1 00:00:00,080 --> 00:00:02,319 Are your patients looking for an easy way 2 00:00:02,319 --> 00:00:04,480 to pay for health care? Want to level 3 00:00:04,480 --> 00:00:06,639 up the way you do business? Then the 4 00:00:06,639 --> 00:00:09,199 CareCredit Health and Wellness card just might be 5 00:00:09,199 --> 00:00:09,859 the answer. 6 00:00:10,160 --> 00:00:13,539 For over 30 years, CareCredit, a Synchrony solution, 7 00:00:13,759 --> 00:00:16,454 has been providing patients with a modern, flexible 8 00:00:16,454 --> 00:00:18,375 way to pay for their health and wellness 9 00:00:18,375 --> 00:00:18,875 expenses. 10 00:00:19,414 --> 00:00:22,875 CareCredit seamlessly integrates with your business, helping minimize 11 00:00:23,015 --> 00:00:25,975 account receivable, all while your patients enjoy budget 12 00:00:25,975 --> 00:00:27,595 friendly financing options. 13 00:00:28,054 --> 00:00:30,214 To learn more about how CareCredit works for 14 00:00:30,214 --> 00:00:31,274 you and your patients, 15 00:00:31,679 --> 00:00:32,420 visit carecredit.comforward/beccarspodcast. 16 00:00:37,520 --> 00:00:39,760 This is Gracelyn Keller with the Becker's Healthcare 17 00:00:39,760 --> 00:00:42,479 Podcast, and we are live at the business 18 00:00:42,479 --> 00:00:44,260 and operations of ASCs. 19 00:00:45,039 --> 00:00:46,899 I am currently joined by 20 00:00:47,335 --> 00:00:49,734 Scott Kolstad, who is the CEO at Saint 21 00:00:49,734 --> 00:00:51,655 Paul Eye Clinic. So, Scott, thanks so much 22 00:00:51,655 --> 00:00:53,254 for joining me today. I would love to 23 00:00:53,254 --> 00:00:54,695 have you introduce yourself and tell us a 24 00:00:54,695 --> 00:00:56,134 little bit more about your work as we 25 00:00:56,134 --> 00:00:58,295 get started. Wonderful. Thank you. And I just 26 00:00:58,295 --> 00:01:00,134 wanna begin by saying thank you to the 27 00:01:00,134 --> 00:01:03,689 Becker's organization for not only inviting me, but 28 00:01:03,689 --> 00:01:04,430 more importantly, 29 00:01:05,129 --> 00:01:07,530 putting on this conference. It's it's always well 30 00:01:07,530 --> 00:01:08,909 run, highly organized, 31 00:01:09,530 --> 00:01:11,530 and it's really a valuable conference. So I 32 00:01:11,530 --> 00:01:14,170 just wanna extend my thanks for that. Again, 33 00:01:14,170 --> 00:01:15,930 my name is Scott Colston, and I currently 34 00:01:15,930 --> 00:01:17,530 serve as the CEO of the Saint Paul 35 00:01:17,530 --> 00:01:18,189 Eye Clinic. 36 00:01:18,594 --> 00:01:21,474 My professional background is actually athletic training, sports 37 00:01:21,474 --> 00:01:22,614 medicine, and orthopedics. 38 00:01:23,394 --> 00:01:24,915 So the eyeball is a bit new to 39 00:01:24,915 --> 00:01:27,334 me, but the world of ASCs is not. 40 00:01:28,114 --> 00:01:30,594 Throughout my career, I've had a great pleasure 41 00:01:30,594 --> 00:01:33,969 of standing up. Ambulatory surgery centers, some single 42 00:01:33,969 --> 00:01:35,670 specialty, some multi specialty. 43 00:01:36,290 --> 00:01:38,469 I served on, several boards, 44 00:01:39,250 --> 00:01:41,890 of ASCs. Some, again, some joint ventures, some 45 00:01:41,890 --> 00:01:42,390 single 46 00:01:42,770 --> 00:01:43,909 practice owned, 47 00:01:44,450 --> 00:01:44,950 organizations. 