54,360 --> 00:10:57,240 there's so many different, factors that come into 277 00:10:57,240 --> 00:10:59,179 just how you're thinking about growth and development, 278 00:10:59,240 --> 00:11:00,725 whether it's from, as you said, you know, 279 00:11:00,725 --> 00:11:00,845 migration to the Florida area, trying to figure 280 00:11:00,845 --> 00:11:01,500 out where people are going and where 281 00:11:01,845 --> 00:11:03,764 trying to figure out where people are going 282 00:11:03,764 --> 00:11:05,365 and where surgery should be done inpatient versus 283 00:11:05,365 --> 00:11:05,708 outpatient. And then too, you know, I'm very 284 00:11:05,708 --> 00:11:07,044 interested in this idea of, looking at some 285 00:11:07,044 --> 00:11:07,544 of 286 00:11:07,924 --> 00:11:09,924 the costs as well as, you know, reimbursement 287 00:11:09,924 --> 00:11:10,424 shifts 288 00:11:15,909 --> 00:11:17,429 in in health care. I know that's something 289 00:11:17,429 --> 00:11:18,809 top of mind for so many, 290 00:11:19,269 --> 00:11:22,309 orthopedic practices and spine groups across the country 291 00:11:22,309 --> 00:11:23,049 as well. 292 00:11:23,590 --> 00:11:25,909 You mentioned kind of how you're thinking about, 293 00:11:26,309 --> 00:11:28,230 some of the different ways you can measure 294 00:11:28,230 --> 00:11:30,794 and report and check outcomes and and look 295 00:11:30,794 --> 00:11:33,475 at, you know, your relationships with insurance companies 296 00:11:33,615 --> 00:11:35,855 and and value based care as well. Where 297 00:11:35,855 --> 00:11:37,615 are you, you know, when you're thinking about, 298 00:11:37,855 --> 00:11:39,534 some of those different kinds of unique, 299 00:11:40,095 --> 00:11:40,995 payment methodologies 300 00:11:41,375 --> 00:11:42,914 or value based arrangements? 301 00:11:43,360 --> 00:11:45,440 Is that something that you've done for years 302 00:11:45,440 --> 00:11:47,600 at at Jewett Orthopedic Institute, or is it, 303 00:11:47,600 --> 00:11:50,080 you know, something you're dipping your toe into 304 00:11:50,080 --> 00:11:51,679 currently and and trying to figure out what 305 00:11:51,679 --> 00:11:52,500 works best? 306 00:11:52,960 --> 00:11:55,940 Yeah. So as as an organization at Orlando 307 00:11:56,000 --> 00:11:56,480 Health, 308 00:11:57,120 --> 00:11:59,504 this is something that we're we are always 309 00:11:59,504 --> 00:12:00,004 watching. 310 00:12:00,384 --> 00:12:02,464 It's really vital to the success of an 311 00:12:02,464 --> 00:12:02,964 organization. 312 00:12:03,585 --> 00:12:04,085 And, 313 00:12:05,024 --> 00:12:08,085 and what we understand is that insurance companies, 314 00:12:08,945 --> 00:12:10,164 value based care, 315 00:12:11,184 --> 00:12:12,245 that that approach 316 00:12:13,629 --> 00:12:15,490 really wants to ensure 317 00:12:16,190 --> 00:12:16,690 that 318 00:12:17,070 --> 00:12:18,209 patients are receiving 319 00:12:19,149 --> 00:12:20,450 high quality care 320 00:12:20,830 --> 00:12:25,169 because that reduce cost. Right? And it also, 321 00:12:26,110 --> 00:12:28,324 contributes to patient satisfaction. 