1 00:00:00,080 --> 00:00:02,319 Hi, everyone, and welcome to the Becker's Healthcare 2 00:00:02,319 --> 00:00:04,580 podcast series. I'm Lucas Voss. 3 00:00:04,960 --> 00:00:07,359 Very excited to be joined by doctor Marvin 4 00:00:07,359 --> 00:00:10,080 k Smith and doctor Daniel b Chan. Lots 5 00:00:10,080 --> 00:00:13,224 of prolific expertise here for our conversation around 6 00:00:13,224 --> 00:00:15,244 sports medicine and the ASC environment 7 00:00:15,785 --> 00:00:18,904 as a whole. Doctor Smith, doctor Chan, thanks 8 00:00:18,904 --> 00:00:20,204 so much for being here. 9 00:00:20,585 --> 00:00:22,285 Thank you. Thank you for having us. 10 00:00:22,744 --> 00:00:24,125 Thank you for having us. 11 00:00:24,585 --> 00:00:25,085 Absolutely. 12 00:00:25,464 --> 00:00:27,064 I'm excited to dive in. We have so 13 00:00:27,064 --> 00:00:28,600 much to talk about here. There's so so 14 00:00:28,600 --> 00:00:31,559 many different aspects to to consider. And and, 15 00:00:31,559 --> 00:00:33,559 doctor Smith, I just wanted to start off 16 00:00:33,559 --> 00:00:35,799 with you. If you could just introduce yourself 17 00:00:35,799 --> 00:00:37,719 to the audience a little bit and how 18 00:00:37,719 --> 00:00:40,439 you came to specialize in sports medicine, and 19 00:00:40,439 --> 00:00:43,505 then even more specifically, what brought you into 20 00:00:43,505 --> 00:00:44,804 the ASC environment, 21 00:00:45,265 --> 00:00:45,765 today? 22 00:00:47,185 --> 00:00:49,265 Yes. So, my name is Marvin k Smith. 23 00:00:49,265 --> 00:00:52,385 I'm a orthopedic surgeon, board certified, and fellowship 24 00:00:52,385 --> 00:00:55,024 trained in sports medicine. I'm from South Florida 25 00:00:55,024 --> 00:00:57,204 originally. My background is sports 26 00:00:57,530 --> 00:01:00,489 participation. I was fortunate to play division 1 27 00:01:00,489 --> 00:01:02,429 college football at Central Michigan University, 28 00:01:02,809 --> 00:01:04,810 and I've always had a love and a 29 00:01:04,810 --> 00:01:07,629 passion for helping athletes, working with athletes. 30 00:01:08,090 --> 00:01:10,375 And, it's been my passion to try to 31 00:01:10,375 --> 00:01:12,234 restore others back to their passion. 32 00:01:12,774 --> 00:01:15,734 And with that, that really lends to working 33 00:01:15,734 --> 00:01:16,715 with ASCs. 34 00:01:17,894 --> 00:01:19,914 Sports medicine cases were amongst 35 00:01:20,215 --> 00:01:22,054 the first cases to be done at ASCs 36 00:01:22,054 --> 00:01:24,159 and continue to be a good fit for 37 00:01:24,159 --> 00:01:26,400 that model. And I'm really happy to be, 38 00:01:26,640 --> 00:01:28,420 a part of a very successful ASC 39 00:01:28,719 --> 00:01:29,540 to this day. 40 00:01:30,799 --> 00:01:33,760 I did save, doctor Smith's number just in 41 00:01:33,760 --> 00:01:35,680 case I have questions about injuries for my 42 00:01:35,680 --> 00:01:38,265 fantasy football team. So if you're interested in 43 00:01:38,265 --> 00:01:38,744 that, just, 44 00:01:39,384 --> 00:01:41,064 hang along and then we'll share that at 45 00:01:41,064 --> 00:01:42,604 the end. Just kidding. 46 00:01:43,944 --> 00:01:47,064 Doctor doctor Chan, same for you. What what's, 47 00:01:47,304 --> 00:01:49,979 what's your background and and how how how 48 00:01:49,979 --> 00:01:52,939 was your approach, in in AAC in general, 49 00:01:52,939 --> 00:01:54,780 and how did you come to specialize in 50 00:01:54,780 --> 00:01:55,439 the area? 51 00:01:56,459 --> 00:01:59,420 Sure. I'm an orthopedic trauma surgeon by training. 52 00:01:59,420 --> 00:02:01,759 I've been in practice about 15 years now. 53 00:02:02,379 --> 00:02:05,064 Over time, my practice has migrated more and 54 00:02:05,064 --> 00:02:07,145 more to doing total joint replacements, 55 00:02:07,625 --> 00:02:09,965 specifically hip and knee replacements and the revisions. 56 00:02:10,824 --> 00:02:12,444 And about 5 years ago, 57 00:02:13,305 --> 00:02:15,324 it just seemed like a natural move 58 00:02:15,625 --> 00:02:17,959 to move these cases to the ASC. 59 00:02:18,340 --> 00:02:19,479 Here in South Florida, 60 00:02:20,259 --> 00:02:22,180 there was not much of an ASC presence 61 00:02:22,180 --> 00:02:23,620 at that time. And so it was a 62 00:02:23,620 --> 00:02:25,860 nice opportunity for us to move these cases 63 00:02:25,860 --> 00:02:28,019 that we were already doing as outpatients in 64 00:02:28,019 --> 00:02:28,759 the hospital 65 00:02:29,299 --> 00:02:31,959 into the ASC setting really to provide, 66 00:02:32,844 --> 00:02:35,405 a benefit for the patients and, a more 67 00:02:35,405 --> 00:02:36,145 cost effective, 68 00:02:36,764 --> 00:02:38,145 environment in general. 69 00:02:38,604 --> 00:02:40,764 And we've really leveraged that to our advantage. 70 00:02:40,764 --> 00:02:43,564 We're now our ASC at Cypress Creek is 71 00:02:43,564 --> 00:02:46,469 the leading orthopedic ASC in South Florida and 72 00:02:46,469 --> 00:02:49,110 definitely the leading ASC for outpatient hip and 73 00:02:49,110 --> 00:02:49,849 knee replacement. 74 00:02:51,030 --> 00:02:52,629 That's awesome. And we'll touch on and we'll 75 00:02:52,629 --> 00:02:53,909 touch on that in a little bit more 76 00:02:53,909 --> 00:02:55,270 in a little bit more detail in talking 77 00:02:55,270 --> 00:02:57,430 about some of those aspects for you and 78 00:02:57,430 --> 00:02:59,210 for your for your business specifically. 79 00:03:00,150 --> 00:03:01,965 Doctor Smith, I I wanna come back to 80 00:03:02,525 --> 00:03:03,664 to you, a little bit here, 81 00:03:04,205 --> 00:03:05,405 specifically to, 82 00:03:05,805 --> 00:03:08,685 to to ASCs and and the transformation that's 83 00:03:08,685 --> 00:03:10,764 that's been under that's the field really has 84 00:03:10,764 --> 00:03:13,504 been undergoing for for quite some time now. 85 00:03:14,525 --> 00:03:18,329 How has the environment changed since you first 86 00:03:18,329 --> 00:03:19,310 started practicing, 87 00:03:20,489 --> 00:03:21,930 in terms of the site of care and 88 00:03:21,930 --> 00:03:23,689 just in general? What are some of the 89 00:03:23,849 --> 00:03:25,629 these transformations that you've observed? 90 00:03:26,650 --> 00:03:28,110 Well, I've definitely seen, 91 00:03:28,489 --> 00:03:29,310 an evolution 92 00:03:29,854 --> 00:03:31,534 of the types of cases that we're doing 93 00:03:31,534 --> 00:03:34,594 at ASCs even within the sports medicine subspecialty. 