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forward slash beckers podcast.
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 currently joined by Michael Boutros who serves
as the clinical operations chief and medical director
for pain services at the Keck School of
Medicine of USC. So, Michael, thanks for joining
me today. Would love to have you start
off by introducing yourself and telling us a
little bit more about what you do.
Thanks so much, for having me on, Grace.
So I'm the clinical operations
and,
medical director for pain services at the Keck
School of Medicine of USC,
as well as the pain fellowship director and
the chair of the opioid stewardship committee.
And so, you know, wearing a lot of
hats, I'm involved with a lot of the
outpatient,
pain procedures
as well as the care paths and protocols
that involve patients and pain, whether it's postoperative
or whether it's, chronic pain.
Well, thank you for taking the the time
to join me today. And let's start our
conversation
with what trends or shifts you're currently seeing
right now in the industry that you think
are most important for industry leaders to pay
attention to.
There's been an overall trend towards non opioid
pain management strategies, and that includes
medications as well as interventional approaches.
When it comes to medications, there are newer
medications that are coming out. For example, Suzetrajene
was recently approved by the FDA as a
non opioid based approach
to taking care of acute pain
episodes.
It uses a novel
mechanism, sodium subtype one point eight channel blockade.
This is in a class in of itself
and has opened a new
genre and category of medications that can benefit
patients
postoperatively,
for example, or after acute pain episodes
where they're able to,
help manage their pain without some of the
typical
side effects that we see with opioids like
nausea and vomiting,
typical questions about the risks of opioid addiction,
constipation,
all of these things. And and it's important
because
all of these things also
cost both money and time from the perspective
of efficiency planning, especially when it comes to
an ASC
trying to move things forward, next cases and
whatnot.
So having protocols and care pads in place
that involve these types of medications upfront to
move things forward is wonderful.
And then from an interventional perspective, we have
newer types of procedures
that are more on the curative side of
things rather than patchwork.
So there's a trend away from things like
epidural steroid injections, which we know don't last
very long. They don't necessarily fix many things.
They just sort of
provide relief that we know can be mostly
temporary,
and that has been shifting away and moving
towards
more
curative procedures like minimally invasive lumbar decompression, the
mild procedure, or basivertebral
nerve ablation,
which provide longer lasting relief and more definitive
approaches to taking care of what the actual
problem is with the patient.
And staffing and workforce challenges also continue to
be a concern across health care. So what
is your organization doing to navigate these pressures,
and what strategies have you seen work well?
So, so there are a number of different
approaches
that organizations can take when it comes to
trying to retain and to attract
staffing and and workforce,
especially in today's day and age. So a
number of different things that we've been, doing
is
providing,
obviously, competitive pay and and flexibility focused benefits.
But in addition to that, we're, as an
academic institution,
able to provide
professional development opportunities
for them as well as,
technology
that can help ease the administrative burdens.
So we partner with different third party vendors
and different companies
to help from the preauthorization
perspective for a lot of these procedures.
So that offloads a lot of that kind
of work from our specific group.
And then in addition to that,
USC
provides
the workforce
a an opportunity
to
move forward with
more educational
opportunities.
For example, like earn and learn programs.
And that way,
that allows them to
want to retain them, you know, or want
to stay on that on that workforce,
because they know that they're gonna be able
to to move up,
that that that ladder.
And as outpatient care continues to grow, how
do you see the role of orthopedics,
spine, ASCs, all those things evolving with the
broader healthcare ecosystem?
It's gonna be a deeper integration
into that system because more and more
procedures are
coming out that
do a pretty good job when it comes
to reimbursement.
But the key here is that as these
are newer procedures, there's,
more time required to get these things pre
authorized. So there's a patience that needs to
be put in play and and setting expectations
for example with patients and and when they're
gonna be able to get these things done.
But,
as more and more of these procedures are
being developed
more pain physicians, for example, are going to
be incorporating this into their practice. And so
now the real question is, how do we
allocate resources more efficiently and effectively to allow
for that limited resource of, for example, OR
time
to allow
all these newer procedures
to compete with preexisting
procedures
like neuromodulation,
for example, or radio frequency ablation. And so
how do we allocate these procedures to the
appropriate domains?
What needs to be done in an operating
room? What can be moved to an outpatient,
you know, procedure clinic, for example?
I think that that obviously is going to
be dependent on where you practice and the
resources that you have, But I think it's
a question that now needs to be asked,
much more astutely
to allow for these newer procedures to effectively,
be implemented in the area that you work.
And then finally, many organizations are exploring new
technologies, partnerships, or care models to improve efficiency
and outcomes. So are there any innovations or
initiatives you found particularly promising?
So there are a number of different things
that we're doing essentially in terms of protocolizing,
efficiency.
So trying to incorporate
specific medications,
that are non opioid
and getting them in the hands of patients
before their procedure to make sure that they
have it ready for them when they get
discharged,
is is essentially one component of this.
And then on top of this, ensuring that
we are staying up to date with the
newest evidence based approaches that are available out
on the market.
And so we wanna make sure that we're
providing
patients
with the things that can empower them to
achieve the type of pain relief that they're
looking for without necessarily,
you know, staying in the in the in
the dark ages
with some of these older procedures that, you
know, if you wanna call them bread and
butter,
remain sort of the the the
the stable crop of procedures that have been
historically used. We you have to be able
to innovate. You have to be able to
stay with the latest,
innovative approaches
to keep relevant
with the industry
and to allow more patients
to want to be able to come in
and and look at your organization
as, you know, a beacon for,
innovation and and options for them.
Well, Michael, thanks so much for joining me
today on the Becker's Healthcare Podcast. Again, we
are recording live at the twenty second annual
Spine Orthopedic and Pain Management Conference. Thanks so
much for having me, Grace.