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forward slash beckerspodcast.

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This is Gracelyn Keller with the Becker's Healthcare

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Podcast, and we are live at the twenty

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second annual Spine Orthopedic and Pain Management Conference.

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I'm currently joined by doctor Earl Kilbride, who

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is an orthopedic surgeon at the Austin Orthopedic

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

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Let's start off by having you share a

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little bit about yourself, your role in your

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organization. Sure. My name is Earl Kilbride, MD.

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I've been an orthopedic surgeon in Austin, Texas

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since 02/2002.

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I'm fellowship trained in sports medicine.

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My practice consists of about a third trauma,

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which I do in a hospital, a third

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total joints, and a third sports medicine. The

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latter,

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two, I do mainly at a ASC or

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a surgical hospital.

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Wonderful. Well, thanks for taking the time to

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be here. And let's start our conversation with

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what trends or shifts you're currently seeing in

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the industry that you think are most important

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for industry leaders to pay attention to.

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So one trend that's been in particular,

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that I've watched over the past twenty years

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or so is the employed model, whether it's

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private equity or hospital employment. I'm still in

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a small group. I was in a big

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group, and, we peeled off to form a

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small group. We currently are five.

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And in that sense, I think,

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we have to really watch to maintain our

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volume. We have to watch to maintain our

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contracts.

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The hospitals tend

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to be able to, put more money to

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marketing, put more money to primary care physicians.

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And so that's been something that really, we

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keep in the radar.

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And staffing and workforce challenges also continue to

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be a concern across health care sectors. So

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how is your organization navigating these pressures, and

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what strategies have you seen work well?

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Yeah. So it's a difficult scenario, right, because

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our reimbursements are going down, so we just

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can't keep throwing money at staffing,

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because

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that makes them even sort of

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more fluid in the sense that they'll leave

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you for a dollar more an hour. And

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so I think what you have to do

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is create culture and create stickiness in your

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organization. You have to treat people right. You

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have to make sure that they have adequate

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time to do their job.

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You let them off. Our employees don't work

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Friday afternoons. And so it's things like that

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that we hope to keep them around as

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opposed to just continuing to throw money at

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them.

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100%.

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And as outpatient care continues to grow, how

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do you see the role of orthopedics

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evolving within the broader health care ecosystem?

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Yeah. I think ASCs are not gonna go

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anywhere. I think a lot of the hospital

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systems initially thought they would just hopefully go

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away, but you can see Ascension is in

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the process of buying AMSURGE. And so that's

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just evidence that a big health care system

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needs an ASC system to go along with

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it. And so from our standpoint, I think

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it's gonna complement the inpatient care very well,

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and probably more and more of it's gonna

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move to the outpatient setting just as Medicare

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has

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allowed for some of the inpatient only coasts

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and now become outpatient as well, such as

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total shoulder replacements.

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And finally, many organizations are exploring new technologies,

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partnerships, and care models to improve efficiency and

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outcomes. So are there any innovations or initiatives

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you found particularly promising?

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Well, I think unlike most orthopedists, I actually

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think there's an initiative that we have to

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report patient reported outcomes,

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in total knee replacements. I actually think it's

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a good thing. I think it's gonna objectify

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some of the data.

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Some of the partnerships that we do is

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we try to go one on one with

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certain businesses like Whole Foods

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or Concentra, the work comp system, and we

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avoid the middleman such as the insurance companies

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to really try to work to get a

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partnership with them,

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and keep things streamlined.

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Absolutely.

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Was there anything else you'd like to share

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that we didn't touch on today? Yeah. The

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only other thing I would say in the

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ASC setting is I in addition to moving

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more volume over, I think the case mix

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is changing. The acuity levels are getting higher,

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but there's also some other procedures that we

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are pretty much limited to the ASC.

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I do a lot of peripheral neuromodulation,

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which is a little bit odd for an

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orthopedist to do. There's plenty of back surgeons,

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whether it's neurosurgery or orthopedic surgery, that do

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spinal cord stimulation. And so some of these

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procedures aren't really,

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reimbursed

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even above cost in a hospital setting, and

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so they have to come to the ASC.

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Well, doctor Kilbride, thanks so much for joining

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me today on the Becker's healthcare podcast to

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share these insights. Again, we are recording live

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at the twenty second annual Spine Orthopedic and

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Pain Management Conference.

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Thank you.