94 00:03:35,215 --> 00:03:37,715 Initially, it was solely arthroscopic 95 00:03:38,254 --> 00:03:41,614 surgeries and and very small open surgeries, whereas 96 00:03:41,614 --> 00:03:42,114 now, 97 00:03:42,574 --> 00:03:44,735 the envelope has definitely been pushed where we're 98 00:03:44,735 --> 00:03:45,235 doing 99 00:03:45,590 --> 00:03:46,889 even more open, 100 00:03:47,510 --> 00:03:49,510 have the ability to do more open sports 101 00:03:49,510 --> 00:03:50,490 medicine procedures, 102 00:03:50,790 --> 00:03:51,290 larger 103 00:03:51,669 --> 00:03:53,530 ligament and soft tissue reconstructions 104 00:03:54,230 --> 00:03:56,389 in the ASC settings. And it also lends 105 00:03:56,389 --> 00:03:58,150 to what doctor Chan was alluding to, you 106 00:03:58,150 --> 00:04:00,485 know, obviously on the total joint side, really 107 00:04:00,485 --> 00:04:02,784 expanding what we're doing and taking that model 108 00:04:02,784 --> 00:04:05,284 and that mindset that, well, if we're discharging 109 00:04:05,504 --> 00:04:07,824 patients from the hospital same day for these 110 00:04:07,824 --> 00:04:08,324 surgeries, 111 00:04:08,625 --> 00:04:09,985 then do we really need to do them 112 00:04:09,985 --> 00:04:11,185 in the hospital setting, 113 00:04:11,504 --> 00:04:12,245 per se? 114 00:04:12,544 --> 00:04:14,224 And, that's one of the biggest shifts that 115 00:04:14,224 --> 00:04:16,170 I've seen is, you know, when people think 116 00:04:16,170 --> 00:04:17,930 of sports medicine, they tend to think about 117 00:04:17,930 --> 00:04:20,649 minimally invasive arthroscopic, which is definitely a a 118 00:04:20,649 --> 00:04:22,889 large share, maybe even lion's share of those 119 00:04:22,889 --> 00:04:25,389 cases. However, there's a very significant 120 00:04:25,769 --> 00:04:28,910 part of sports medicine surgery that does involve, 121 00:04:29,370 --> 00:04:30,269 larger cases. 122 00:04:31,064 --> 00:04:33,305 Yeah. Doctor Chan, same for you here. What 123 00:04:33,305 --> 00:04:35,064 what sort of been your perspective on how 124 00:04:35,064 --> 00:04:37,805 this this field has transformed over the last 125 00:04:37,865 --> 00:04:39,944 last decade or so and even since you 126 00:04:39,944 --> 00:04:41,165 you began your career? 127 00:04:42,264 --> 00:04:44,504 I think initially when we started doing total 128 00:04:44,504 --> 00:04:46,949 joints in the ASC, it was just a 129 00:04:46,949 --> 00:04:48,790 proof of concept. This show that it could 130 00:04:48,790 --> 00:04:49,610 be done safely, 131 00:04:50,149 --> 00:04:52,310 to show insurance companies that we could have 132 00:04:52,310 --> 00:04:54,149 good results, and that this should be something 133 00:04:54,149 --> 00:04:54,949 that they would, 134 00:04:55,509 --> 00:04:58,275 reimburse for. Mhmm. But now I think as 135 00:04:58,275 --> 00:05:01,475 things get more mature, it's about efficiencies and 136 00:05:01,475 --> 00:05:02,535 how can we really 137 00:05:03,074 --> 00:05:06,035 leverage the ASC as an efficient side of 138 00:05:06,035 --> 00:05:07,814 care to really do more cases, 139 00:05:08,675 --> 00:05:09,895 while maintaining patient 140 00:05:10,500 --> 00:05:11,800 safety and really, 141 00:05:12,419 --> 00:05:14,819 expanding the scope of the procedures we're doing. 142 00:05:14,819 --> 00:05:17,220 So we're we're even doing some basic revision 143 00:05:17,220 --> 00:05:19,079 hip and knee replacements in the ASC. 144 00:05:19,860 --> 00:05:22,274 So it's just an expansion of both the 145 00:05:22,274 --> 00:05:24,675 type of cases and the efficiency and quantity 146 00:05:24,675 --> 00:05:26,774 of cases that we're doing, which has dramatically 147 00:05:26,834 --> 00:05:28,435 changed even in the past 4 to 5 148 00:05:28,435 --> 00:05:28,935 years. 149 00:05:29,475 --> 00:05:31,475 Yeah. So we're really moving you mentioned proof 150 00:05:31,475 --> 00:05:32,675 of concept. So we've 151 00:05:33,314 --> 00:05:34,455 we know it works. 152 00:05:34,800 --> 00:05:37,139 So now it's now we're getting to optimizing 153 00:05:37,360 --> 00:05:39,599 this whole this whole area. Is that correct? 154 00:05:39,599 --> 00:05:41,360 And and being able to to kinda see 155 00:05:41,360 --> 00:05:43,279 what what's next. How can how can we 156 00:05:43,279 --> 00:05:44,879 take this to the next level? Is that 157 00:05:44,879 --> 00:05:46,319 sort of where we're where we're at right 158 00:05:46,319 --> 00:05:47,459 now, doctor Chen? 159 00:05:48,495 --> 00:05:49,535 Absolutely. I think, 160 00:05:50,574 --> 00:05:53,134 there's gonna be a certain limit, obviously, and 161 00:05:53,134 --> 00:05:55,055 I know some people really focus on the 162 00:05:55,055 --> 00:05:56,035 number of cases. 163 00:05:56,814 --> 00:05:58,894 I think I really focus on just being 164 00:05:58,894 --> 00:06:01,694 efficient, and, ultimately, patient outcome should be the 165 00:06:01,694 --> 00:06:02,675 driving factor. 166 00:06:03,259 --> 00:06:04,860 I think as we see more and more 167 00:06:04,860 --> 00:06:05,360 changes 168 00:06:05,740 --> 00:06:08,479 in terms of how health care is reimbursed 169 00:06:08,699 --> 00:06:11,600 and pressures from CMS and private insurance, 170 00:06:12,379 --> 00:06:12,879 companies, 171 00:06:13,740 --> 00:06:15,439 there's gonna be more, 172 00:06:15,979 --> 00:06:19,634 interest in alternative, payment structures, either value based 173 00:06:19,634 --> 00:06:20,134 care 174 00:06:20,754 --> 00:06:23,475 or for us some medical tourism since we 175 00:06:23,475 --> 00:06:26,435 are in South Florida. Mhmm. I definitely attract, 176 00:06:26,435 --> 00:06:28,694 you know, patients from the Caribbean, South America, 177 00:06:28,834 --> 00:06:29,735 out of the country. 178 00:06:30,115 --> 00:06:33,060 And so leveraging that with the ASC benefits 179 00:06:33,199 --> 00:06:36,160 really makes, an an attractive package for patients 180 00:06:36,160 --> 00:06:38,399 looking to seek premier care in a an 181 00:06:38,399 --> 00:06:40,420 efficient kind of cost effective setting. 