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forward slash beckerspodcast.
This is Gracelyn Keller with the Becker's Healthcare
Podcast, and we are live at the twenty
second annual Spine Orthopedic and Pain Management Conference.
I'm currently joined by Zeeshan Tayeb, who is
the medical director at Pain Specialists of Cincinnati.
Thanks for being here. And let's start our
conversation off by having you tell us a
little bit more about yourself, your background, and
your current role.
Hello. Thank you, Grace, for having me over
here and inviting me to be able to
share a few ideas, with the group at
large. So a little background about me.
Dual board certified in physical med and rehab
and pain management.
I've been practicing,
fourteen
about fourteen years now. I've been private practice
since about 02/2016,
with my own practice, and I've been participating
with Becker's on different levels since 02/2017.
We started off with our original practice of
a pain specialists of Cincinnati
in the Lays and Regenerative Center.
And, since then, we have actually grown and
have expanded out our our practice model to
be a little bit more holistic in nature.
And so now we're doing
or we've started something known as, like, our
region life, and then we're also expanding that
into a surgical center. So that's gonna be
region life surgical center.
And then we have also expanded out into,
some research. So we've started an organization called
IQRA,
ICRA. We've also expanded into having a, nonprofit,
with all the other things we have going
on. And I could go on and on
about that, but I will, digress over there.
Wonderful. Well, thank you for taking the time
to be here. Let's start with some trends
and shifts you're seeing right now in the
industry,
things that you think are most important for
industry leaders to pay attention to.
Yes. So trends and shifts. Things are always
trending and shifting, and we just have to
be able to adapt. So I would say
probably the biggest thing right now that has
really been accentuated over the last, few years,
especially since, COVID,
are the fact that we continue to get
hit with payers
and, you know, just the different things that
are involved with that. So not only, you
know, do costs
or reimbursements continue to get cut, we also
deal with, you know, increased denials and a
lot more work to do for prior authorizations.
So now what does that all translate into?
It's not just less money or more work.
It actually translates into,
maybe maybe an opportunity. Right? So things don't
happen necessarily to us. That's a victim mindset.
It happens for us. So where do we
go from here? So I've been thinking about
this on multiple levels. There are shifts where,
you know, things are going from,
you know, hospitals
or what we would consider more on an
inpatient basis over to ASCs and some things
in the private practice. But the other thing
is happening
also. So
there's things that are happening in private practice
that need to shift over into
surgical centers,
possibly hospitals.
A lot of the reason for that is
because of
there's sometimes a lack of accountability if you're
just running your own practice. There's not as
much oversight. And so some of these governing
bodies are wanting to try to get
more oversight over the different things that are
coming about in in our practice of medicine.
So what does this force us to do?
It forces us to basically become more multidisciplinary.
And what I mean by that or even
interdisciplinary.
So I mean,
it's not just gonna be about filling a
script or doing an injection. It's about working
with
people from different fields, not just our surgeons,
but our doctors and all their different subspecialties.
So in internal medicine and I'll probably come
back around to, giving a couple examples about
that. But also with some of our,
other folks that are also involved in pain
management. So behavioral health, exercise therapists, physical therapists,
and so on.
We were basically at one point, because of
all the cuts,
trying to make up for it by doing
just more volume.
And now
it's not going to be enough just to
do more volume because we're also being scrutinized
for quality of care.
So we're gonna have to the pendulum is
gonna swing. We're gonna have to find that
balance. And so there is a huge push
now for for, value based care. And that's
where AI then comes in. So AI
is,
is gonna be sweep it is sweeping us
off of our feet. And if we don't
get on board with that, we're gonna get
left behind. So with that said,
AI, it can be as simple as just
doing things for intake,
but it's also gonna help with clinical decision
making, crossing t's, dotting i's, and helping to
mitigate, hopefully, some costs with,
you know, how much it takes to, you
know, staff a place or to be able
to run a place.
But it's all gonna be about data,
and AI is also being used for denials.
So we talked about that just just moments
ago.
So on the flip side, we're gonna have
to be able to use AI in a
quote, unquote smart way so that we can,
start getting, things to kinda swing back the
other way.
Absolutely.
All great points.
And let's touch on staffing and workforce challenges
as these continue to be concerns across health
care as well. So how is your organization
navigating these pressures, and what strategies have you
seen work well?
Great question. I think that's always been applied.
It's just different time,
relatively the same issues,
but with a different a different hat or
a different mask.
