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forward slash beckerspodcast.

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This is Gracelyn Keller with the Becker's Healthcare

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Podcast, and we are recording live at the

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twenty second annual Spine Orthopedic and Pain Management

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Driven ASC

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and the Future of Spine Conference.

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I am joined right now by Tammy Smittle,

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who is the group CEO at SCA Health.

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So, Tammy, thanks so much for being here.

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Let's start off by having you introduce yourself

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and telling us a little bit more about

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your role and your organization.

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Okay. Hi. I'm Tammy Smittle. I,

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by trade, I'm a nurse. I'm almost thirty

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years of being a nurse. Proud of that.

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I will always be a nurse. I am

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group CEO in Austin, Texas. I have a

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surgery center called Stonegate Surgery Center and a

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surgical hospital called Northwest Hills Surgical Hospital. So

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I run up and down the highway most

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days,

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maintaining both of these facilities. So I have,

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14 ORs in all, and,

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we do mostly ortho and spine.

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Wonderful. Well, thank you for joining me today.

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And let's start off with what trends or

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shifts you're currently seeing right now in the

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industry that you think are the most important

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for industry leaders to pay attention to.

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Yeah. I think it's the thing same thing

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that we've been seeing the last few years

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is just it's been interesting seeing

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the higher acuity cases hitting the ASCs and

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even the surgical hospital. So we're seeing a

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higher ASA levels also. So we're kinda seeing

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some sicker patients,

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go through the doors and being

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treated well and,

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safely in our surgery center. So that's been

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a fun trend to watch. I think that

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leaders

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are having to learn to walk a tight

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rope in between what's pushing the envelope on

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higher ASA and higher acuity, and what's can

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safely be performed in the ASC. And I

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think a lot of times until you do

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it that first time, you don't know. And

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so you have to team up with a

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great anesthesia group and great surgeons, obviously,

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that can help you, teeter that tight rope.

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But I think that's

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what I'm watching, and it's been really cool

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to see. And being a nurse for so

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long is how much was been moved to

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the ASC

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and how patients are performing

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great, and they're having good outcomes without any

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infections.

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Absolutely.

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And staffing and workforce challenges continue to be

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a concern across health care. So how is

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your organization navigating these pressures, and what strategies

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have you seen work well?

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So, obviously,

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staffing is always gonna be an issue, and

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I'm all about building culture.

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And my two facilities, the culture is totally

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different at both of them. It's works perfectly

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for the facility that it's in.

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My South Austin facility is a little bit

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cookier than my North Austin facility, and that's

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how life should be. So I I think

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that you have to build a culture and

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a team and a family

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that works for that environment.

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Of course, like everyone's leaving or wanting to

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leave, and it's interesting for higher pay, but

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then all those people end up coming back

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to you because I don't wanna be the

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highest

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paying employee

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employer out there because then you're just getting

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these staff that's there for the money and

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not there for the for the right reasons

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of of, you know, creating this family and

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taking care of patients as a team.

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I want to create a culture where we're

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a team and that we all work together

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and

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it's never someone's not my job to do

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something. Like, we all work together. I mop

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floors. Everyone mops floors. And so I think

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that it's if you focus on building culture,

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then the rest of it kinda falls into

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place. And I've not had staffing challenges at

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my two facilities because I think that as

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focusing on culture and not necessarily focusing on

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the highest pay

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has really

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made it, a positive environment for people to

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wanna come and work.

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And as outpatient care continues to grow, how

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do you see the role of orthopedics,

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spine, ASCs, all those things evolving within the

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border or the broader healthcare ecosystem?

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That's been fun to watch. So I have

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I I told you I do mostly ortho,

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and spine in my facilities. And my ASC

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has done some neat things recently.

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I had the very first orthopedic surgeon to

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perform a peripheral nerve stem on a patient

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post total knee,

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for having chronic pain after a total knee.

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So it's been interesting watching

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traditional orthopedist

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evolve into these non traditional procedures,

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and seeing the patient outcomes have been great.

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And yet it just takes you know, you

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have to have that catalyst. It takes the

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one guy to start doing these procedures. And

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then now I have a a whole group

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of orthopedists that are doing these procedures.

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And one of them are is traveling around

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the world doing papers and talking about,

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how peripheral nerve stims work great in orthopedic

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population for orthopedists to perform these. So it's

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been it's been fun to watch. And then

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I think that I I think that as

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the technology in improves,

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like, we're just gonna have to continue to

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be open to have new technology in your

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door.

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Absolutely. And as we wrap up our conversation,

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many organizations are exploring new technologies, partnerships, or

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care models to improve efficiency and outcomes. So

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are there any innovations or initiatives you found

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particularly promising?

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Yeah. I mean, that's always a a good

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question,

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with care models and and trying to find

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the right mix of taking good care of

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patients and then still making money and a

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facility and my facilities are physician owned.

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My two facilities have teamed up with a

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large hospital system.

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That has helped us tremendously. And I think

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it's a win win for both

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the surgery centers and the surgical hospitals as

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well as the,

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the hospital system because none that gives them

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like, they have outlets because everything's moving to

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the ASCs, and these hospitals see it. So

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when they team up with us, they actually

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can be like, hey. We're part of this.

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So it's been a good win. I think

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there's gonna be struggles and we're all struggling

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through it, like, who gets what patient and

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there's still those fights.

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And it's interesting how the doctors get pulled

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in between them. But I think that that

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will continue. I think we'll continue to see

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a bigger growth of

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ASCs pairing up

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with these big hospital systems.

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Wonderful. Well, is there anything else you'd like

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to share that we didn't touch on? No,

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I think that's it. Thank you guys for

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having me. Awesome, Tammy. Thank you so much.

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Again, we are recording live at the Becker's

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twenty second Annual Spine Orthopedic and Pain Management

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Conference.