182 00:06:40,959 --> 00:06:43,279 Yeah. Absolutely. Doctor Smith, I wanna come back 183 00:06:43,279 --> 00:06:45,120 to you here as well. And and I 184 00:06:45,120 --> 00:06:46,634 was wondering if you could touch could touch 185 00:06:46,634 --> 00:06:49,095 a little bit on on the technology 186 00:06:49,475 --> 00:06:51,634 side of things as well in terms of 187 00:06:51,634 --> 00:06:53,875 how it's changed. How are you seeing it 188 00:06:53,875 --> 00:06:56,754 evolve still consistently, and and what are sort 189 00:06:56,754 --> 00:06:59,235 of the things that you're you're using you're 190 00:06:59,235 --> 00:07:01,235 seeing really make a difference from a from 191 00:07:01,235 --> 00:07:02,580 a technology perspective? 192 00:07:03,680 --> 00:07:04,960 That's one of the things that I really 193 00:07:04,960 --> 00:07:07,279 love about medicine in general and, you know, 194 00:07:07,279 --> 00:07:11,040 specifically orthopedic surgery, that technological advances are just 195 00:07:11,040 --> 00:07:12,020 continuing to 196 00:07:12,560 --> 00:07:14,935 occur year over year. A lot of changes 197 00:07:14,935 --> 00:07:17,095 even since the time that I trained in 198 00:07:17,095 --> 00:07:17,595 fellowship, 199 00:07:18,055 --> 00:07:19,194 just seeing the capabilities 200 00:07:19,574 --> 00:07:20,794 of different devices. 201 00:07:21,254 --> 00:07:23,115 I like to use the 202 00:07:23,495 --> 00:07:26,615 Dynacord suture and many of my cases that 203 00:07:26,615 --> 00:07:30,319 require good tight suture fixation because that actually 204 00:07:30,319 --> 00:07:32,560 is a suture that gets tighter with time 205 00:07:32,560 --> 00:07:35,300 as opposed to looser over time. That contractile, 206 00:07:36,399 --> 00:07:39,199 central cord really can make a difference as 207 00:07:39,199 --> 00:07:40,160 opposed to, 208 00:07:40,800 --> 00:07:42,786 noncontractile sutures as far as your healing rates 209 00:07:42,786 --> 00:07:43,485 and compression for your your 210 00:07:44,604 --> 00:07:45,104 tensioning. 211 00:07:45,805 --> 00:07:47,324 So those are some of the things that 212 00:07:47,324 --> 00:07:49,164 that we're using, that we're seeing. I like 213 00:07:49,164 --> 00:07:51,185 a lot of the more ergonomic 214 00:07:51,564 --> 00:07:53,664 meniscal repair devices that, 215 00:07:54,044 --> 00:07:56,204 really help you get various angles when you're 216 00:07:56,204 --> 00:07:58,810 dealing with a lot of complex meniscus repairs. 217 00:07:58,810 --> 00:07:59,870 I'm very aggressive, 218 00:08:00,410 --> 00:08:01,949 when it comes to repairing menisci, 219 00:08:02,569 --> 00:08:05,209 as I do serve a very active and 220 00:08:05,209 --> 00:08:06,830 tends to be a younger population. 221 00:08:07,370 --> 00:08:09,709 Many of my patients are professional and 222 00:08:10,185 --> 00:08:10,685 division 223 00:08:11,145 --> 00:08:13,944 1, elite level college athletes. So if we're 224 00:08:13,944 --> 00:08:16,264 able to preserve the meniscus as opposed to 225 00:08:16,264 --> 00:08:17,245 resect the meniscus, 226 00:08:17,705 --> 00:08:19,064 it can make all the difference in the 227 00:08:19,064 --> 00:08:21,225 world. And, I've found that some of the 228 00:08:21,225 --> 00:08:22,125 newer technologies, 229 00:08:22,745 --> 00:08:25,590 like TruSpan, for example, have really allowed me 230 00:08:25,590 --> 00:08:27,750 to do things that might not have otherwise 231 00:08:27,750 --> 00:08:28,490 been possible. 232 00:08:29,350 --> 00:08:31,830 Yeah. Doctor Ken, interested in your perspective here 233 00:08:31,830 --> 00:08:33,750 as well in terms of just the changing 234 00:08:33,750 --> 00:08:36,230 of technology in general and and how you've 235 00:08:36,230 --> 00:08:38,415 how you've seen this really influence, 236 00:08:38,795 --> 00:08:39,615 the environment, 237 00:08:39,995 --> 00:08:42,495 within the ASC and and practice in itself? 238 00:08:43,274 --> 00:08:43,774 Absolutely. 239 00:08:44,795 --> 00:08:47,535 We partnered with DE PUA from the very 240 00:08:47,835 --> 00:08:49,855 inception of our time in the ASC, 241 00:08:50,394 --> 00:08:52,889 just basically bringing over the same technologies we 242 00:08:52,889 --> 00:08:54,750 were using in the hospital. And 243 00:08:55,209 --> 00:08:58,089 like it or not, orthopedic surgery is the 244 00:08:58,089 --> 00:09:00,889 most patient consumerism driven specialty in all of 245 00:09:00,889 --> 00:09:03,789 medicine. So people or patients, I should say, 246 00:09:04,009 --> 00:09:07,955 will search online for specific techniques, technologies, and 247 00:09:07,955 --> 00:09:09,975 they come to the office asking for them. 248 00:09:10,274 --> 00:09:12,355 And so initially, it was, you know, do 249 00:09:12,355 --> 00:09:14,035 you do anterior hips? Do you use a 250 00:09:14,035 --> 00:09:16,195 special table? Then it was, do you use 251 00:09:16,195 --> 00:09:18,695 robotics? Do you use advanced navigation? 252 00:09:19,340 --> 00:09:21,040 And so patients come in, 253 00:09:21,500 --> 00:09:23,200 expecting that their surgeon, 254 00:09:23,580 --> 00:09:26,320 utilizes these latest technologies. And 255 00:09:27,019 --> 00:09:29,580 fortunately, where we have been, we've been able 256 00:09:29,580 --> 00:09:31,899 to leverage all those technologies from DPU. We 257 00:09:31,899 --> 00:09:35,085 started with the Velas hip navigation system, which 258 00:09:35,085 --> 00:09:37,884 really allowed accurate reproducing of leg length and 259 00:09:37,884 --> 00:09:39,825 offset during hip replacement procedures. 260 00:09:40,445 --> 00:09:43,725 We utilized the, Kinsize automated impactor to make 261 00:09:43,725 --> 00:09:44,225 for, 262 00:09:44,524 --> 00:09:45,830 a more precise broaching. 263 00:09:46,290 --> 00:09:49,029 We've added the Velas robotic knee system 264 00:09:49,570 --> 00:09:50,070 recently, 265 00:09:50,690 --> 00:09:53,670 for both total and soon partial knee replacements. 