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forward slash beckerspodcast.
This is Gracelyn Keller with the Becker's Healthcare
Podcast, and we are recording live at the
twenty second annual Spine Orthopedic and Pain Management
Conference.
I'm joined today by Brett Shore, who is
an orthopedic surgeon at Shore Orthopedics. So doctor
Shore, thanks for joining me today. Let's start
off by having you share a little bit
more about yourself, your role, and your organization.
Hi. Thanks for having me. Again, yeah, my
name is Brett Shore. I am a fellowship
trained sports medicine orthopedic surgeon with a particular
interest in hips in kinda comprehensive hip care,
from
treating hip dysplasia and hip impingement,
and hip replacements as well.
So in terms of my role in the
organization, so the other organization that I'm here
kind of, I guess, representing or that I
work with is DISC Sports and Spine. And
within
DISC Sports and Spine, I'm one of the,
primary orthopedic
surgeons.
A lot of
the a lot of the bandwidth within, Disc,
Sports and Spine is in spine care,
and they have recently expanded to bring on,
extremity orthopedics. And I was one of the
one of the early people that joined for
that purpose.
And then within Shore Orthopedics, I'm the it's
my company. So I'm the president and CEO
of that.
Wonderful. Well, thank you for being here. And
let's start off with
some of the trends and shifts you're seeing
right now in the industry that you think
are the most important for industry leaders to
be paying attention
to? I think one of the things that
that we see at DISC and that I
think is a trend across,
the industry is, the formation of partnerships between
some of the surgery centers and,
the payers, the insurance providers.
In an effort to both minimize health care
costs both for the patient and for the
insurer and also as a way to try
and maximize
value for,
the insurance company.
Additionally, I think it's clear that more and
more procedures are being moved to the ambulatory
setting.
I think back to some of the surgeries
that
were two to three night or more overnight
stays when I was in my training,
which was back I finished in 2011.
And now a lot of those surgeries either
done as twenty three hour obs or same
day discharges.
And let's touch on staffing and workforce challenges
as these continue to be a concern across
health care. So how is your organization navigating
these pressures, and what strategies have you seen
work well? Yeah. This is a this is
definitely a challenging,
environment
for
hiring and maintaining good staff.
I think one of the areas where I've
seen some of the greatest challenges, which is
partially in relation to the fact that the
medical director of my surgery center is my
wife, who is an anesthesiologist,
doctor Amy Shore,
is
the
sort of onboarding and
collaboration with,
anesthesia providers, with anesthesiologists.
And
one of the challenges is that the landscape
in
anesthesia has changed dramatically over the last five
to ten years in terms of both availability
and reimbursement.
And it can be hard to identify those
changes as they're happening,
and it can be easy for an organization
to
kind of get caught on the wrong foot
with respect to those changes.
And
I think one of the keys
in maintaining
and running an efficient,
safe, and profitable,
surgery center
is high quality anesthesia care.
And it's an area where I'm not sure
that
it's always it hasn't always been a priority
because the market didn't necessitate it.
But at this point, the demand for high
quality anesthesiologists
is so high that it's an area where
both DISC Sports and Spine and other,
organizations,
I think, are putting a greater emphasis on
reimbursement
and
bringing on
well trained qualified anesthesiologists.
Absolutely.
And as outpatient care continues to grow, how
do you see the role of orthopedics evolving
within the broader healthcare ecosystem?
Well, I think orthopedics lends itself nicely to
outpatient care in general because
the majority of our surgeries,
there are surgeries that are high risk that
have high capacity for blood loss. One of
them that I perform is the periacetabular
osteotomy, PAO.
That is an operation that
technically could probably be done in a surgery
center with a 23 obvs, but there's not
gonna be a big push for that because
most of those patients
have a lot of pain and stay overnight.
But for the majority of the procedures that
we do,
as minimally invasive surgery becomes more widespread
and as
we're able to use,
products such as, tranexamic
acid
to reduce blood loss,
Orthopedics is, in some ways, gonna be, a
leader and a pioneer, I think, in bringing
the majority of surgeries into the ambulatory setting,
both as a way to improve
patient outcomes, but also to reduce health care
costs that are associated with inpatient stays.
And then many organizations are also exploring new
technologies, partnerships, and care models to improve efficiency
and outcomes. So are there any innovations or
initiatives that you found particularly promising?
Yeah. It's a good question.
And this is actually referring back a little
bit to one of my previous answers in
terms of the trends and shifts.
This is one where I think partnerships between
the surgery centers and the insurance providers,
when done in a way that
both checks a couple of boxes.
One is providing safe and effective care.
Two is providing it at a
cost savings or value for both the surgery
center
and for the provider for the for the
insurance company.
And finally, that also improves physician reimbursement both
on the surgical and and the anesthesia side.
When you can check all those boxes, then
it it ends up being, I think, a
really promising development in the ambulatory surgery model.
And as we wrap up, was there anything
else you'd like to share that we didn't
touch on today?
I guess the one other thing that I
would that I would, you know, mention in
terms of some of the previous, topics that
we've discussed is the unique challenge that Medicare
brings
to, the ambulatory surgery setting.
As there are some procedures that are reimbursed
reasonably well with through Medicare, but others which
are not.
And,
understanding how to incorporate
or choosing not to incorporate Medicare into the
ambulatory model and what that means both in
terms of physician and and and in terms
of surgeon and anesthesiologist
reimbursement, I think is gonna be critical for
the success of surgery centers going forward
as there doesn't seem to be a lot
of appetite for increasing
the reimbursement rates in Medicare in the federal
government anytime soon.
Wonderful. Well, doctor Brett Short, thanks so much
for joining me today on the Becker's Healthcare
podcast, and we are recording live at the
twenty second annual Spine Orthopedic and Pain Management
Conference.