Speaker 0: Hello. This is Francesca Matthews with the Becker's ASC review podcast. I'm thrilled to be joined today by doctor Sumana Mule, founding physician of Merus Gastroenterology and Gut Health. Doctor Mule, thank you so much for being here today.

Speaker 1: Absolutely. And thank you so much for having me.

Speaker 0: K. Great. To start us off, could you please just introduce yourself and tell us a little bit about your background?

Speaker 1: Yeah. Absolutely. Yeah. I'm a board certified gastroenterologist and the founder of Medus Gastroenterology and Gut Health based in Johns Creek, Georgia, which is just outside of Atlanta. My training journey started in the medical school in India, then I moved to Detroit, Michigan where I trained in internal medicine at Wayne State University.

Later, I did a gastroenterology fellowship at Penn State, University. And following that, I had the privilege of practicing in a variety of environments. The first my first job was at a VA hospital, system in Lebanon, Pennsylvania. Later on, I moved to a large multi specialty group of over a 100 physicians in Tampa, Florida, and later a single specialty, GI practice here in Georgia. So it kind of gave me a nice spectrum of different setups with GI.

It's all gastroenterology, but the setup is very different. Gave me a firsthand experience on on how things run-in each of these areas. What I noticed through these experiences, was that while each system had its strengths, there was often very little flexibility or autonomy for physicians to truly practice medicine the way it's meant to be practiced. I like medicine to be thoughtful, collaborative, and without unnecessary barriers, and I couldn't find it in these other systems. That was frustrating, and that frustration really pushed me to take a leap of faith and start my own independent, fully outpatient practice, here in Georgia.

In in this location is frankly one of the most competitive GI markets in Metro Atlanta. It was risky, but it was it has been incredibly rewarding so far. So today, my independent practice, METAS Gastroenterology, has we built this fortunate to build a strong reputation just purely through authentic patient relationships and word-of-mouth. And more recently, we've been recognized and featured as the Santa top doctor. So we're really honored and, pleased as to how far we've come in the last four years since our practice has opened.

But what's more satisfying is really having the freedom to, you know, care for patients in a way that feels personal, undrushed, and really deeply fulfilling.

Speaker 0: Absolutely. Yeah. That physician autonomy component, I find comes up a lot in the ASC space is one of the things that sort of draws people into the outpatient setting or just into independent practice overall, but especially related to ASCs. It seems like physician autonomy and ASCs are kind of intertwined at times. I'm wondering what are the top three trends that you're following in health care and ASCs today?

Speaker 1: Yeah. There is so much, going on in the in the trends in health care SCs, but the top three things I think I am excited about is, one is in in SCs, we are seeing a migration of more complex GI procedures into the outpatient setting and advances in technology, sedation safety, and post procedure monitoring. All of them that made it possible for what traditionally was done in hospital departments to come into the outpatient setting, and it's still safe and efficient as well. And payers are recognizing the value, and patients appreciate the convenience and comfort, which which is much easier to be done in ASCs rather than in a hospital setting. The second one that I'm seeing is a definite renewed interest in physician led ownership models.

For years, at least the last decade, consolidation into private equity, hospital systems immediately like independence was impossible. And when I even when I started, it felt like I don't know where this is going, but I just got back from our annual ACG, the College of Gastroenterology Conference in Phoenix. And I saw more and more physicians, especially younger ones, who are looking for independent models that combine autonomy, with efficiency and support. And they like practices that integrate ASCs into the into their, model as well. So there I think in general, GI or more physicians are realizing that ownership is not just about equity, but it's also having a voice in how medicine is practiced, which is often lacking when you practice in larger health systems where there's not much autonomy and flexibility.

And the third one that is really exciting and is still evolving quite a bit and rapidly is the integration of AI or digital tools and operational automation in ASCs. Things like AI enabled patient engagement, streamlined scheduling, real time analytics, they've all they're all helping small centers compete with the larger systems. It's, in and you think of them sometimes as are we gonna lose human touch, but it's really helping us scale empathy seamlessly and remove that friction between the patient and staff experience. So all of these are really I mean, it's an exciting time to be an independent GI physician and with all of these resources available. They're they make us health care more cost efficient, and they're leading innovation in quality and patient satisfaction as well.

So so it's really exciting.