266 00:09:54,290 --> 00:09:56,049 And so all of these all of these 267 00:09:56,049 --> 00:09:59,024 things really give the patients the latest technology 268 00:09:59,024 --> 00:10:00,704 when they come in for the joint replacement 269 00:10:00,704 --> 00:10:02,644 procedure, which is really what they're expecting, 270 00:10:03,345 --> 00:10:04,565 in this day and age. 271 00:10:05,424 --> 00:10:08,144 And I would assume also with with all 272 00:10:08,144 --> 00:10:10,065 of these innovations and all of these new 273 00:10:10,065 --> 00:10:13,019 tools, there's a huge driver in efficiency as 274 00:10:13,019 --> 00:10:15,100 well. Doctor Smith, I was gonna ask too. 275 00:10:15,100 --> 00:10:17,980 I feel like especially with high level athletes, 276 00:10:17,980 --> 00:10:19,740 right, that need to be, you know, in 277 00:10:19,740 --> 00:10:21,259 some cases, either need to be on the 278 00:10:21,259 --> 00:10:23,100 field right away or they need, hey. I 279 00:10:23,100 --> 00:10:24,965 have a week to get this done. I 280 00:10:24,965 --> 00:10:27,205 feel like that that if the efficiency piece 281 00:10:27,205 --> 00:10:29,365 is huge, is that where technology really makes 282 00:10:29,365 --> 00:10:31,365 a difference too in terms of providing that 283 00:10:31,365 --> 00:10:31,865 efficient, 284 00:10:32,565 --> 00:10:34,404 efficient care, being able to say I can 285 00:10:34,404 --> 00:10:36,485 I can do this now versus having to 286 00:10:36,485 --> 00:10:36,985 wait? 287 00:10:37,990 --> 00:10:39,829 Certainly. Having the ability to have a higher 288 00:10:39,829 --> 00:10:40,329 level 289 00:10:40,789 --> 00:10:41,289 of, 290 00:10:42,149 --> 00:10:42,649 specificity 291 00:10:43,190 --> 00:10:43,690 of 292 00:10:44,149 --> 00:10:45,769 accuracy with your cases 293 00:10:46,070 --> 00:10:48,070 can allow you to be more efficient. And, 294 00:10:48,070 --> 00:10:50,329 you know, we're very fortunate in our ASC 295 00:10:50,629 --> 00:10:52,889 at Cypress Creek. We have a tremendous team 296 00:10:53,565 --> 00:10:55,325 who they're very familiar with the cases that 297 00:10:55,325 --> 00:10:57,565 we do as it relates to orthopedics. So 298 00:10:57,565 --> 00:10:59,904 we're able to move efficiently and safely, 299 00:11:00,445 --> 00:11:03,404 and that obviously opens up more access for 300 00:11:03,404 --> 00:11:05,325 our patients. And that gives us the ability 301 00:11:05,325 --> 00:11:06,785 to maybe add on that patient, 302 00:11:07,245 --> 00:11:08,629 that was just seen in the office a 303 00:11:08,629 --> 00:11:10,629 few days ago. But by virtue of their 304 00:11:10,629 --> 00:11:12,629 career, it really makes all the difference if 305 00:11:12,629 --> 00:11:13,830 we can get them in a few days 306 00:11:13,830 --> 00:11:16,389 sooner. Yeah. So the technology is definitely a 307 00:11:16,389 --> 00:11:18,950 contributing factor that helps us be successful in 308 00:11:18,950 --> 00:11:21,750 that room. Yeah. Absolutely. And I know you've 309 00:11:21,750 --> 00:11:23,634 both mentioned this a little bit. I love 310 00:11:23,634 --> 00:11:25,634 this question because I think it's so it's 311 00:11:25,634 --> 00:11:28,115 so interesting because of the innovation and because 312 00:11:28,115 --> 00:11:30,355 of everything that's that's been going on, and 313 00:11:30,355 --> 00:11:32,835 and certainly you both have mentioned how how 314 00:11:32,835 --> 00:11:35,475 everything has changed. And and, doctor Chan, I 315 00:11:35,475 --> 00:11:36,934 wanna start with you here. 316 00:11:37,580 --> 00:11:40,559 What is sort of the one tool, instrument, 317 00:11:40,620 --> 00:11:42,460 or technique that you wish you would have 318 00:11:42,460 --> 00:11:45,040 had when you first started your career? 319 00:11:45,980 --> 00:11:47,580 I would say without a doubt, it would 320 00:11:47,580 --> 00:11:49,920 be the, Kinsight's automated impactor. 321 00:11:50,495 --> 00:11:52,575 Now as somebody that does, you know, several 322 00:11:52,575 --> 00:11:54,995 100 total hip replacements a year, 323 00:11:55,534 --> 00:11:56,674 not having to, 324 00:11:57,214 --> 00:11:59,634 swing a mallet or a hammer at all 325 00:11:59,934 --> 00:12:01,855 during that case. And on days when we 326 00:12:01,855 --> 00:12:03,615 do up to 10 pivotal joints a day, 327 00:12:03,615 --> 00:12:04,320 that's a huge, 328 00:12:05,840 --> 00:12:06,340 preservation, 329 00:12:06,879 --> 00:12:08,980 and mitigation of any occupational, 330 00:12:09,680 --> 00:12:10,180 hazard 331 00:12:10,559 --> 00:12:12,879 for the surgeon as well as providing the 332 00:12:12,879 --> 00:12:14,259 precise bone preparation 333 00:12:14,639 --> 00:12:16,800 and accuracy for the patient. So if I 334 00:12:16,800 --> 00:12:18,485 had that in the very beginning, I'd probably 335 00:12:18,485 --> 00:12:21,625 have a lot less tennis elbow and, CMC 336 00:12:21,684 --> 00:12:22,184 arthritis. 337 00:12:23,524 --> 00:12:25,445 Doctor Smith, same for new same for you 338 00:12:25,445 --> 00:12:27,144 here. What what's the number 1? 339 00:12:28,004 --> 00:12:29,924 I I have I have several, but if 340 00:12:29,924 --> 00:12:31,144 I have to pick 1, 341 00:12:31,710 --> 00:12:32,610 I would say 342 00:12:33,309 --> 00:12:36,910 the Milagro screws, the bio absorbable interference screws, 343 00:12:36,910 --> 00:12:39,230 I use them for my ACL reconstructions when 344 00:12:39,230 --> 00:12:42,529 I am doing bone patellatin and bone grafting 345 00:12:42,590 --> 00:12:43,090 technique. 346 00:12:43,790 --> 00:12:44,929 I also use them 347 00:12:45,309 --> 00:12:47,144 for MPFL reconstructions 348 00:12:47,524 --> 00:12:48,745 and I really prefer 349 00:12:49,445 --> 00:12:51,225 to avoid leaving metal behind 350 00:12:52,004 --> 00:12:53,785 in the patient if I can, 351 00:12:54,165 --> 00:12:57,045 particularly we're working with soft tissue reconstruction. So, 352 00:12:57,045 --> 00:12:58,184 there is an alternative 353 00:12:58,500 --> 00:13:01,220 to metal fixation. Many patients prefer that. Many 354 00:13:01,220 --> 00:13:02,840 patients have strong convictions 355 00:13:03,460 --> 00:13:06,840 about metal. And, I'm really happy that's become 356 00:13:06,899 --> 00:13:08,360 more commonplace, whereas, 357 00:13:09,139 --> 00:13:11,220 maybe years ago and just starting off, it 358 00:13:11,220 --> 00:13:13,825 wasn't as common. And we've been very fortunate 359 00:13:13,825 --> 00:13:16,804 to work with our ASC and working with 360 00:13:17,184 --> 00:13:19,204 Depew on getting very, 361 00:13:19,745 --> 00:13:22,784 ASC friendly rates for those products, even coming 362 00:13:22,784 --> 00:13:25,125 in comparable to competitors' Meta Splus. 363 00:13:26,129 --> 00:13:27,649 Feel like we should just do an episode 364 00:13:27,649 --> 00:13:28,549 on these tools. 