322 00:12:28,865 --> 00:12:31,024 So this is something that we are doing 323 00:12:31,024 --> 00:12:33,904 at Orlando Health Jewett Orthopedic Institute. This is 324 00:12:33,904 --> 00:12:36,064 almost on a daily basis that we are 325 00:12:36,064 --> 00:12:37,684 reviewing our quality metrics, 326 00:12:38,784 --> 00:12:41,345 not not only just with our administrative team, 327 00:12:41,345 --> 00:12:42,644 but our frontline staff, 328 00:12:42,980 --> 00:12:44,120 with our physicians, 329 00:12:44,559 --> 00:12:45,059 with 330 00:12:45,500 --> 00:12:46,000 our, 331 00:12:47,379 --> 00:12:50,679 our caregivers in the clinics, with our navigators. 332 00:12:50,980 --> 00:12:54,440 We've institute instituted a nurse navigation program 333 00:12:54,899 --> 00:12:56,759 that allows us to be 334 00:12:57,554 --> 00:12:59,634 walking step by step, hand in hand with 335 00:12:59,634 --> 00:13:01,495 the patient along their journey 336 00:13:01,875 --> 00:13:02,855 with us from 337 00:13:03,154 --> 00:13:05,335 the moment that they're scheduled for surgery 338 00:13:05,794 --> 00:13:07,815 until they are are discharged, 339 00:13:08,355 --> 00:13:10,995 from rehab, you know, until they complete that 340 00:13:10,995 --> 00:13:12,215 journey with us. 341 00:13:13,269 --> 00:13:14,570 And all the while, 342 00:13:14,950 --> 00:13:17,049 we are ensuring that 343 00:13:17,669 --> 00:13:20,649 all of the the quality standards are met. 344 00:13:20,789 --> 00:13:23,110 And those those standards are things like, what 345 00:13:23,110 --> 00:13:24,970 is the length of stay for a patient? 346 00:13:25,110 --> 00:13:26,870 We know that it's best to be able 347 00:13:26,870 --> 00:13:29,184 to get patients out and back home 348 00:13:29,565 --> 00:13:32,044 from the hospital after surgery as quick as 349 00:13:32,044 --> 00:13:34,544 we possibly can. You're in a safer environment 350 00:13:34,605 --> 00:13:36,764 in in your home, right, when when you 351 00:13:36,764 --> 00:13:37,745 look at it from, 352 00:13:38,445 --> 00:13:41,710 the quality perspective. We're also looking at where 353 00:13:41,710 --> 00:13:44,269 are we discharging our patients to. The best 354 00:13:44,269 --> 00:13:47,090 environment to discharge our patients to is home. 355 00:13:48,190 --> 00:13:49,889 If if we are 356 00:13:50,509 --> 00:13:52,289 having to focus efforts on 357 00:13:52,669 --> 00:13:55,475 preparing patients to go to a skilled nursing 358 00:13:55,475 --> 00:13:56,195 facility or, 359 00:13:57,955 --> 00:14:00,054 an inpatient rehab facility, 360 00:14:01,154 --> 00:14:03,414 then maybe that patient's not necessarily 361 00:14:03,875 --> 00:14:07,200 a great candidate right now for surgery, and 362 00:14:07,200 --> 00:14:09,759 maybe we need to optimize them before we 363 00:14:09,759 --> 00:14:12,080 have surgery so that we can ensure that 364 00:14:12,080 --> 00:14:14,800 they go home. So, we are really working 365 00:14:14,800 --> 00:14:15,620 on our presurgical 366 00:14:15,920 --> 00:14:16,420 optimization 367 00:14:16,800 --> 00:14:17,620 with our patients, 368 00:14:18,000 --> 00:14:19,460 making sure that 369 00:14:19,955 --> 00:14:22,695 they receive the proper nutrition prior to surgery. 370 00:14:23,554 --> 00:14:26,134 Believe it or not, we have malnourished patients, 371 00:14:26,434 --> 00:14:28,674 and we need to take care of those 372 00:14:28,674 --> 00:14:31,394 patients to make sure they're in prime condition 373 00:14:31,394 --> 00:14:32,535 prior to their surgery 374 00:14:32,995 --> 00:14:34,934 as well as our patients that 375 00:14:35,319 --> 00:14:36,059 are obese. 