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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 Nikhil Shetty, who is
the chief operating officer at Midwest Interventional Spine
Specialists. So thanks so much for being here.
Let's start off by having you introduce yourself
a little bit further and tell us more
about your role and organization.
Well, thank you very much for having me.
My name's Nikhil Shetty. I'm an interventional pain
physician,
and, I've been working at Midwest Interventional Spine
Specialists in Northwest Indiana for the past eight
years. It's my first job out of fellowship.
I love the area. I love the region,
and I love doing interventional pain. I have
very good partners and very good colleagues in
the area.
And, we've been able to build a practice
in a surgery center just been growing over
the past,
several years, eight of which I've been a
part of.
And, it's a very fulfilling role,
you know, treating patients in the Northwest Indiana
area and the full region corridor
from a full spectrum of interventional pain medicine.
Well, thank you for joining me. And let's
start with what trends and shifts you're seeing
right now in the industry
that you think are the most important for
leaders to pay attention to.
Well, I think, this conference being one, Becker's
ASC,
kinda highlights the importance
and the trends of everything shifting to the
outpatient setting in the ambulatory surgery center. The
ambulatory surgery center model,
allows for faster, more efficient,
safer,
delivery of health care. And some of the
higher acuity procedures that previously were done only
in the hospital to HOPD settings are now
being transitioned to an ambulatory surgery center where
we have more control
of the throughput. And so our clinical staff,
who we are very familiar
working with, they understand how our ORs operate.
They understand patient turnover. They understand OR turnover.
And,
it has allowed us to
offer these therapies that weren't previously
available to patients unless they went to a
hospital, sometimes had to stay overnight in the
hospital. A lot of times,
these same procedures, namely interventional pain procedures and
specifically neuromodulation or spinal cord stimulation can be
delivered in the outpatient setting or in the
ASC
more efficiently.
Absolutely.
And staffing and workforce challenges also continue to
be a concern across health care. So how
is your organization
navigating these pressures and which strategies have seemed
to work well?
Yeah. So staffing and workforce
challenges are a concern across health care. And
I think I share that with a lot
of my colleagues here at Becker speaking specifically
of anesthesia services.
Anesthesia as a service line has been very
difficult to obtain
in the ambulatory surgery center setting as well
as in the hospital.
It's harder and harder to get anesthesiologists
to cover or c r n a's to
cover your cases.
So we have turned in we have turned
to
temp agencies, other independent contractors to provide those
anesthesia services. A lot of my anesthesia colleagues
have given up a portion of their pain
practice and are now doing anesthesia because of
the high demand. And And so we've kind
of been able to shift and provide those
anesthesia services by reaching out to those
resources.
I mean, additional staffing and workforce challenges are
always a challenge in the small business setting.
There's obviously a lot of office turnover
and,
hiring.
Our workforce
is becoming more and more difficult and challenging.
So we take it upon ourselves to educate
from a top down perspective.
All of our clinical staff, our APPs, our
advanced practice providers,
our medical assistants, our nursing staff, our front
office staff that you know, us being a
small practice, we're able to kind of control
that environment a little bit more. And it
is more of a family. You know? My
practice is a little bit more of a
family feel to it. And so when we
foster that
relationship and sort of nurture them, because a
lot of times they're young, and we educate
them as they grow into careers and they
advance into other careers other aspects of their
careers, we try and do everything that we
can to retain that part of the work
for
workforce. And as these transitions happen as they
naturally do, we establish a good training protocol
so that as a person moves on to
bigger and better things and we wish them
well, part of their exit strategy is to
help train the new person who's gonna assume
that responsibility.
Absolutely.
And you touched on it a little bit.
But as outpatient care continues to grow, how
do you see the role of orthopedic spine
and ASCs evolving within the broader health care
ecosystem?
Well, I think orthopedic spine and ASCs are
going to become a bigger and bigger piece
of the overall health care pie and taking
up a bigger space within the health care
ecosystem. I think it's because of our efficiencies.
The fact that we are able to kinda
limit waste, limit overhead,
limit,
unnecessary
wastage that happens when you go to a
hospital to do certain kinds of procedures. We're
able to streamline those processes
and sort of, you know, almost micromanage every
level into an area where everybody has their
own responsibilities. So we work as a well
oiled machine. It's sort of like an f
one team when the car stops in the
pit stop. They change all their tires in
seconds. And so everybody has a role. Everybody
has a responsibility.
We are all dedicated to our roles and
our responsibility in service of the better outcome
for the patient. And I think because that
mindset starting from a small business mentality and
then growing to a larger and larger ASC,
that model is now being looked at by
bigger health health systems who are now, in
turn, acquiring ASCs for their efficiencies.
And so I think
as to answer your question, I think it's
only begun going to become a bigger and
bigger role and a bigger part of the
ecosystem.
And as we wrap up our conversation, many
organizations are exploring new technologies, partnerships, or care
models to improve
efficiency and outcomes. So are there any innovations
or initiatives that you found particularly promising?
Yes. I think, through this conference,
the utilization
of artificial intelligence,
particularly in the scrubbing down of our notes,
making sure that our codes are appropriate,
making sure that everything is submitted on time,
this whole revenue cycle management or RCM process.
There are many different aspects to what happens
throughout the throughput of a patient's
life cycle, so to speak, in as far
as revenue cycle management is concerned. And the
more of these processes that we are able
to automate and
capitalize on, I think that makes our practice
run more efficiency. First,
you know, it's been said before, but if
you can't measure it, you can't really change
it. And so it starts with data collection.
And we're starting to be
more aware of how much time
of a person in our clinical staff is
spending on a certain task. We quantify that,
and we graph it out. And we are
able to see how where the inefficiencies
are lying.
And if we can marry that with an
adoption of artificial intelligence,
we're able to possibly streamline those processes,
making
our already burdened
workforce
lives a little bit easier. And I think
there will be and there are already
companies that are employing and utilizing
AI to streamline this workflow
so that the patient's
experience from start to finish,
is a little bit more streamlined. And if
we're able to capitalize on those processes
and applications out there, that's something that I'm
personally interested in, and that's one of the
reasons I'm at this conference as well.
Absolutely. Well, thank you so much for being
here to share these insights today. Is there
anything else you'd like to share that we
didn't touch on?
No. I think we touched on everything. I
do think that,
you know, two things are growing. One is
that,
outpatient ambulatory surgery centers, orthopedics, and spine, and
particularly interventional pain management that practice because of
the ASC ASC model is growing. And if
even if we were to set that aside,
the practice of interventional pain medicine is also
growing in and of itself and in its
own scope. And so as we adopt these
newer and newer technologies,
offer these newer therapies for newer indications capturing
a bigger population of the patients,
especially with chronic pain, we are able to
see that, you know, we're both both fields
are able to grow together and harmoniously.
Wonderful. Well, thanks so much for being here.
Again, we are recording live at the twenty
second annual Spine Orthopedic and Pain Management Conference.
Thank you. Lovely to be here.