48 00:01:46,004 --> 00:01:47,305 So it's been a great journey. 49 00:01:48,004 --> 00:01:50,004 Wonderful. Well, thank you for taking the time 50 00:01:50,004 --> 00:01:52,084 to be here, and let's start our conversation 51 00:01:52,084 --> 00:01:54,724 today talking about ASC volume. So this is 52 00:01:54,724 --> 00:01:56,584 expected to increase by 16% 53 00:01:56,885 --> 00:01:58,905 across the country by the year 2032. 54 00:01:59,765 --> 00:02:01,890 With this growth, what is the most pressing 55 00:02:01,890 --> 00:02:04,630 challenge to maintaining a positive patient experience? 56 00:02:05,490 --> 00:02:06,549 That's a great question. 57 00:02:07,010 --> 00:02:08,689 I think there are a few challenges that 58 00:02:08,689 --> 00:02:10,689 we will have to address and keep our 59 00:02:10,689 --> 00:02:13,169 eye on as we go forward. And first, 60 00:02:13,169 --> 00:02:15,525 while the patient demand will be there, we 61 00:02:15,525 --> 00:02:17,465 have to recognize that in certain subspecialties, 62 00:02:19,205 --> 00:02:21,064 we'll actually have a physician shortage. 63 00:02:21,525 --> 00:02:22,425 And so 64 00:02:23,685 --> 00:02:25,284 on one hand, that's a good problem to 65 00:02:25,284 --> 00:02:27,365 have. I'd rather not solve the problem of 66 00:02:27,365 --> 00:02:29,305 too many doctors and not enough patients, 67 00:02:30,085 --> 00:02:32,270 but we are going to have to solve 68 00:02:32,270 --> 00:02:33,009 that problem, 69 00:02:33,789 --> 00:02:34,289 because 70 00:02:34,750 --> 00:02:37,569 as we decrease the supply of our physicians, 71 00:02:37,629 --> 00:02:38,289 I think 72 00:02:38,830 --> 00:02:40,189 we still have to make sure we keep 73 00:02:40,189 --> 00:02:41,949 our eyes on the fact that a patient 74 00:02:41,949 --> 00:02:43,009 experience is 75 00:02:43,534 --> 00:02:44,435 is in measure, 76 00:02:45,375 --> 00:02:46,835 the access to timely, 77 00:02:47,935 --> 00:02:48,435 equitable, 78 00:02:48,895 --> 00:02:51,455 efficient access to care. And if, you know, 79 00:02:51,455 --> 00:02:53,294 if our supply of doctors is down, I 80 00:02:53,294 --> 00:02:56,014 couldn't see I can see the their access 81 00:02:56,014 --> 00:02:57,615 being delayed, and so we'll have to focus 82 00:02:57,615 --> 00:02:59,829 on that. So staying with the workforce 83 00:03:00,209 --> 00:03:00,709 theme, 84 00:03:01,169 --> 00:03:02,849 I think the other thing we'll have to 85 00:03:02,849 --> 00:03:05,750 keep in mind is the downstream effect of 86 00:03:06,049 --> 00:03:09,349 cost pressures that we find inside the ASC. 87 00:03:10,609 --> 00:03:12,150 CRNA costs are increasing. 88 00:03:12,449 --> 00:03:15,395 Reimbursement for anesthesia services services is decreasing, 89 00:03:15,775 --> 00:03:16,514 and so 90 00:03:17,055 --> 00:03:18,735 what will happen then, I think, as a 91 00:03:18,735 --> 00:03:20,194 butterfly effect is 92 00:03:20,655 --> 00:03:23,055 the the anesthesia coverage will be a little 93 00:03:23,055 --> 00:03:24,034 bit more lean, 94 00:03:24,415 --> 00:03:25,955 which will then inherently 95 00:03:26,495 --> 00:03:27,555 or could inherently 96 00:03:28,175 --> 00:03:29,235 increase the 97 00:03:30,050 --> 00:03:30,950 turnaround times, 98 00:03:31,490 --> 00:03:33,810 which means patients