376 00:14:37,000 --> 00:14:39,559 So we have those patients that that along 377 00:14:39,559 --> 00:14:41,100 that that span 378 00:14:41,639 --> 00:14:43,419 that we have to solve for, 379 00:14:44,039 --> 00:14:45,959 and we wanna solve for them up front. 380 00:14:45,959 --> 00:14:48,839 You know, you have comorbidity, comorbidity, such as 381 00:14:48,839 --> 00:14:49,339 as 382 00:14:49,745 --> 00:14:50,245 diabetes, 383 00:14:50,865 --> 00:14:52,804 cardiovascular diseases, osteoporosis. 384 00:14:53,424 --> 00:14:55,044 We have to solve for those 385 00:14:55,424 --> 00:14:58,464 before we do surgery to ensure best outcomes 386 00:14:58,464 --> 00:15:00,945 for those patients. We don't want those patients 387 00:15:00,945 --> 00:15:03,845 to be readmitted after they're sent home 388 00:15:04,300 --> 00:15:05,519 with with complications. 389 00:15:06,139 --> 00:15:07,600 We want them to have a successful, 390 00:15:08,379 --> 00:15:10,559 surgery and a successful recovery 391 00:15:10,940 --> 00:15:11,920 in their home, 392 00:15:12,860 --> 00:15:15,279 with very minimal, if any, 393 00:15:16,059 --> 00:15:16,559 complications 394 00:15:16,860 --> 00:15:17,680 or readmissions. 395 00:15:18,394 --> 00:15:20,235 And and so those are the things that 396 00:15:20,235 --> 00:15:22,975 we are working on, and and that requires 397 00:15:23,514 --> 00:15:24,735 a a laser 398 00:15:25,195 --> 00:15:26,335 light focus 399 00:15:27,115 --> 00:15:27,615 on 400 00:15:28,235 --> 00:15:30,174 really connecting with the patient 401 00:15:30,639 --> 00:15:33,440 throughout their entire journey. So we don't leave 402 00:15:33,440 --> 00:15:34,899 anything, any uncertainties 403 00:15:35,360 --> 00:15:36,100 to them. 404 00:15:36,720 --> 00:15:39,039 We want to solve all of that for 405 00:15:39,039 --> 00:15:40,179 them with them. 406 00:15:41,440 --> 00:15:42,959 I love that. That's such a a great 407 00:15:42,959 --> 00:15:44,959 way to think about it and really make 408 00:15:44,959 --> 00:15:45,459 sure, 409 00:15:45,804 --> 00:15:46,785 you know, those 410 00:15:47,165 --> 00:15:47,985 kind of new, 411 00:15:48,845 --> 00:15:49,345 technologies 412 00:15:49,804 --> 00:15:51,725 and new ways of connecting with patients and 413 00:15:51,725 --> 00:15:53,725 really serving them better are coming to the 414 00:15:53,725 --> 00:15:54,225 forefront. 415 00:15:54,845 --> 00:15:57,404 Now I'm wondering, you know, given your your 416 00:15:57,404 --> 00:15:59,245 position, how do you see the field of 417 00:15:59,245 --> 00:16:01,370 spine orthopedics evolving over the next 2 to 418 00:16:01,370 --> 00:16:02,350 3 years? What's, 419 00:16:03,129 --> 00:16:05,230 going to be be paramount for, 420 00:16:05,850 --> 00:16:06,350 practices 421 00:16:06,889 --> 00:16:09,129 in surgeons and those in the industry as 422 00:16:09,129 --> 00:16:10,889 they're trying to make sure, as you mentioned, 423 00:16:10,889 --> 00:16:12,570 they're able to care for patients and and 424 00:16:12,570 --> 00:16:13,070 really, 425 00:16:14,490 --> 00:16:16,269 expand access to care? 426 00:16:17,095 --> 00:16:19,575 Yeah. I I think that what we're seeing 427 00:16:19,575 --> 00:16:21,915 is, you know, the continued push to 428 00:16:22,375 --> 00:16:24,634 the outpatient setting. Right? So 429 00:16:25,014 --> 00:16:27,995 really planning for