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forward slash beckers podcast.
This is Gracelyn Keller with the Becker's Healthcare
podcast, and we are live at the business
and operations of ASCs.
I'm currently joined by doctor Michael Stuntz, who
is the chief medical officer and chairman of
the board at Monterey Peninsula Surgery Center. Thanks
so much for joining me today. I would
love to have you introduce yourself and tell
us a little bit more about your background
and role in the industry.
Hi. Thanks for having me. I always like
to start out by saying my biggest credential
for what I do is having been a
patient at an early age.
Around the age of 16, I was in
a major car accident and spent a week
in the hospital.
And I think that to this day
helps me in everything I've done. I'm trained
as a oncologic surgeon. I did a general
surgery residency and a surgical oncology fellowship, and
I followed that with private practice for twenty
five years in the Monterey area. While I
was in private practice, I became involved in
the surgery center and immediately
saw how important that model is for surgery
and how it has developed my career and
been good for my patients.
And then from there, I,
got on the leadership
of the surgery center on the board of
directors
and eventually became the chairman of that board.
And now currently,
I'm also the chief medical officer,
in the facility.
We we have,
four different facilities
over the Monterey Peninsula area and are doing
most, if not
90% of the outpatient surgery in our area.
I also
am on the California Ambulatory Surgery assent association
board, as well. So I said, and I
get to see what happens at a statewide
level as well here. Wonderful. Well, thank you
for being here to share your insights.
And let's start our conversation here today with
ASC volume.
This is expected to increase by 16%
across the country by the year 2032.
So with this growth, what is the most
pressing challenge to maintaining a positive patient experience?
Well, I think the biggest challenge to ASC
administrators
is going to be maintaining
what we have with,
the challenge of having decreased
or or flat reimbursement
and dramatically climbing expenses
and also
anesthesia coverage. Just even covering
at any level anesthesia can be challenging.
And so you have to do all of
those things together. If you can maintain all
of that, hopefully, then you can maintain the
patient experience. But
there's all sorts of nonmonetary
ways you can improve patient experience. And I
also think you should be very patient focused
on what goes on to the patient at
their level,
having patient surveys to see how their quality
of their experiences
and addressing any problems that comes up come
up appropriately and quickly.
And kind of going along with that, what
strategies have worked for your organization as you
tackle some of these challenges, and what is
the recommendation you have for health care leaders
to stay ahead?
Well, we do a a patient,
satisfaction survey, and we have a team of
people that get together and go over the
results. And so we do that. And I
see so I think at that level, it's
important. We also have our front facing
people go through training to,
interact with patients well.
We've over the years made a lot of
different,
adjustments to how we present our financial information
to the patients and how we collect and
and the opportunities they have to pay their
bills, things like that.
I think, like, looking at your operations and
its efficiency has become important.
I think when we first started our surgery
center, we had
a relatively close market and and,
we had
we didn't have to be as efficient as
we have to be in today's,
environment.
And
I think you can look at all different
aspects of where the inefficiencies
are.
The biggest one I see is scheduling your
blocks,
of time in your day. And it used
to be we'd have seven patient seven rooms
start at 07:30, and almost everybody was done
by noon. And and the staff just hung
out until three, and then that was the
day, and you could afford that,
in prior environments. Now it's not like that.
You can't have everybody start at 07:30 and
end at noon. They have to go the
full day
to pay for anesthesia,
to pay for
our staffing.
And, so look at your blocks very carefully,
see where patients who or doctors who are
doing
half volume, maybe give them every other week.
Like, you could on Wednesday, you know,
every Monday or every, first and third,
of the first and third week of the
month instead of every Monday of the month.
So you could do things like that. You
also have,
some efficiencies you can garner in
using not not using anesthesia, but having open
local
anesthesia. Or one thing we did was, we
had our ophthalmologist,
deliver their own
sedation and anesthesia. And I think that has
freed up
a freed up a, anesthesiologist
to cover our volume elsewhere.
And shifting a little bit to the financial
side,
how can leaders ensure their staff are well
equipped to help patients navigate financial aspects of
care, and how does this benefit patient provider
relationships?
Well, I'll I'll tackle the second half of
that first. The If if your patients are
happy financially, they're happy patients.
I can remember
back when there was a much higher percentage
of patients who are uninsured or who had
issues with, the payment problems.
It was very uncomfortable when a patient comes
to you as a as a surgeon with
a financial problem because you're not trained really
in finance at all. And to help them,
you're just trained to do their surgery, recognize
their problem, and how to fix it.
Whereas nowadays,
I think,
luckily, I think more people are insured, but
there's the other issue is they have to
pay their coinsurance. They have to pay their,
deductibles. And so
you they need to know in advance
what they're gonna pay when they show up.
So I think clearly communicating
to the patient what they need in a
timely manner, not,
okay. You've showed up for your surgery. You
need $5,000. Hand me your credit card. That's
not gonna work, and that's gonna cancel a
case, and that's gonna be inefficient for all
of your other resources like we were discussing
earlier.
And as we wrap our conversation up, are
there any parting words you'd like to share
on the podcast today?
I think the biggest one is that we
are in a challenging environment, but I would
like I look at it as an opportunity.
We are seeing a dramatic shift in how
things are done. We're seeing a massive migration
into
outpatient surgery
environment, which I think is an appropriate shift
in most cases with, the care going to
where it should be. And,
like, for me, I had to do my
first cases at the surgery center because I
didn't have any opportunity, but that made me
shift to
having those patients out of the hospital or
and, well, in this case, the ASC
fast. And so I had to do more
local anesthesia blocks. I had to use less
narcotics. I had to use less overall anesthesia.
I had to have more efficient techniques.
And so,
that really forced me into this pattern of
care, which I think is so much better
where my patients recover so much faster. I
don't use narcotics in most of what I
do now. I use over the counter kind
of medications like Advil and Tylenol.
One out of ten of my I do
mostly breast surgical oncology, and only one out
of ten of my partial mastectomies gets a
prescription. All the rest do fine without it.
And so,
I think, you know, view it as an
opportunity because you might learn something.
And in the process, you'll make the whole
a whole,
the whole enterprise
more efficient.
Absolutely. Well, thank you for taking the time
to join me today on the Becker's Healthcare
podcast. Again, we are live at the business
and operations of ASCs. Thanks so much.