Speaker 0: Absolutely. Yeah, you you mentioned AI is something you're excited about. I'm wondering what else are you most excited about in this space right now or if, you know, if AI is the answer, kind of if you can expound on that a little bit.

Speaker 1: Within the AI, you mean?

Speaker 0: Well, just what in general are you excited about? Whether it's AI or whether it's something else?

Speaker 1: Yeah. I think, yeah, for the AC is really, the AI tools are making it more cost efficient and, making it seamless. Some of the hurdles we used to face with the revenue cycle management are decreasing with the AI tools and then the migration of addition of newer, service lines within the GIM gastroenterology. So such as adding new things such as my view, interest in placement. They're adding more revenue to the ASCs, as well as hemorrhoid, ablation.

So adding new procedures that we traditionally haven't done before, is is also exciting. But within the AI world, there's there's just so much. I was just speaking to someone just as I was hopping on this call, a new company that's literally a year old who, enable medicines specialty medicines that we prescribe often run into prior authorization, peer to peer, all of which take is a burden on the staff and as as physicians do when we have to do that peer to peer. But this AI tool is doing this all seamlessly behind the scenes, almost 80 to 90% approvals without pulling resources or time from the staff. So for every pain point, there seems to be a nice, model tech model that's coming up that's able to solve this.

So, you know, it lets us practice medicine and not think about all these other, operational burdens.

Speaker 0: Mhmm. Yeah. Absolutely. And it's always great to hear you know, I think there's so much talk about AI, but it's great to hear observations about where it's, you know, really having an impact in physician practices. How are you thinking about growth over the next twelve months?

Speaker 1: Yeah. For us, we are an independent practice, and I, as I mentioned, I'd started about four years ago. So for now right now, we have a solid foundation. We've been recognized. We've had a good rapport with the patients.

So for us, the next stage is really growing growth over, the next twelve months. We wanna expand our team, bring on another gastroenterologist. We actually just completed signing on onboarding a great physician for that. She who's gonna be starting next year. So increase this will help us increase our office and procedural capacity while we still remain aligned to our philosophy of patient first high touch care.

We're also, focusing on operations again, bringing AI into the clinic side as well refining workflows. We are trying to adapt smart automation and optimizing staff engagement so that as we scale, we don't lose what makes us special. Right now, as an independent practice, it's a sense of connection and responsiveness for patients that they really appreciate. We wanna keep that going as we scale. So deepening that quality of every patient interaction and building a team culture that supports that is is truly exciting.

So if we can maintain that alignment between clinical quality, patient experience, and physician satisfaction, I think that's the formula for sustainable success in this next, phase of outpatient GI care.

Speaker 0: Absolutely. That's something I hear from a lot of independent physicians, especially GIs, is when when I ask, you know, kind of what keeps you all going. It's that connection to community and that, yeah, like, that that real sense of, patient responsiveness as you said.

Speaker 1: Yeah.

Speaker 0: Is there anything else I haven't asked about that you think is important in this conversation?

Speaker 1: I think we hit on all the all the main points, but, really, I think what's most exciting is this revival or the renaissance of independent patient centered medicine for a while. Even few years ago, it felt like the only path was consultation. But now physicians are finding new creative ways to build sustainable independent models. So I'm really excited. I am really excited for all the physicians out there to build their own independent practices or join independent practices and make their voice heard.

And that lets them practice the medicine the way they wanted to all along. So we're seeing practices in ASCs that reflect individual values and local community needs. So it's a win win, I think, for the patients, for the physicians, and reduce, you know, burnout when which happens when they practice in, stiff systems that that can't flex, that can't give them the autonomy they need. So, I think that's really key. This this next chapter in medicine is so energizing, and that's what is redefining, what quality means, not by adding layers, but by, you know, bringing it back to the basics, listening and partnering with the patient.

Speaker 0: Absolutely. I like to we can end it there. It's really, yeah. I think that resonates with so much of our audience. But, yeah, that's actually all I have for you today, doctor Mule.

Thank you so much for joining us.

Speaker 1: Oh, thank you so much. It was a pleasure.

Speaker 0: Yeah. Yeah.

Speaker 1: It was

Speaker 0: a pleasure for me as well, and I look forward to connecting with you again in the future.

Speaker 1: Likewise.