365 00:13:29,009 --> 00:13:30,069 I think that would be 366 00:13:31,089 --> 00:13:32,850 I'll I'll bring you both back and we'll 367 00:13:32,850 --> 00:13:34,769 talk about the we'll talk about the most 368 00:13:34,769 --> 00:13:36,529 important tools and the the number 1, and 369 00:13:36,529 --> 00:13:38,129 then we can we can do a complete 370 00:13:38,129 --> 00:13:40,565 ranking. We'll do 1 through 10 of what 371 00:13:40,565 --> 00:13:42,004 you would have liked to have and and 372 00:13:42,004 --> 00:13:43,684 then the best ones. I I think that's 373 00:13:43,684 --> 00:13:44,264 a good 374 00:13:44,644 --> 00:13:46,105 that's a good approach there. 375 00:13:47,044 --> 00:13:48,345 Doctor doctor Smith, 376 00:13:48,965 --> 00:13:52,184 with your expertise in in sports medicine specifically, 377 00:13:52,980 --> 00:13:55,000 these were some of the cases that were 378 00:13:55,299 --> 00:13:56,279 some of the earliest 379 00:13:56,899 --> 00:13:58,519 move to ASC settings, 380 00:13:59,220 --> 00:14:00,899 that that were moved to in out in 381 00:14:00,899 --> 00:14:03,240 terms of outpatient surgeries, etcetera. 382 00:14:04,595 --> 00:14:07,315 Obviously, there's others. You talked about total knees, 383 00:14:07,315 --> 00:14:09,315 hips, shoulders, etcetera. We we have all of 384 00:14:09,315 --> 00:14:11,394 those as well. With with the reimbursement of 385 00:14:11,394 --> 00:14:12,375 these higher acuity, 386 00:14:12,835 --> 00:14:14,695 procedures that I just mentioned, 387 00:14:15,554 --> 00:14:18,419 how does your facility look at procedure mix, 388 00:14:19,299 --> 00:14:20,600 OR time allotment, 389 00:14:21,379 --> 00:14:23,720 and and certainly also the recruiting of surgeons 390 00:14:23,779 --> 00:14:24,600 with different, 391 00:14:24,980 --> 00:14:25,480 specialties? 392 00:14:25,860 --> 00:14:27,240 What role does that play, 393 00:14:27,620 --> 00:14:29,779 and and what what what kind of impact 394 00:14:29,779 --> 00:14:30,600 does it have? 395 00:14:31,394 --> 00:14:34,514 It definitely behooves the leadership in NAFC to 396 00:14:34,514 --> 00:14:36,674 be very intentional at looking at the case 397 00:14:36,674 --> 00:14:37,174 mixes, 398 00:14:37,554 --> 00:14:40,054 looking at not only reimbursements, but also 399 00:14:40,514 --> 00:14:42,834 operative efficiencies, looking at how teams can move 400 00:14:42,834 --> 00:14:44,629 in and out of cases, scheduling 401 00:14:45,090 --> 00:14:47,090 surgical days in a way that, you know, 402 00:14:47,090 --> 00:14:48,769 even if you do have a surgeon that 403 00:14:48,769 --> 00:14:50,850 may do open surgeries, may do a lot 404 00:14:50,850 --> 00:14:51,509 of arthroscopy 405 00:14:51,889 --> 00:14:53,110 arthroscopic surgeries, 406 00:14:53,649 --> 00:14:56,290 scheduling those days where you try to have 407 00:14:56,290 --> 00:14:58,450 more of the arthroscopic surgeries on the same 408 00:14:58,450 --> 00:15:01,065 day. So you're not having to do as 409 00:15:01,065 --> 00:15:03,945 much work for the room turnovers and scheduling 410 00:15:03,945 --> 00:15:05,945 those open cases and kind of clustering them 411 00:15:05,945 --> 00:15:06,445 together, 412 00:15:06,904 --> 00:15:09,865 clustering the total joints together on a day 413 00:15:09,865 --> 00:15:11,304 where you can get things done. But also 414 00:15:11,304 --> 00:15:13,465 keeping in mind the sterile processing aspect of 415 00:15:13,465 --> 00:15:16,320 it, and making sure that those trays can 416 00:15:16,320 --> 00:15:18,559 get processed and flipped around so that you 417 00:15:18,559 --> 00:15:20,240 can continue to move forward with those cases. 418 00:15:20,240 --> 00:15:22,639 There are so many moving parts. And even 419 00:15:22,639 --> 00:15:24,879 though sports medicine did lead the charge as 420 00:15:24,879 --> 00:15:27,299 it relates to orthopedic cases in the AFC, 421 00:15:27,695 --> 00:15:29,855 We now have such a wide variety of 422 00:15:29,855 --> 00:15:32,414 orthopedics that there's really not much that can't 423 00:15:32,414 --> 00:15:34,014 be done. There's so many cases that we 424 00:15:34,014 --> 00:15:36,495 are able to do. So with that, it 425 00:15:36,495 --> 00:15:39,134 does behoove us to really be intentional about 426 00:15:39,134 --> 00:15:41,970 how we plan that. And it also really 427 00:15:41,970 --> 00:15:44,769 opens up the door to recruiting surgeons of 428 00:15:44,769 --> 00:15:47,269 various specialties outside of sports medicine 429 00:15:47,809 --> 00:15:49,970 to service the ASCs and the patients that 430 00:15:49,970 --> 00:15:50,870 seek care there. 431 00:15:51,330 --> 00:15:52,769 Yeah. I would assume that that's a huge 432 00:15:52,769 --> 00:15:55,169 huge business case as well. Doctor Chan, feel 433 00:15:55,169 --> 00:15:56,835 free to feel free to chime in here 434 00:15:56,835 --> 00:15:59,235 as well in terms of the impact that 435 00:15:59,235 --> 00:16:01,394 has on the business itself when you're able 436 00:16:01,394 --> 00:16:03,154 to offer all of these types of these 437 00:16:03,154 --> 00:16:04,915 types of surgeries and and certainly in the 438 00:16:04,915 --> 00:16:07,154 in the recruiting aspect, interested in your your 439 00:16:07,154 --> 00:16:08,519 perspective here as well. 440 00:16:09,320 --> 00:16:11,720 Well, certainly, in the ASC market, there are 441 00:16:11,720 --> 00:16:13,019 different types of ASCs. 442 00:16:13,480 --> 00:16:15,019 I would say ours is a multispecialty 443 00:16:15,480 --> 00:16:17,639 ASC, so there are some ASCs that just 444 00:16:17,639 --> 00:16:19,879 do total joints or just do sports medicine. 445 00:16:19,879 --> 00:16:20,620 And so, 446 00:16:21,080 --> 00:16:23,785 when it comes to an ASC that has 447 00:16:23,785 --> 00:16:26,585 more breadth of types of specialties that are 448 00:16:26,585 --> 00:16:27,085 offered, 449 00:16:27,705 --> 00:16:29,625 there are a lot of different factors that 450 00:16:29,625 --> 00:16:30,605 you have to consider. 451 00:16:31,305 --> 00:16:32,925 At the end of the day, the ASC 452 00:16:33,144 --> 00:16:36,045 is a for profit entity, and so everything, 453 00:16:36,649 --> 00:16:38,210 you know, has to start with is this 454 00:16:38,410 --> 00:16:41,470 is gonna be financially viable for the ASC? 455 00:16:42,169 --> 00:16:44,110 But that goes beyond just, 456 00:16:44,570 --> 00:16:46,730 what the insurance company or the payer will 457 00:16:46,730 --> 00:16:48,649 will reimburse for the case. It depends on 458 00:16:48,649 --> 00:16:51,574 the disposable. It depends on, you know, how 459 00:16:51,574 --> 00:16:53,414 fast the surgeon is. You could have you 460 00:16:53,414 --> 00:16:55,495 know, if a surgeon takes, you know, too 461 00:16:55,495 --> 00:16:56,855 long to do a case, the case no 462 00:16:56,855 --> 00:16:59,574 longer become profitable. And so those are the 463 00:16:59,574 --> 00:17:00,794 issues that matter, 464 00:17:01,174 --> 00:17:02,394 more and more as 465 00:17:03,209 --> 00:17:04,909 OR space becomes more limited. 