that. And and it takes 430 00:16:28,134 --> 00:16:29,835 it takes a good 3 years 431 00:16:30,700 --> 00:16:33,339 to to plan for facilities that can take 432 00:16:33,339 --> 00:16:35,259 pay take care of patients in in the 433 00:16:35,259 --> 00:16:36,959 outpatient setting. So, 434 00:16:37,820 --> 00:16:41,419 you have to start your strategic planning 3 435 00:16:41,419 --> 00:16:43,259 to 5 years in advance. You have to 436 00:16:43,259 --> 00:16:44,959 be looking towards the future 437 00:16:45,375 --> 00:16:47,535 at all times and be willing to adjust 438 00:16:47,535 --> 00:16:48,195 as needed 439 00:16:48,894 --> 00:16:51,934 in order to solve for that pay patient 440 00:16:51,934 --> 00:16:52,434 population. 441 00:16:52,975 --> 00:16:55,294 So ensuring that that you have, 442 00:16:55,934 --> 00:16:56,995 enough outpatient, 443 00:16:58,110 --> 00:17:00,930 settings for patients to receive care, ambulatory 444 00:17:01,550 --> 00:17:02,529 surgical center, 445 00:17:03,230 --> 00:17:05,970 are are a must. And, you know, 446 00:17:06,830 --> 00:17:08,750 not only is it good for patients, they 447 00:17:08,750 --> 00:17:10,109 go in, they have their surgery, they go 448 00:17:10,109 --> 00:17:11,170 home the same day, 449 00:17:11,710 --> 00:17:13,585 but it it provides care at a lower 450 00:17:13,585 --> 00:17:14,085 cost. 451 00:17:15,184 --> 00:17:15,684 So 452 00:17:15,984 --> 00:17:18,404 these these are things that are important 453 00:17:18,704 --> 00:17:22,464 to patients, important to payers. So you we 454 00:17:22,464 --> 00:17:24,724 we really are focusing on 455 00:17:25,105 --> 00:17:28,085 how we can get in front of 456 00:17:28,990 --> 00:17:31,730 that complete shift and flip towards, 457 00:17:32,349 --> 00:17:35,250 providing care in an ambulatory setting. Also, 458 00:17:35,630 --> 00:17:36,130 advancements 459 00:17:36,750 --> 00:17:37,569 in robotics. 460 00:17:39,470 --> 00:17:42,365 As I mentioned before, the use of robotic 461 00:17:42,424 --> 00:17:43,484 systems technology 462 00:17:43,865 --> 00:17:44,605 is advancing 463 00:17:44,904 --> 00:17:45,644 so rapidly 464 00:17:46,345 --> 00:17:49,065 that you have to be able to look 465 00:17:49,065 --> 00:17:50,205 ahead and determine 466 00:17:50,825 --> 00:17:52,285 what types of technology, 467 00:17:53,625 --> 00:17:55,484 is gonna be most beneficial 468 00:17:55,865 --> 00:17:56,365 to 469 00:17:56,799 --> 00:17:58,660 your practice, to your surgeons, 470 00:17:59,680 --> 00:18:01,759 and and get ahead of that and be 471 00:18:01,759 --> 00:18:03,940 part of that be part of that 472 00:18:04,400 --> 00:18:05,539 push in technology 473 00:18:05,920 --> 00:18:06,660 with industry. 474 00:18:07,279 --> 00:18:08,180 Form partnerships 475 00:18:08,559 --> 00:18:09,220 with industry, 476 00:18:10,240 --> 00:18:12,934 that are are no longer adversarial 477 00:18:13,795 --> 00:18:15,954 but beneficial to each. You know, I think 478 00:18:15,954 --> 00:18:17,974 there's that nash that that natural 479 00:18:18,515 --> 00:18:19,015 tension 480 00:18:19,394 --> 00:18:20,295 that's created 481 00:18:20,674 --> 00:18:21,174 between 482 00:18:21,634 --> 00:18:22,535 industry partners 483 00:18:23,234 --> 00:18:23,734 and 484 00:18:24,390 --> 00:18:26,890 providers, health care providers like ourselves. 