are waiting just incrementally a 99 00:03:33,810 --> 00:03:34,710 few more minutes, 100 00:03:35,090 --> 00:03:37,010 and compounding that over the course of a 101 00:03:37,010 --> 00:03:38,930 day, it can it can add up. I 102 00:03:38,930 --> 00:03:39,669 think there's 103 00:03:40,210 --> 00:03:41,110 other considerations 104 00:03:41,409 --> 00:03:44,355 we have to, keep in mind regarding the 105 00:03:44,814 --> 00:03:46,974 capital investment into the centers. Many of these 106 00:03:46,974 --> 00:03:49,135 centers are now 15 to 20 years old, 107 00:03:49,135 --> 00:03:51,055 and so they're showing their wear. We have 108 00:03:51,055 --> 00:03:52,814 to figure out how to make the capital 109 00:03:52,814 --> 00:03:53,314 investments, 110 00:03:54,895 --> 00:03:56,675 to maintain that positive experience. 111 00:03:57,959 --> 00:03:59,739 And then I guess we just have to 112 00:03:59,800 --> 00:04:02,919 be thoughtful that the patients' experiences and their 113 00:04:03,000 --> 00:04:04,680 the attributes of what makes for a good 114 00:04:04,680 --> 00:04:05,180 experience, 115 00:04:05,479 --> 00:04:07,879 those change over time, but I think they 116 00:04:07,879 --> 00:04:09,019 change more rapidly 117 00:04:10,325 --> 00:04:13,125 than maybe health care has been able to 118 00:04:13,125 --> 00:04:15,365 adapt. So we're gonna have to stay kind 119 00:04:15,365 --> 00:04:17,605 of mindful of how we, get ahead of 120 00:04:17,605 --> 00:04:18,264 that curve. 121 00:04:18,884 --> 00:04:20,884 A 100%. Well, thank you for your insights 122 00:04:20,884 --> 00:04:23,365 there. And and going along with that last 123 00:04:23,365 --> 00:04:23,865 question, 124 00:04:24,279 --> 00:04:26,759 what strategies have worked for your organization to 125 00:04:26,759 --> 00:04:28,220 tackle some of these challenges, 126 00:04:28,680 --> 00:04:30,519 and what's one recommendation that you have for 127 00:04:30,519 --> 00:04:32,459 health care leaders to stay ahead of them? 128 00:04:33,240 --> 00:04:35,240 I think we have to be nimble and 129 00:04:35,240 --> 00:04:37,259 flexible and open minded 130 00:04:37,879 --> 00:04:38,379 to 131 00:04:39,415 --> 00:04:40,795 changing care paradigms. 132 00:04:41,335 --> 00:04:43,035 We've seen this in other subspecialties 133 00:04:43,495 --> 00:04:43,995 where, 134 00:04:44,855 --> 00:04:47,995 in orthopedics, for example, primary care sports medicine 135 00:04:48,295 --> 00:04:50,555 doctors did all of the preoperative 136 00:04:50,935 --> 00:04:52,475 workup and postoperative 137 00:04:52,935 --> 00:04:53,435 management, 138 00:04:54,300 --> 00:04:57,339 leaving the surgeon to manage the surgical cases 139 00:04:57,339 --> 00:04:59,919 and the the patients that required the 140 00:05:00,220 --> 00:05:01,680 expertise of a surgeon, 141 00:05:02,779 --> 00:05:05,759 thereby freeing up the surgeon's time for more 142 00:05:06,139 --> 00:05:07,199 operative cases. 143 00:05:07,660 --> 00:05:08,399 In ophthalmology, 144 00:05:08,699 --> 00:05:09,680 that may mean 145 00:05:10,444 --> 00:05:10,944 optometrists 146 00:05:11,404 --> 00:05:13,645 do more of the routine eye exams and 147 00:05:13,645 --> 00:05:16,125 the and the primary medical exams and some 148 00:05:16,125 --> 00:05:17,504 of the clinical workups, 149 00:05:17,964 --> 00:05:19,504 and then feeding the ophthalmologist 150 00:05:19,884 --> 00:05:22,384 with the surgical cases that only the ophthalmologist 151 00:05:22,764 --> 00:05:23,504 can perform. 