So I think at this point,
you know, we mentioned AI, and I'll circle
back around to that. I think right now,
we have to find people that have some
heart and some soul. And so rather than
just finding people that can quote unquote just
do a job, we need to start actually,
like, looking at people that actually share
actually, that wanna actually invest in your business
or invest in your practice or your philosophy,
and then also kinda share the mission and
the goals that you have as an organization
or as a provider.
So that's one thing that we've been looking
for. So for some of our
what I call, like, the quote unquote smaller
jobs,
those folks
bring them in, share the philosophy, the vision,
and they have their ninety days.
On the flip side, if we're looking for
people to try to direct programs, like, be,
like, a director of a specific department that
we have in place,
those folks need to really kind of internalize
that, take that in, and they're gonna be
looked at in a different way. But a
lot of it, in terms of trying to
prevent turnover,
providing a platform for people to be quote
unquote happy, I think it's imperative for us
to try to do the due diligence upfront
as opposed to just bringing people in and
then hoping that they make it. Other things,
I think, some of the more practical things
that I think we do as an organization,
we're in a day and age where there's
a lot of ADHD or ADD. A lot
of people are bored.
So it there was a lot of value
back in the day just to be able
to kind of focus on on a task
at a time.
I think most people are designed now or
have basically gone into a way of being
able to multitask to an extent. And a
lot a lot of it has to do
with the fact that, you know, we have,
technology,
electronics,
AI, and things like that at our disclosure.
And so if one used correctly,
those kind of things can be optimized.
So it helps with the role optimization,
but it also then helps with,
preventing burnout,
for everybody pretty much involved. I think it
also provides flexibility for people. So when people
can do things outside of the office,
it also gives them that opportunity to still
be able to do the work. But, hey,
I have a sick kid or I have
something else popped up. My parent is sick.
I can still get the job done and
still provide the service, and still get paid
without necessarily being reprimanded to the point where
I may lose my job.
And then we'll probably circle back around to
this as well, I believe. But outsourcing is
becoming a huge thing. There's always people out
there that wanna continue or groups of people
out there that wanna try to provide services
for us. So I think working with groups
that are specialized in specific areas, I think,
is very beneficial.
And, I've already used the buzz term AI
at least twice, so I'll do it a
third time now and just basically say that
as,
we continue to work together with AI, I
think we're gonna actually continue to grow and
prosper.
A 100%.
And as outpatient care continues to grow, how
do you see the role of orthopedics and
ASCs evolving within the broader healthcare ecosystem?
So like I mentioned before, there's a shift
for things that were
more, on the inpatient end that were kinda
shifting one direction, and then the things from
the outpatient setting is shifting in the other
direction. So, again, things happen for us, not,
against us. And so it's about kinda going
with the flow in some ways and trying
to figure out, okay. Well, this is where
I'm at, and this is what I need
to do. So looking at it from that
angle with everything,
with a lot more shifting to outpatient, that
just means that there's gonna be a lot
more volume. So how are we gonna be
able to basically take that volume in? So
in some ways, it actually aligns with,
CMS,
Medicare guidelines,
what insurance companies are looking for. So we're
looking for cost efficiencies,
you know, patient satisfaction, you know, aligning with,
the payers and so on. You have to
also understand that
pain in orthopedics is one of the number
one reasons why people actually even go and
see a physician or provider or to see
actually seek out help,
period.
So
it gives us an opportunity in this specific
field
to actually become the quote unquote gatekeeper.
Previously, primary care doctors were kinda looked at
as the gatekeepers, but how often do they
see their primary care doc?
Maybe once every three months, six months, maybe
once a year, depending on what's going on.
But if you're working, if you're having an
an orthopedic issue or a pain issue, you're
gonna end up seeing those providers
much more frequently. And so it gives us
an opportunity not necessarily to do everything ourselves,
but to be able to outsource
to our behavioral health specialists, our exercise therapists,
and so on.
And so we're we have a huge opportunity
here.
Absolutely. And as we round out our conversation,
you've touched on this, throughout the conversation so
far, but many organizations are exploring new technologies
and partnerships and care models to improve efficiency
and outcomes. So are there any other innovations
outside of the ones you've already touched on,
or initiatives that you found particularly promising?
Yeah. Absolutely. 100%.
I think this is actually an opportunity for
us to be able to see, like, how
we can kinda look at things a little
bit more holistically.