485 00:18:27,190 --> 00:18:29,450 But what we've done is actually 486 00:18:30,070 --> 00:18:32,170 turn that to a relationship. 487 00:18:33,190 --> 00:18:35,670 We we have some great industry partners that 488 00:18:35,670 --> 00:18:36,789 we're at the table with, 489 00:18:37,269 --> 00:18:38,025 every month, 490 00:18:38,984 --> 00:18:41,484 and we are working to solve for these, 491 00:18:42,585 --> 00:18:44,605 these advancements in in technology 492 00:18:45,144 --> 00:18:45,644 together. 493 00:18:46,585 --> 00:18:49,305 We're part of their solution. We're part of 494 00:18:49,305 --> 00:18:50,765 their their development. 495 00:18:51,890 --> 00:18:53,669 So I think that that is something 496 00:18:54,130 --> 00:18:57,569 that, is very important that orthopedics and spine 497 00:18:57,569 --> 00:18:58,630 care providers 498 00:19:00,529 --> 00:19:02,450 are a part of and and is and 499 00:19:02,450 --> 00:19:05,644 that is being being at the table when 500 00:19:05,704 --> 00:19:07,644 when new technology is being creative 501 00:19:08,024 --> 00:19:08,765 or created. 502 00:19:09,464 --> 00:19:09,964 Implants, 503 00:19:10,984 --> 00:19:13,625 you know, we are also seeing some talk 504 00:19:13,625 --> 00:19:14,125 about 505 00:19:14,904 --> 00:19:17,224 3 d printing. We we actually had a 506 00:19:17,224 --> 00:19:18,750 a half a 3 d printer in our 507 00:19:18,910 --> 00:19:20,930 facility that we've been able to use, 508 00:19:21,789 --> 00:19:23,089 to to create 509 00:19:23,710 --> 00:19:24,930 certain anatomy 510 00:19:25,309 --> 00:19:25,789 and, 511 00:19:26,509 --> 00:19:28,670 have our our physicians be able to look 512 00:19:28,670 --> 00:19:31,150 at that and and and determine what's what 513 00:19:31,150 --> 00:19:33,490 their best approach to surgery to their procedure 514 00:19:33,549 --> 00:19:36,025 is going to be using patients' 515 00:19:37,525 --> 00:19:38,265 own customized, 516 00:19:39,125 --> 00:19:41,464 anatomy. It's it's there. It's their 517 00:19:41,924 --> 00:19:44,085 anatomy right there that we're able to print, 518 00:19:44,085 --> 00:19:44,984 and our surgeons 519 00:19:45,444 --> 00:19:47,944 can potentially practice their case, 520 00:19:48,565 --> 00:19:49,065 before 521 00:19:49,460 --> 00:19:51,640 before actually performing it on 522 00:19:51,940 --> 00:19:53,799 on their patients. We're seeing, 523 00:19:54,339 --> 00:19:54,839 augmented 524 00:19:55,220 --> 00:19:57,160 augmented and virtual reality 525 00:19:57,539 --> 00:20:00,019 that is something that is consistently used in 526 00:20:00,019 --> 00:20:00,680 our practice 527 00:20:01,220 --> 00:20:01,700 in, 528 00:20:02,180 --> 00:20:03,894 our our surgical cases. 529 00:20:04,515 --> 00:20:05,015 And, 530 00:20:05,794 --> 00:20:09,095 this is really being embraced by our team. 531 00:20:09,315 --> 00:20:11,734 And we, you know, we know AI 532 00:20:12,674 --> 00:20:15,794 can can be scary. Right? And and and 533 00:20:15,794 --> 00:20:18,569 what does AI really mean? You know? And 534 00:20:18,730 --> 00:20:20,909 and how do you really want to use 535 00:20:21,609 --> 00:20:23,789 AI in the future? We know it's here. 536 00:20:24,730 --> 00:20:27,230 We know that we're going to have to 537 00:20:27,289 --> 00:20:27,789 learn 538 00:20:28,169 --> 00:20:29,069 how to work 539 00:20:29,690 --> 00:20:31,690 with it. And so how do we best 540 00:20:31,690 --> 00:20:33,984 do that? What is best for our practice? 