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forward slash beckers podcast.

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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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Conference.

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I'm currently joined by doctor Izzy Lieberman, who

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is an orthopedic surgeon at the Texas Back

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Institute. So, doctor Lieberman, thanks for being here.

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Let's start off by having you introduce yourself

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a little bit further and share more about

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your role and organization.

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Thank you very much. It's a privilege and

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a pleasure to be here and sharing this

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information with you.

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I do work at the Texas Back Institute.

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I've been there for the last fifteen years.

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Prior to that, I was at the Cleveland

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Clinic for thirteen years. I,

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trained and worked at the University of Toronto

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in Toronto, Canada for five years before that.

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I principally do orthopedics and spine surgery today.

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The easiest way to describe my practice is

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I do whatever

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anyone else doesn't want to do.

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And, I do a lot of revision, a

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lot of deformity work. I'm also involved in

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a lot of development work. I've got, relationships

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with, multiple strategic companies

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in terms of consulting, and I've got,

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my own startup company also that's involved in

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the spine space.

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Wonderful. Well, thank you for being here. And

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let's start our conversation

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by talking about trends and shifts. So what

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are you seeing right now in the industry

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that you think is most important for leaders

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to pay attention to?

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There's there's two big trends that that I'm

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seeing right now,

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both of which personally are a little concerning

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to me.

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The first trend is the

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use of social media

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in spine surgery.

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Now it's permeated in everything in society

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today,

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and absolutely there are benefits to it. But

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there are also,

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some

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non benefits to it. It can be problematic.

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As spine surgeons, we wanna make sure that

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we're competitive. We stay in the in in

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the practice. We can attract the right patients

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to us, and the use of social media

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for that is exceptionally important.

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But I do see a trend

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where social media

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is embellishing

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what's going on out there in spine surgery,

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where individuals

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are promoting themselves

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inappropriately

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to a certain extent.

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I do a lot of revision surgery, and

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unfortunately,

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I see the guys on social media, and

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then I see the patients coming to me.

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They're on social media, and they're saying, oh,

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I do this operation under forty five minutes,

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mainly invasive skin to skin.

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But then they're back with me six months

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later because the surgery was not done appropriate.

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So the use of social media has to

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somehow

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be regulated

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and monitored.

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And and likewise,

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the ability

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for ratings

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online

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has become problematic.

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Now there's a lot

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of fake ratings out there. There's a lot

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of legitimate ratings out there. But when there

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is a negative

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unwarranted

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rating

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on somebody, that becomes very, very difficult

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to correct.

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So we need to figure all of that

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out.

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The second issue

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that I see is problematic

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now

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in in spine surgery

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is the amalgamation

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of groups

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and, essentially, a lot of physicians

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moving towards an employee model

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or the

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PE firms that are coming up

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and are starting to

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gobble up

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spine practices.

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Now at Texas Back Institute, we're a big

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group, and we were looking at ways

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to maintain our relevance and sustainability.

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And we met with a number of the

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private equity groups, and it dawned on me

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that if if these guys think

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they can make money off of myself and

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my partners,

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we have to figure out how to make

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money off ourselves. Why why are we giving

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it away

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to them?

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And until the private equity group can actually

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bring a benefit to the table

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to the surgeons, and that benefit obviously is

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some form of contracting

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rather than just practice efficiency by rolling up.

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Unless they can do that, I really don't

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see

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any role. And we see this pendulum

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swinging towards the private equity and the roll

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up of the groups,

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but it's self limited. And that pendulum is

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gonna swing right back and knock people over.

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Absolutely.

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And I'd also love to touch on staffing

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and workforce challenges as these continue to be

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a concern across health care.

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So how is your organization

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navigating these pressures, and what strategies have you

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seen work well?

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The reality today is that

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the employment workforce is mobile. We're not getting

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beyond that.

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The post pandemic reality

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is that people wanna work from home.

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If we wanna

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maintain

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our

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current

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business profile, we have to be able to

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adapt to that.

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So we have taken steps to provide

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our employees

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with the ability to work from home, from

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the

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office,

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combination things.

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Working from home, you have to be able

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to monitor the employees.

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It's pretty clear that they are not as

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productive at home as they are in the

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office.

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So that's been a challenge for us as

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a group, but we've been

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able to to work through that.

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The transient

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nature

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of the employee

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workforce, they they're just going after the the

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higher paycheck. They'll go from our practice to

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the practice next door to the practice next

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door, and then eventually they come back to

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our practice again because they see that it's

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really not that much better. They're making any

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difference there.

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So we just have to accept that fact,

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but we have to add something to the

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mix. And what we've tried to add at

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the Texas Back Institute is more of a

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collegial

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family

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related type approach to this,

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where we have events. We bring people together.

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We do things on it. So you're building

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some camaraderie in the team.

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And over time, and we've started to see

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this, but over time, we're seeing a drop

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in that turnover rate.

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And as outpatient care continues to grow, how

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do you see the role of spine evolving

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within the broader health care ecosystem?

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The good news

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about

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spine care is that everyone has a spine.

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The better news

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is that over your lifetime, everyone with a

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spine has got an eighty percent chance of

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a problem. So we know we're always gonna

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be in business. Okay. There is no doubt

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that we can do more, and we can

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do it better now

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in a less invasive, potentially outpatient environment.

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Our diagnostics

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are so much better at this point. Our

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treatment plans have improved substantially.

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The execution of surgery has become more precise,

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more efficient.

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The understanding of physiology

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has has improved where we can be more

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predictive and avoid some of those complications.

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So spine is here to stay in in

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the global health care. I think spine is

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going to be,

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a much more important economic

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driver

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as well, especially with the aging population.

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And I see exciting things ahead of us

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with the technology

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that's out there.

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There's so much

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technology

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at hand right now. We just have to

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figure out how to use it to the

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advantage of our patients.

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And that is a perfect segue actually into

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my final question.

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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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Critical review

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of how we do things is important.

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Now we do have a lot of

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data analysis

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packages where we can look at our efficiency

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in the clinic, our outcomes in the operating

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room.

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We can look at our patient flow, patient

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satisfaction.

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So looking at all that,

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the ultimate though and and I'm kinda reluctant

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to use that that term, but the AI

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component. Everyone's using AI AI.

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But the reality is

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that data information that's gonna come back to

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us is gonna help us do better for

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for our patients in the future.

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If I know that I do

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operation x on patient y the same way

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every time and I get this result,

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the AI is gonna remind me,

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this is patient x. Do operation wide. This

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is what you're gonna get. So that's where

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I think we're gonna see a lot of

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benefit in spine surgery.

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Wonderful. Well, as we wrap up, is there

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anything else you'd like to share that we

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didn't touch on today?

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Just to reemphasize, despite all the rhetoric and

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scrutiny on spine surgery, it is an exciting

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time. There there's a lot that we can

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do.

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We can really

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change our patients' lives now.

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And the the myth

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that having a bad back and undergoing spine

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care is gonna be problematic

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is all just a myth. We we can

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we are doing better.

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Wonderful. Well, doctor Lieberman, thanks so much for

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being here today on the Becker's Healthcare Podcast.

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Again, we're recording live at the twenty second

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annual Spine Orthopedic and Pain Management Conference.