So number one, one of the reasons we
actually shifted our pain practice and our regenerative
practice, which were actually two separate entities
under one umbrella
or, to try to have an umbrella organization
for all of it was so that we
could provide that holistic care. And so what
I mean by that is
I'm actually
running lab tests and things like that on
people
to see where their kidney and liver is.
I'm also looking to see, like, where some
of their hormonal or nutritional,
imbalances or deficiencies are. And so this gives
us an opportunity now to actually send them
back to their primary care doctor or to
their rheumatologist or endocrinologist
or a GI specialist or whatnot.
The other thing that we also saw as
an opportunity here was to actually then start
up our own little,
primary care clinic so that we can start
that and be able to streamline that without
necessarily taxing the current providers
that are doing,
the traditional pain management in orthopedics.
So that's from that one angle. So, basically,
in a nutshell there, we're looking at trying
to get people more care and optimize their
condition so that no matter what procedure, medication,
or, innovations are being,
recommended to them, they'll be in a good
place to be able to receive receive it,
not just, physically, but also on, multiple levels,
be it spiritually, mentally, and so on.
Now in terms of just, I'll I'll call
the next part innovative interventions.
So we have now not just opioids. When
opioids first came out, it was like like
a godsend.
Now we're amidst a a pandemic or an
epidemic of or people call it, like, the
opioid crisis. And so now we're looking for
other things to try to help,
mitigate those issues. And so medications,
that are sodium or specific sodium channel blockers,
I e, gen generics,
There's an opportunity to help, with something like
that, and there's many other,
examples
just like that. And then, of course, the
field is also continuing to blow up in
the sense that we have all of the,
the different, interventional procedures all the way from
SI joint fusions, facet fusions, minimally invasive lumbar
decompressions,
basovertebral nerve ablations.
We still have our traditional stem. We have
our peripheral nerve stem. And then, I'll I
saved, talking about pain pumps, for last because
they have been around for a little while.
But pain pumps have actually become a huge
thing because it helps mitigate the opioid crisis.
And we've actually,
grown our practice significantly with that,
technology, and we started doing microdosing.
And this is a big thing now. Not
only is the research supporting a lot of
it, but we've also been able to,
get that out onto, larger, forums, and we're
able to present this, information at, other,
big society meetings as well.
Then the last thing I'm gonna mention is
not just
the clinical aspect, but you actually have a
team that is
has to be, I guess, optimized.
And that means
we talked about multitasking,
but you can also overdo it. And peep
and that can result in burnout and people
getting stressed and wanting to leave their jobs
and not having a work life balance and
so on. And so this is where I'm
gonna circle back around and just highlight
the importance of,
outsourcing. And so we have teams now outside,
different places in The United States and even
outside of The United States that actually, work
with us to be able to do things
like remote patient monitoring, therapeutic monitoring, chronic care
management.
We even have, like, another team dedicated to
handling all of our durable medical equipment. And
then we have people also helping with our
revenue cycles, scribing,
and prior authorizations.
Now with all of that said, that's still
a lot of man manpower in a sense
or
people power.
This is also as AI is involved with
this process, hopefully, we'll be able to,
mitigate
some of the issues of
cost in that regard and also help streamline
processes
that are already, you
know, pretty much, simple. They just need to
have
some form of,
organization.
And if it's
where it doesn't involve, say, as much thought
and it's something that just needs to be
done in terms of, from an
algorithmic,
standpoint. That's where, AI can actually really come
in and fit in until it, quote unquote,
gets smarter.
Absolutely. Well, Zeeshan, thank you so much for
joining me today. Is there anything else you'd
like to touch on that we didn't get
to?
Just a shout out to all of our
organizations that have been working with us and
all of the societies that continue to, support
us
in our, endeavors to try to further,
basically everything that we do in our patient
care. That includes,
Ipsos, ASAP,
NASS,
and I could go on and on, AAPM,
ABPM,
all all of our different boards. And then,
one other thing I would like to just
have a little, personal,
if you have enjoyed any of this, you
can just, you know, reach out, and find
out from us on how we have been
trying to utilize all of these services because
a lot has changed in the last, like,
year or year and a half. And, things
are going at a very fast pace.
And, also, I am actually a new author
of a book. And so if you'd like
to check that out, it's called Reversing Osteoarthritis,
and it can be found on Amazon.
Wonderful. Well, thanks for being here. Again, we
are recording live at the twenty second annual
Spine Orthopedic and Pain Management Conference.