541 00:20:33,984 --> 00:20:35,365 What is best for our surgeons? 542 00:20:36,785 --> 00:20:37,285 Telemedicine 543 00:20:37,825 --> 00:20:40,325 patients really want to, 544 00:20:41,345 --> 00:20:43,984 receive care in their home, and so we're 545 00:20:43,984 --> 00:20:46,545 looking at that. We have incorporated telemedicine into 546 00:20:46,545 --> 00:20:47,205 our practices, 547 00:20:48,710 --> 00:20:51,910 probably similar to many others out there. But 548 00:20:51,910 --> 00:20:54,309 this is just providing convenient care for our 549 00:20:54,309 --> 00:20:54,809 patients, 550 00:20:56,230 --> 00:20:58,090 in their home environment, 551 00:20:58,710 --> 00:21:00,570 reducing the burden on them 552 00:21:00,924 --> 00:21:02,845 to, you know, have to come in for 553 00:21:02,845 --> 00:21:04,625 a clinic visit. Transportation 554 00:21:04,924 --> 00:21:07,005 can be a challenge for for a lot 555 00:21:07,005 --> 00:21:08,924 of patients. So how can we meet our 556 00:21:08,924 --> 00:21:11,984 patients where they are and provide 557 00:21:12,684 --> 00:21:14,545 the the best care to them, 558 00:21:15,339 --> 00:21:16,559 using technology 559 00:21:17,099 --> 00:21:18,559 that we have at our fingertips. 560 00:21:20,059 --> 00:21:21,659 I love that. I I think there's so 561 00:21:21,659 --> 00:21:23,659 much there as you mentioned, just thinking about 562 00:21:23,659 --> 00:21:24,319 the technology, 563 00:21:24,700 --> 00:21:26,859 whether it's robotics and and how that can 564 00:21:26,859 --> 00:21:29,099 make the most sense for each individual practice 565 00:21:29,099 --> 00:21:32,194 or artificial intelligence and incorporating that into the 566 00:21:32,194 --> 00:21:32,694 broader 567 00:21:33,154 --> 00:21:35,154 operations as well as clinical care. I I 568 00:21:35,154 --> 00:21:37,234 can imagine there's just so much information and 569 00:21:37,234 --> 00:21:40,035 so much change. It's, you know, sometimes overwhelming, 570 00:21:40,035 --> 00:21:41,954 but at the same time, really exciting to 571 00:21:41,954 --> 00:21:42,900 think about how, 572 00:21:43,859 --> 00:21:45,000 health care is changing 573 00:21:45,299 --> 00:21:47,539 in really able to better serve patients in 574 00:21:47,539 --> 00:21:48,200 the future. 575 00:21:49,460 --> 00:21:51,220 Now I I know we've talked a lot 576 00:21:51,220 --> 00:21:51,960 about growth, 577 00:21:52,420 --> 00:21:53,080 you know, 578 00:21:53,619 --> 00:21:56,234 throughout our conversation, but I'm wondering, you know, 579 00:21:56,234 --> 00:21:58,315 when you think about the future, both near 580 00:21:58,315 --> 00:21:59,434 and long term, what do you see as 581 00:21:59,434 --> 00:22:01,434 some of the best opportunities for growth and 582 00:22:01,434 --> 00:22:02,654 development going forward? 583 00:22:03,994 --> 00:22:05,035 Yeah. So, 584 00:22:05,515 --> 00:22:08,075 this this is something that we work on 585 00:22:08,075 --> 00:22:10,710 every day and we talk about every day, 586 00:22:10,789 --> 00:22:13,049 and I think it's very important that 587 00:22:13,509 --> 00:22:17,349 orthopedic spine practices and and organizations that support 588 00:22:17,349 --> 00:22:18,250 them do. 589 00:22:19,750 --> 00:22:23,109 You have to always be looking towards the 590 00:22:23,109 --> 00:22:24,950 future and how are we gonna care for 591 00:22:24,950 --> 00:22:26,169 patients in the future. 