152 00:05:24,020 --> 00:05:26,128 So we're I think we're gonna have to 153 00:05:26,128 --> 00:05:27,860 stay ahead of that paradigm. I do think 154 00:05:27,860 --> 00:05:30,020 we're also going to have to find ways 155 00:05:30,020 --> 00:05:32,759 to be as efficient as we possibly can 156 00:05:32,819 --> 00:05:34,040 and using technology 157 00:05:34,660 --> 00:05:36,840 to do that. AI is certainly, 158 00:05:37,745 --> 00:05:39,345 taking on a big presence here in this 159 00:05:39,345 --> 00:05:39,845 conference, 160 00:05:40,625 --> 00:05:44,064 but there's other tools around business automation and 161 00:05:44,064 --> 00:05:45,125 others that I think 162 00:05:45,504 --> 00:05:48,064 can help us not only become more efficient, 163 00:05:48,064 --> 00:05:49,204 but at the same time, 164 00:05:49,504 --> 00:05:52,964 reduce the risk for errors along the way. 165 00:05:53,720 --> 00:05:56,120 And shifting gears just a little bit toward 166 00:05:56,120 --> 00:05:57,339 the financial side, 167 00:05:57,639 --> 00:05:59,639 how can leaders ensure their staff are well 168 00:05:59,639 --> 00:06:02,199 equipped to help patients navigate the financial aspects 169 00:06:02,199 --> 00:06:04,199 of care, and how does this benefit patient 170 00:06:04,199 --> 00:06:05,180 provider relationships? 171 00:06:06,754 --> 00:06:09,095 Yeah. That's a great question too. 172 00:06:09,714 --> 00:06:11,394 Abe Lincoln once said that if you gave 173 00:06:11,394 --> 00:06:13,235 him 6 hours to chop down a tree, 174 00:06:13,235 --> 00:06:15,894 he'd spend the first floor sharpening the ax. 175 00:06:16,355 --> 00:06:19,074 In our world, we we in in my 176 00:06:19,074 --> 00:06:21,479 clinic, we call that sharpening the saw. Act 177 00:06:21,479 --> 00:06:23,720 seemed a little bit too barbaric, but we 178 00:06:23,720 --> 00:06:25,639 say we have to sharpen the saw. And 179 00:06:25,639 --> 00:06:27,000 what I mean by that is we need 180 00:06:27,000 --> 00:06:28,060 to be really precise. 181 00:06:29,959 --> 00:06:31,959 Need to be as precise as we can 182 00:06:31,959 --> 00:06:32,459 about 183 00:06:33,159 --> 00:06:33,659 the 184 00:06:34,120 --> 00:06:34,620 expectations 185 00:06:35,634 --> 00:06:37,475 that are that we have of our patients 186 00:06:37,475 --> 00:06:40,514 and that our patients should should reasonably have 187 00:06:40,514 --> 00:06:41,175 of us. 188 00:06:42,194 --> 00:06:43,175 What I see 189 00:06:44,035 --> 00:06:44,535 creating, 190 00:06:46,035 --> 00:06:48,935 unfavorable patient experiences, frankly, is when 191 00:06:49,449 --> 00:06:51,550 when we have variation in our processes 192 00:06:52,170 --> 00:06:54,509 or we have variation in those expectations. 193 00:06:55,050 --> 00:06:58,270 So we can't have patients experience us 194 00:06:59,129 --> 00:06:59,629 differently 195 00:07:00,730 --> 00:07:03,149 depending on the doctor that they see 196 00:07:03,850 --> 00:07:04,350 or 197 00:07:05,404 --> 00:07:07,404 the person that picks up their phone to 198 00:07:07,404 --> 00:07:08,944 do their financial counseling. 