466 00:17:05,450 --> 00:17:07,929 And so we use very advanced metrics even 467 00:17:07,929 --> 00:17:09,690 looking at, you know, what's our revenue or 468 00:17:09,690 --> 00:17:12,009 profit per minute in the OR per procedure 469 00:17:12,009 --> 00:17:13,690 per surgeon. And so when you get down 470 00:17:13,690 --> 00:17:15,470 to that granularity, you can really 471 00:17:15,974 --> 00:17:19,194 figure out how best to allocate limited resources. 472 00:17:19,815 --> 00:17:21,734 And then looking ahead, we're always looking at 473 00:17:21,734 --> 00:17:23,194 specialties that potentially 474 00:17:23,734 --> 00:17:26,234 are a a new horizon in the ASC 475 00:17:26,454 --> 00:17:27,595 field. And so, 476 00:17:27,974 --> 00:17:30,794 obviously, orthopedics has always been, at the forefront, 477 00:17:30,855 --> 00:17:33,119 but now we're looking at things like cardiovascular 478 00:17:33,420 --> 00:17:34,559 procedures, like, 479 00:17:35,259 --> 00:17:36,480 you know, basic angiography 480 00:17:37,019 --> 00:17:38,880 or, you know, peripheral interventions 481 00:17:39,180 --> 00:17:40,640 or even pacemaker 482 00:17:40,940 --> 00:17:43,820 implantation. So those things are kind of more 483 00:17:43,820 --> 00:17:44,640 cutting edge. 484 00:17:45,259 --> 00:17:47,595 But if an ASC is to remain viable, 485 00:17:47,595 --> 00:17:48,475 we need to be, 486 00:17:48,875 --> 00:17:51,134 you know, looking at a multipronged approach. 487 00:17:51,755 --> 00:17:53,115 Yeah. And a and a big piece of 488 00:17:53,115 --> 00:17:54,715 this too is, I I would imagine, is 489 00:17:54,715 --> 00:17:56,255 is partnerships and collaborations 490 00:17:56,555 --> 00:17:59,455 and and seeing where where that financial financial 491 00:18:00,500 --> 00:18:02,579 piece really lies in terms of partnering with 492 00:18:02,579 --> 00:18:04,119 folks and seeing where they're at. 493 00:18:04,819 --> 00:18:07,079 How do you choose? What are the collaborations 494 00:18:07,380 --> 00:18:09,079 in terms of business planning, 495 00:18:09,779 --> 00:18:11,299 that you look at? Okay. How do I 496 00:18:11,299 --> 00:18:14,154 choose my partners? What do I look for? 497 00:18:14,315 --> 00:18:15,934 How do you choose the right 498 00:18:16,315 --> 00:18:18,474 partner to support some of the things that 499 00:18:18,474 --> 00:18:19,455 you've just mentioned? 500 00:18:20,634 --> 00:18:22,815 I I think one of the key aspects 501 00:18:22,875 --> 00:18:24,654 of our initial success, 502 00:18:25,115 --> 00:18:27,029 from day 1, and we were profitable from 503 00:18:27,029 --> 00:18:29,289 day 1, which is very uncommon for ASCs. 504 00:18:29,350 --> 00:18:30,789 But I think in large part, it was 505 00:18:30,789 --> 00:18:31,529 due to our 506 00:18:31,830 --> 00:18:34,170 collaboration with J&J Medtech and Depew. 507 00:18:34,789 --> 00:18:37,269 And, really, it was a continuation of relationship 508 00:18:37,269 --> 00:18:39,690 that started in the hospital, but we designed, 509 00:18:40,230 --> 00:18:40,890 the ASC 510 00:18:41,430 --> 00:18:43,075 orthopedic endeavor with 511 00:18:43,454 --> 00:18:43,954 that 512 00:18:44,335 --> 00:18:46,365 partnership in mind. And so, when you go 513 00:18:46,365 --> 00:18:47,085 all in with one company, it just allows 514 00:18:47,085 --> 00:18:48,335 for a lot more efficiency, a lot more 515 00:18:48,335 --> 00:18:49,474 benefits in terms of, 516 00:18:49,934 --> 00:18:50,835 multiple platforms. 517 00:18:55,529 --> 00:18:57,849 So we have general surgeons that do hernia 518 00:18:57,849 --> 00:19:00,090 repairs that will use Ethicon. Obviously, we use 519 00:19:00,090 --> 00:19:02,650 Ethicon suture. Doctor Smith will use MyTech products 520 00:19:02,650 --> 00:19:05,130 for sports medicine. I'll do Depute Total Joints. 521 00:19:05,130 --> 00:19:07,070 When I fix fractures, I'll use Synthes. 522 00:19:07,690 --> 00:19:09,394 And so getting that multiline 523 00:19:09,695 --> 00:19:11,715 support, which ultimately will 524 00:19:12,095 --> 00:19:14,095 contribute to rebate dollars that goes back to 525 00:19:14,095 --> 00:19:15,955 the ASC has been very beneficial. 526 00:19:16,575 --> 00:19:18,994 It's allowed for us to acquire technologies 527 00:19:19,455 --> 00:19:21,650 like the, Velas robotic system, 528 00:19:22,430 --> 00:19:25,549 and it also allows for just economies of 529 00:19:25,549 --> 00:19:27,470 scale, and we have a dedicated team. And 530 00:19:27,470 --> 00:19:29,789 so all those things will really make it 531 00:19:29,789 --> 00:19:31,869 a win for all the stakeholders and especially 532 00:19:31,869 --> 00:19:32,529 the patient. 533 00:19:33,525 --> 00:19:35,365 Yeah. I was gonna say keeping that that 534 00:19:35,365 --> 00:19:37,285 in mind as well, who is who is 535 00:19:37,285 --> 00:19:40,005 really focused on on patient care, patient outcomes, 536 00:19:40,005 --> 00:19:41,365 and being able to support some of the 537 00:19:41,365 --> 00:19:43,605 goals that you you as an organization have 538 00:19:43,605 --> 00:19:45,684 as well and having some alignment there. I 539 00:19:45,684 --> 00:19:47,460 think that's a that's a really great point. 540 00:19:47,940 --> 00:19:49,619 Doctor Smith, I wanna look ahead a little 541 00:19:49,619 --> 00:19:52,279 bit in terms of what developments and opportunities 542 00:19:52,579 --> 00:19:53,960 you're really looking forward 543 00:19:54,339 --> 00:19:57,059 to in sports medicine, in ASCs. I feel 544 00:19:57,059 --> 00:19:59,460 like this is such an evolving field. You 545 00:19:59,460 --> 00:20:01,700 mentioned new procedures, new tools. We talked a 546 00:20:01,700 --> 00:20:03,794 little bit about that. What are you most 547 00:20:03,794 --> 00:20:05,974 excited about in the next couple of years 548 00:20:06,194 --> 00:20:07,794 about some of the innovations that are that 549 00:20:07,794 --> 00:20:08,375 are coming? 