592 00:22:26,595 --> 00:22:28,674 And, you know, we we've talked about some 593 00:22:28,674 --> 00:22:30,134 of those things, but I think, 594 00:22:30,914 --> 00:22:32,054 the the 595 00:22:32,595 --> 00:22:33,095 trends 596 00:22:33,554 --> 00:22:35,954 suggest, and we know that it is here. 597 00:22:35,954 --> 00:22:37,095 We know that 598 00:22:37,634 --> 00:22:39,414 we have to become 599 00:22:40,090 --> 00:22:42,750 a comprehensive care provider for our patients. 600 00:22:43,130 --> 00:22:45,150 We have to be patient centered. 601 00:22:45,529 --> 00:22:47,710 We have to leverage our technology, 602 00:22:48,490 --> 00:22:49,630 our care models, 603 00:22:50,170 --> 00:22:51,150 our outcomes. 604 00:22:51,610 --> 00:22:53,529 We have to reduce costs. We have to 605 00:22:53,529 --> 00:22:54,990 enhance the patient experience. 606 00:22:55,369 --> 00:22:58,224 So we always have to be looking towards 607 00:22:58,224 --> 00:23:00,085 that and how we can do 608 00:23:00,705 --> 00:23:01,765 that more efficiently, 609 00:23:02,144 --> 00:23:02,805 more effectively. 610 00:23:03,424 --> 00:23:04,325 We know that 611 00:23:04,865 --> 00:23:06,945 meeting patients where they are in the outpatient 612 00:23:06,945 --> 00:23:08,325 setting in their communities, 613 00:23:09,265 --> 00:23:10,565 is very, very important. 614 00:23:10,980 --> 00:23:12,519 So looking forward, 615 00:23:13,140 --> 00:23:15,319 we talked about this before as well, Florida 616 00:23:15,460 --> 00:23:18,019 being just a place where we are seeing 617 00:23:18,019 --> 00:23:19,240 a huge population, 618 00:23:20,339 --> 00:23:20,839 boom. 619 00:23:22,179 --> 00:23:23,400 Where do we invest 620 00:23:23,794 --> 00:23:25,794 in those facilities to take care of those 621 00:23:25,794 --> 00:23:27,974 patients? Ambulatory surgery centers 622 00:23:28,434 --> 00:23:30,755 are are that, and and those are the 623 00:23:30,755 --> 00:23:32,515 things that we have to focus on and 624 00:23:32,515 --> 00:23:34,434 we have to start planning for right now. 625 00:23:34,434 --> 00:23:36,054 We have to plan for these today. 626 00:23:36,595 --> 00:23:38,849 Construction costs are rising. 627 00:23:39,470 --> 00:23:40,849 How do we solve for that? 628 00:23:41,630 --> 00:23:44,210 So, those are the things we're looking at, 629 00:23:44,349 --> 00:23:47,250 and we we also are embracing 630 00:23:48,669 --> 00:23:51,484 robotics as we've talked about and the navigation 631 00:23:51,865 --> 00:23:52,365 systems. 632 00:23:53,065 --> 00:23:54,204 These are really 633 00:23:54,744 --> 00:23:57,644 important as they continue to improve 634 00:23:58,105 --> 00:23:58,605 daily. 635 00:23:59,545 --> 00:24:02,184 The the development that's being done in this 636 00:24:02,184 --> 00:24:02,684 area 637 00:24:03,380 --> 00:24:03,880 significant, 638 00:24:04,420 --> 00:24:07,059 and we know that patients are more likely 639 00:24:07,059 --> 00:24:09,400 to choose us if we have, 640 00:24:10,019 --> 00:24:13,000 cutting edge robotic systems. We just know that. 641 00:24:13,620 --> 00:24:16,660 Patients ask for that. So we want to 642 00:24:16,660 --> 00:24:19,154 be able to offer that, and we also 643 00:24:19,454 --> 00:24:21,555 have to make sure that we're training 644 00:24:22,654 --> 00:24:23,394 our surgeons 645 00:24:23,855 --> 00:24:25,855 and all of our physicians to be able 646 00:24:25,855 --> 00:24:26,355 to 647 00:24:27,134 --> 00:24:28,195 use this technology 648 00:24:29,055 --> 00:24:31,295 and provide the best care for their patients. 