199 00:07:09,485 --> 00:07:10,785 We have to have, 200 00:07:11,485 --> 00:07:12,464 very standard, 201 00:07:12,845 --> 00:07:13,345 deliberate, 202 00:07:14,685 --> 00:07:15,904 consistent processes. 203 00:07:16,444 --> 00:07:17,185 The variation, 204 00:07:17,884 --> 00:07:19,564 because I've seen this in the past too, 205 00:07:19,564 --> 00:07:20,064 where 206 00:07:20,720 --> 00:07:22,639 if you go to one physician, the physician 207 00:07:22,639 --> 00:07:23,840 will say, oh, don't worry about it. We 208 00:07:23,840 --> 00:07:25,759 won't collect that patient balance up front. And 209 00:07:25,759 --> 00:07:27,199 then they go to a different physician and 210 00:07:27,199 --> 00:07:29,439 says, oh, no. No. No. We have to 211 00:07:29,439 --> 00:07:30,100 do that. 212 00:07:30,560 --> 00:07:33,439 And that creates that creates variation in the 213 00:07:33,439 --> 00:07:35,439 process, and it makes it difficult for the 214 00:07:35,439 --> 00:07:35,939 people 215 00:07:36,555 --> 00:07:39,915 executing those processes to to have consistency and 216 00:07:39,915 --> 00:07:41,615 to know what to do. And that variation 217 00:07:41,834 --> 00:07:43,855 then can can challenge the 218 00:07:44,235 --> 00:07:46,975 experiences that patients have. So I 219 00:07:47,435 --> 00:07:50,779 I do believe that reducing variation in that, 220 00:07:50,779 --> 00:07:51,279 eliminating 221 00:07:51,580 --> 00:07:53,580 any of the, I don't know, call it 222 00:07:53,580 --> 00:07:56,639 background noise, if you will, is really important. 223 00:07:57,819 --> 00:08:00,300 And as we wrap our conversation here, is 224 00:08:00,300 --> 00:08:02,379 there any closing remarks you'd like to share 225 00:08:02,379 --> 00:08:03,680 on the podcast today? 226 00:08:04,384 --> 00:08:06,305 Well, again, I just wanna say thanks for 227 00:08:06,305 --> 00:08:07,764 the opportunity to, 228 00:08:08,305 --> 00:08:10,704 speak today and speak later this afternoon. It's 229 00:08:10,704 --> 00:08:13,104 it's a well run conference. I'm excited to 230 00:08:13,104 --> 00:08:13,604 see 231 00:08:15,425 --> 00:08:16,884 how emerging technologies 232 00:08:17,504 --> 00:08:19,524 and AI will help us 233 00:08:20,439 --> 00:08:20,939 clinically, 234 00:08:21,480 --> 00:08:21,980 operationally, 235 00:08:22,519 --> 00:08:23,019 strategically. 236 00:08:24,040 --> 00:08:25,899 I think it will have the 237 00:08:26,439 --> 00:08:28,519 it it'll present an opportunity for us to 238 00:08:28,519 --> 00:08:32,279 be more nimble and and, more quickly react 239 00:08:32,279 --> 00:08:33,659 to a changing landscape. 240 00:08:33,960 --> 00:08:36,404 Having said that, it's still such a wild 241 00:08:36,404 --> 00:08:38,485 west. I don't know that we know exactly 242 00:08:38,485 --> 00:08:40,485 how that will work out yet, and we 243 00:08:40,485 --> 00:08:41,465 have to be prepared, 244 00:08:42,404 --> 00:08:44,425 to manage some bumps along the road. 245 00:08:45,045 --> 00:08:47,045 Wonderful. Well, Scott, thanks so much for joining 246 00:08:47,045 --> 00:08:49,088 me today on the Becker Healthcare podcast. Again, 247 00:08:49,088 --> 00:08:51,008 we're live at the business and operations of 248 00:08:51,008 --> 00:08:51,508 ASCs. 249 00:08:52,128 --> 00:08:53,268 Thank you so much.