550 00:20:09,154 --> 00:20:10,595 So there's so much that we can do 551 00:20:10,595 --> 00:20:13,794 in sports medicine now. I really enjoy cases 552 00:20:13,794 --> 00:20:15,015 like cartilage restoration 553 00:20:15,474 --> 00:20:17,500 and complex ligament reconstruction 554 00:20:18,359 --> 00:20:21,179 Mhmm. And even meniscal allograft transplants. 555 00:20:21,879 --> 00:20:23,399 When it comes to ASC, though, you do 556 00:20:23,399 --> 00:20:24,940 have to be mindful of 557 00:20:25,559 --> 00:20:26,619 allograft cost. 558 00:20:27,079 --> 00:20:28,759 So that's one of the things that I 559 00:20:28,759 --> 00:20:30,519 would love to see in the future if 560 00:20:30,519 --> 00:20:32,055 we can start getting some of the cost 561 00:20:33,015 --> 00:20:35,414 down or some of the allografts, some of 562 00:20:35,414 --> 00:20:36,555 the cartilage restoration, 563 00:20:37,735 --> 00:20:40,634 constructs, or also the sets that are required 564 00:20:40,695 --> 00:20:41,755 to perform surgeries. 565 00:20:42,215 --> 00:20:43,815 I would love to see us do even 566 00:20:43,815 --> 00:20:44,789 more. There are some of those 567 00:20:47,109 --> 00:20:48,950 but there's been there's definitely been some good 568 00:20:48,950 --> 00:20:50,710 work being done. There's some of those cartilage 569 00:20:50,710 --> 00:20:53,670 restoration procedures that originally you had to convert 570 00:20:53,670 --> 00:20:56,150 to open that now there's some technology where 571 00:20:56,150 --> 00:20:57,674 you can do them all arthroscopic, 572 00:20:58,295 --> 00:21:00,295 and looking forward to see what's on the 573 00:21:00,295 --> 00:21:02,535 horizon with that. Out of the what we 574 00:21:02,535 --> 00:21:03,275 are accomplishing 575 00:21:03,734 --> 00:21:05,414 at our ASC, as doctor Chan said, we've 576 00:21:05,414 --> 00:21:06,875 been profitable since inception. 577 00:21:07,815 --> 00:21:10,154 Year to date, we've done well over 1500, 578 00:21:11,680 --> 00:21:15,119 orthopedic sports medicine cases at Cypress, just this 579 00:21:15,119 --> 00:21:16,880 year so far, and that was actually up 580 00:21:16,880 --> 00:21:19,599 just until September, and we're looking forward to 581 00:21:19,599 --> 00:21:20,980 grow even beyond that. 582 00:21:22,160 --> 00:21:24,400 Doctor Chan, feel free to chime in here 583 00:21:24,400 --> 00:21:26,984 too. Very interested in your your future outlook, 584 00:21:26,984 --> 00:21:28,825 so to speak. What what are you most 585 00:21:28,825 --> 00:21:29,965 looking forward to? 586 00:21:30,744 --> 00:21:32,424 I'm looking forward to just doing more and 587 00:21:32,424 --> 00:21:34,984 more complex cases in the ASC. I've mentioned 588 00:21:34,984 --> 00:21:35,484 briefly, 589 00:21:36,105 --> 00:21:37,724 revision total joints, 590 00:21:38,424 --> 00:21:39,884 especially on the knee side 591 00:21:40,424 --> 00:21:43,210 where it's very amenable to that. 592 00:21:43,589 --> 00:21:46,329 Obviously, when we talk about revisions, the pricing 593 00:21:47,109 --> 00:21:48,409 is the biggest constraint, 594 00:21:48,950 --> 00:21:50,730 and then the reimbursement thereof. 595 00:21:51,349 --> 00:21:53,909 But I think, as again, from a proof 596 00:21:53,909 --> 00:21:56,424 of concept perspective, once we can show the 597 00:21:56,424 --> 00:21:58,184 the payers that we can do these, 598 00:21:58,585 --> 00:21:59,884 safely and effectively, 599 00:22:00,424 --> 00:22:02,204 we'll start to move in that direction. 600 00:22:02,904 --> 00:22:05,304 And then I think channeling back my previous 601 00:22:05,304 --> 00:22:07,244 life as an orthopedic trauma surgeon, 602 00:22:07,784 --> 00:22:09,964 I think being able to perform 603 00:22:10,339 --> 00:22:13,059 outpatient fracture surgery in a timely fashion will 604 00:22:13,059 --> 00:22:15,299 be a great benefit to both patients and, 605 00:22:15,460 --> 00:22:17,000 the health care system in general. 606 00:22:17,299 --> 00:22:19,160 It will help decompress the ERs 607 00:22:19,619 --> 00:22:22,019 at most, major hospital systems. So I think 608 00:22:22,019 --> 00:22:24,884 finding ways to align with hospital systems or 609 00:22:25,045 --> 00:22:26,825 orthopedic urgent cares to 610 00:22:27,365 --> 00:22:29,545 allow these fractures that can be, 611 00:22:30,085 --> 00:22:32,805 done efficiently in the ASC setting will provide 612 00:22:32,805 --> 00:22:33,945 benefit to everybody. 613 00:22:34,964 --> 00:22:36,805 Yeah. And if if trends and numbers or 614 00:22:36,805 --> 00:22:37,289 any 615 00:22:37,609 --> 00:22:39,690 any consideration here, I think this is only 616 00:22:39,690 --> 00:22:41,049 going to grow. This is a trend that 617 00:22:41,049 --> 00:22:43,289 hasn't really stopped, I say. I'd say within 618 00:22:43,289 --> 00:22:45,289 the last 5, 6 years. We hear stories 619 00:22:45,289 --> 00:22:47,450 coming out all the time and and mergers, 620 00:22:47,450 --> 00:22:50,170 acquisitions, etcetera. So I think that ASC trend 621 00:22:50,170 --> 00:22:51,688 and and being able to to do some 622 00:22:51,688 --> 00:22:53,315 of the things that you've described throughout our 623 00:22:53,315 --> 00:22:55,075 conversation here is is really key. 624 00:22:55,714 --> 00:22:57,474 Doctor Chen, coming back to you here real 625 00:22:57,474 --> 00:22:59,554 quickly. We we talked a little bit about 626 00:22:59,554 --> 00:23:02,294 recruitment and being able to sort of diversify, 627 00:23:02,434 --> 00:23:04,960 making sure you find folks that are that 628 00:23:04,960 --> 00:23:06,880 are cape first off, capable and also have 629 00:23:06,880 --> 00:23:07,779 different specialties, 630 00:23:08,320 --> 00:23:08,820 etcetera. 631 00:23:09,360 --> 00:23:11,759 I wanted to touch on your center status 632 00:23:11,759 --> 00:23:13,759 as sort of a center of excellence and 633 00:23:13,759 --> 00:23:14,640 the the, 634 00:23:15,279 --> 00:23:15,779 preceptorships 635 00:23:16,240 --> 00:23:18,480 that you're you're offering. And I was wondering 636 00:23:18,480 --> 00:23:20,180 if you could touch a little bit about 637 00:23:20,240 --> 00:23:22,055 that program and what that means for the 638 00:23:22,055 --> 00:23:22,955 future too. 639 00:23:23,815 --> 00:23:24,315 Sure. 640 00:23:25,255 --> 00:23:27,355 I think we are one of only 7 641 00:23:27,414 --> 00:23:30,535 ASCs in the country through J&J Medtech that 642 00:23:30,535 --> 00:23:31,674 offer this program. 