649 00:24:31,295 --> 00:24:34,940 So utilizing our bioskills lab is very important 650 00:24:35,080 --> 00:24:38,279 in in this area of technology and really 651 00:24:38,279 --> 00:24:41,019 being ready to take care of of patients. 652 00:24:41,720 --> 00:24:42,220 So, 653 00:24:42,680 --> 00:24:43,340 you know, 654 00:24:43,799 --> 00:24:44,860 I mentioned biologics 655 00:24:45,784 --> 00:24:47,865 a little bit earlier. Patients are seeking that. 656 00:24:47,865 --> 00:24:49,005 It's a big buzzword. 657 00:24:49,704 --> 00:24:52,505 Again, there's some controversy to that because we 658 00:24:52,505 --> 00:24:55,224 know as care providers, there are only there's 659 00:24:55,224 --> 00:24:58,765 only so much that that biologics can do. 660 00:24:58,904 --> 00:25:01,325 And making sure that our patients understand 661 00:25:01,920 --> 00:25:04,559 what that is and not giving them false 662 00:25:04,559 --> 00:25:05,860 or misleading information, 663 00:25:06,799 --> 00:25:10,320 is very important. So having experts in in 664 00:25:10,320 --> 00:25:10,820 biologics 665 00:25:11,200 --> 00:25:12,019 to be able 666 00:25:12,799 --> 00:25:15,220 to explain these things, explain the benefits, 667 00:25:15,634 --> 00:25:16,535 explain the limitations 668 00:25:17,394 --> 00:25:19,555 of of these products to our patients is 669 00:25:19,555 --> 00:25:21,875 very, very important, but to be able to 670 00:25:21,875 --> 00:25:23,015 offer it to those 671 00:25:23,315 --> 00:25:24,215 that it's indicated 672 00:25:24,755 --> 00:25:25,255 for. 673 00:25:25,555 --> 00:25:28,515 So those are things that that we're we're 674 00:25:28,515 --> 00:25:30,695 looking forward to really, 675 00:25:31,769 --> 00:25:32,269 again, 676 00:25:32,730 --> 00:25:36,029 quality is is something that that will drive 677 00:25:36,890 --> 00:25:39,769 almost everything we do. Quality is at the 678 00:25:39,769 --> 00:25:41,930 center of it because ultimately at the end 679 00:25:41,930 --> 00:25:42,750 of the day, 680 00:25:43,289 --> 00:25:44,349 the patient demands 681 00:25:44,954 --> 00:25:45,454 quality 682 00:25:45,755 --> 00:25:47,134 care. So we, 683 00:25:47,755 --> 00:25:49,515 need to be able to deliver that, and 684 00:25:49,515 --> 00:25:52,875 that is in turn what will contribute to 685 00:25:52,875 --> 00:25:53,615 our growth 686 00:25:54,154 --> 00:25:56,575 and will contribute to our our reputation 687 00:25:57,515 --> 00:25:58,575 and advance 688 00:25:59,115 --> 00:26:01,130 the vision of of the Orlando Health Jewett 689 00:26:01,130 --> 00:26:02,269 Orthopedic forward. 690 00:26:03,289 --> 00:26:05,130 That's amazing to hear. April, thank you so 691 00:26:05,130 --> 00:26:06,890 much for joining us on the podcast today. 692 00:26:06,890 --> 00:26:08,650 This has been such a a fun conversation, 693 00:26:08,650 --> 00:26:10,169 and I look forward to connecting with you 694 00:26:10,169 --> 00:26:10,990 again soon. 695 00:26:11,544 --> 00:26:13,224 Very good. Thank you so much, Laura. It 696 00:26:13,224 --> 00:26:14,284 was a great time.