643 00:23:32,295 --> 00:23:33,734 And the nice thing is that it's really 644 00:23:33,734 --> 00:23:35,070 an a la carte program, 645 00:23:36,090 --> 00:23:38,330 depending on what the surgeon or or his 646 00:23:38,330 --> 00:23:40,430 or her team is looking to, 647 00:23:41,289 --> 00:23:42,349 learn more about. 648 00:23:42,730 --> 00:23:44,970 And so we've had the gamut where we've 649 00:23:44,970 --> 00:23:46,330 had individual surgeons, come by themselves or they 650 00:23:46,330 --> 00:23:46,830 bring 651 00:23:47,609 --> 00:23:47,954 their 652 00:23:54,115 --> 00:23:56,615 Velas robot, Velas Hypnab, the Kinsize. 653 00:23:57,154 --> 00:23:58,835 How do we do that in an outpatient 654 00:23:58,835 --> 00:24:00,914 setting? How do we move efficiently room to 655 00:24:00,914 --> 00:24:01,414 room? 656 00:24:02,029 --> 00:24:04,190 And they can see that. We also host, 657 00:24:04,509 --> 00:24:07,069 surgeons for cadaver labs to get practice hands 658 00:24:07,069 --> 00:24:09,250 on training with those that we proctor. 659 00:24:09,950 --> 00:24:10,829 We've even had, 660 00:24:11,789 --> 00:24:13,549 surgeons bring their entire team, 661 00:24:13,950 --> 00:24:14,929 including anesthesiologists, 662 00:24:15,470 --> 00:24:16,904 nursing, business staff, 663 00:24:17,384 --> 00:24:19,724 from the ASC or their hospital usually. 664 00:24:20,345 --> 00:24:22,845 We've hosted books from Brazil, from Singapore, 665 00:24:23,945 --> 00:24:24,765 from Japan. 666 00:24:25,224 --> 00:24:27,224 And so we're looking forward to just bring 667 00:24:27,224 --> 00:24:30,025 that, to whomever's interested. And certainly, I think 668 00:24:30,025 --> 00:24:31,319 we were seeing a lot of international interest 669 00:24:37,319 --> 00:24:39,339 commonplace. You know, in Europe, you still see 670 00:24:39,480 --> 00:24:41,319 patients staying in the hospital for a week 671 00:24:41,319 --> 00:24:43,639 after a routine primary total joint. And so 672 00:24:43,639 --> 00:24:44,619 there's great interest 673 00:24:45,134 --> 00:24:45,634 internationally 674 00:24:46,414 --> 00:24:48,914 to learn some of the efficiencies that we've, 675 00:24:49,934 --> 00:24:52,035 mastered here, in South Florida. 676 00:24:52,734 --> 00:24:53,234 Yeah. 677 00:24:53,615 --> 00:24:56,174 Doctor Smith, same for you here. Does, how 678 00:24:56,174 --> 00:24:58,529 much of a role does professional education really 679 00:24:58,609 --> 00:25:00,609 play in in this field, especially because it's 680 00:25:00,609 --> 00:25:02,369 moving so fast? And I feel like there's 681 00:25:02,369 --> 00:25:05,250 a there's a constant need for for professional 682 00:25:05,250 --> 00:25:07,170 education and and being able to to keep 683 00:25:07,170 --> 00:25:08,710 up with what's going on. 684 00:25:10,369 --> 00:25:13,009 Certainly. You know, everything is evidence based, and 685 00:25:13,009 --> 00:25:15,585 as we get better evidence and more literature 686 00:25:15,585 --> 00:25:16,884 and more information, 687 00:25:17,345 --> 00:25:20,144 our practices evolve and with that technology also 688 00:25:20,144 --> 00:25:23,845 evolves with it. So continuing to stay at 689 00:25:23,904 --> 00:25:26,865 at the peak of professional education, I think 690 00:25:26,865 --> 00:25:27,684 is paramount. 691 00:25:28,240 --> 00:25:30,319 I've been fortunate to be involved with J 692 00:25:30,319 --> 00:25:33,039 and J Medtech as it relates to doing 693 00:25:33,039 --> 00:25:35,359 and conducting local labs and also being a 694 00:25:35,359 --> 00:25:37,220 part of the Future Leaders Conference 695 00:25:37,599 --> 00:25:40,480 earlier this year, which, was a great conference 696 00:25:40,480 --> 00:25:42,285 and, was happy to be part of it, 697 00:25:42,285 --> 00:25:44,845 I believe. Moving forward, I'm happy that we 698 00:25:44,845 --> 00:25:46,525 do have it our center of excellence for 699 00:25:46,525 --> 00:25:49,325 preceptorship. I'm looking forward to making myself more 700 00:25:49,325 --> 00:25:51,585 available for that, balancing with my responsibilities 701 00:25:52,045 --> 00:25:54,684 covering our major league professional rugby team and 702 00:25:54,684 --> 00:25:57,230 our our local colleges and their sports teams 703 00:25:57,230 --> 00:25:58,690 and all of their needs. But, 704 00:25:59,230 --> 00:26:00,829 balancing all of that, I also wanna make 705 00:26:00,829 --> 00:26:02,529 myself available to my colleagues, 706 00:26:02,829 --> 00:26:04,130 both local and abroad. 707 00:26:05,069 --> 00:26:07,069 That's that's awesome. I'm I'm I'm really glad 708 00:26:07,069 --> 00:26:09,069 that you're you're really providing I I think 709 00:26:09,069 --> 00:26:10,669 you're providing a a great service to the 710 00:26:10,669 --> 00:26:12,565 community there too, being able to help help 711 00:26:12,565 --> 00:26:13,065 folks 712 00:26:13,765 --> 00:26:16,005 be back quicker. Right? Be on the field 713 00:26:16,005 --> 00:26:18,244 quicker, especially young athletes. I I it's so 714 00:26:18,244 --> 00:26:19,945 important to be able to have that experience 715 00:26:20,244 --> 00:26:22,404 and being able to return, to whatever the 716 00:26:22,404 --> 00:26:23,465 court or the field, 717 00:26:24,085 --> 00:26:26,630 as fast as possible. Doctor Chan, doctor Smith, 718 00:26:26,630 --> 00:26:28,390 thanks so much for being here. Really enjoyed 719 00:26:28,390 --> 00:26:30,309 our conversation. Thanks so much for taking the 720 00:26:30,309 --> 00:26:30,809 time. 721 00:26:31,190 --> 00:26:32,730 Thank you. Appreciate it. 722 00:26:33,349 --> 00:26:35,509 Alright. It was a pleasure. I'd also like 723 00:26:35,509 --> 00:26:37,934 to thank our podcast sponsor, Johnson and Johnson 724 00:26:38,095 --> 00:26:40,674 MedTech. And for more information on the ASC 725 00:26:40,975 --> 00:26:43,695 preceptorship program by the Johnson and Johnson MedTech 726 00:26:43,695 --> 00:26:46,654 Professional Education team, please reach out to the 727 00:26:46,654 --> 00:26:47,634 following email, 728 00:26:48,095 --> 00:26:48,595 ascstrategicthoughtleadership 729 00:26:51,480 --> 00:26:51,980 atits.jnj.com. 730 00:26:55,480 --> 00:26:58,700 This email is also included in this episode's 731 00:26:59,641 --> 00:27:01,721 description. And you can tune into more podcasts 732 00:27:01,721 --> 00:27:04,361 from Becker's Healthcare by visiting our podcast page 733 00:27:04,361 --> 00:27:05,101 at beckershospitalreview.com.