1 00:00:00,160 --> 00:00:02,319 This is Carly Beam with the Becker Spine 2 00:00:02,319 --> 00:00:04,719 and Orthopedics podcast, and I'm thrilled to be 3 00:00:04,719 --> 00:00:07,200 joined today by doctor Nolan Wessel with the 4 00:00:07,200 --> 00:00:10,580 University of Colorado School of Medicine. Doctor Wessel, 5 00:00:10,639 --> 00:00:12,820 thank you so much for being here today. 6 00:00:13,365 --> 00:00:15,125 Yeah. Thanks you thank you so much for 7 00:00:15,125 --> 00:00:16,265 having me on board. 8 00:00:16,565 --> 00:00:18,885 Yeah. Absolutely. And before we dive into our 9 00:00:18,885 --> 00:00:21,125 discussion, I'd love to if you could just 10 00:00:21,125 --> 00:00:22,804 introduce yourself and tell us a bit about 11 00:00:22,804 --> 00:00:24,664 your background. Sure. So, 12 00:00:25,445 --> 00:00:27,320 as you already mentioned, I currently work at 13 00:00:27,320 --> 00:00:30,439 the University of Colorado Department of Orthopedics, but, 14 00:00:31,239 --> 00:00:32,920 I was born and raised in North Central 15 00:00:32,920 --> 00:00:33,420 Wisconsin, 16 00:00:33,799 --> 00:00:34,939 did my undergraduate, 17 00:00:35,719 --> 00:00:38,619 studies at the University of Wisconsin. And then 18 00:00:39,344 --> 00:00:41,825 after graduation, I worked very briefly in medical 19 00:00:41,825 --> 00:00:44,005 research for the Howard Hughes Medical Institute 20 00:00:44,384 --> 00:00:44,884 before 21 00:00:45,344 --> 00:00:47,825 moving on to medical school at Wayne State 22 00:00:47,825 --> 00:00:49,125 University in Detroit. 23 00:00:49,984 --> 00:00:51,604 I stayed in Detroit 24 00:00:52,030 --> 00:00:54,909 for my residency at the Henry Ford Health 25 00:00:54,909 --> 00:00:55,409 System 26 00:00:55,870 --> 00:00:58,770 and then moved out to Colorado in 2017 27 00:00:58,909 --> 00:01:01,870 to do my fellowship in adult spine surgery 28 00:01:01,870 --> 00:01:03,329 at the University of Colorado. 29 00:01:03,885 --> 00:01:06,284 So since 2018, I've been on faculty at 30 00:01:06,284 --> 00:01:06,944 the university. 31 00:01:07,885 --> 00:01:11,105 Currently, the majority of my practice is spent 32 00:01:11,405 --> 00:01:13,645 on the South Side Of Metro Denver in 33 00:01:13,645 --> 00:01:16,145 the Highlands Ranch community, but I still 34 00:01:16,670 --> 00:01:18,750 maintain a small portion of my practice at 35 00:01:18,750 --> 00:01:20,209 the main university campus. 36 00:01:21,229 --> 00:01:22,849 Right. And, yeah, an interesting 37 00:01:23,629 --> 00:01:26,109 aspect of your title is reading about you 38 00:01:26,109 --> 00:01:29,149 earlier, well-being co director. Can you talk more 39 00:01:29,149 --> 00:01:30,344 about that? Sure. 40 00:01:30,745 --> 00:01:31,484 You know, it's, 41 00:01:33,224 --> 00:01:35,704 it's probably no secret to anybody that works 42 00:01:35,704 --> 00:01:37,784 in health care or has friends or family 43 00:01:37,784 --> 00:01:39,245 that work in health care that 44 00:01:39,784 --> 00:01:42,665 burnout, especially on the heels of the COVID 45 00:01:42,665 --> 00:01:44,364 pandemic a few years ago, 46 00:01:45,170 --> 00:01:47,810 has run rampant throughout the system. And that's 47 00:01:47,810 --> 00:01:51,329 not just isolated to orthopedic surgeons. But what 48 00:01:51,329 --> 00:01:52,709 I can tell you is that, 49 00:01:53,890 --> 00:01:54,390 currently 50 00:01:55,090 --> 00:01:58,629 about forty percent of active orthopedic surgeons 51 00:01:59,734 --> 00:02:02,795 endorse symptoms consistent with burnout and depression, 52 00:02:03,655 --> 00:02:06,155 and over the course of an orthopedic surgeon's 53 00:02:06,215 --> 00:02:08,694 career upwards of sixty to sixty five percent 54 00:02:08,694 --> 00:02:09,354 of individuals 55 00:02:09,974 --> 00:02:11,915 may suffer from symptoms of 56 00:02:12,294 --> 00:02:13,435 burnout and depression. 57 00:02:14,689 --> 00:02:17,349 And, in a system that's already very strained, 58 00:02:17,489 --> 00:02:18,709 this can lead to, 59 00:02:20,209 --> 00:02:21,110 early attrition, 60 00:02:21,489 --> 00:02:23,650 which we certainly don't need because as the 61 00:02:23,650 --> 00:02:26,469 baby boomers age into those years where they 62 00:02:26,610 --> 00:02:27,909 demand more care, 63 00:02:28,584 --> 00:02:31,245 Orthopedic care is a major part of that. 64 00:02:32,104 --> 00:02:34,025 And we really just wanna make sure that 65 00:02:34,025 --> 00:02:36,185 we're taking care of not just our patients, 66 00:02:36,185 --> 00:02:38,604 but ourselves. Right? We we can't be 67 00:02:39,465 --> 00:02:42,039 expected to care for other people if we 68 00:02:42,039 --> 00:02:44,599 ourselves are not in good physical and mental 69 00:02:44,599 --> 00:02:47,979 condition. So the University of Colorado, like many 70 00:02:48,120 --> 00:02:49,020 large institutions, 71 00:02:49,400 --> 00:02:49,900 has, 72 00:02:50,759 --> 00:02:54,219 done its best to prioritize wellness, and myself 73 00:02:54,280 --> 00:02:55,419 and one of my, 74 00:02:56,185 --> 00:02:58,985 colleagues from the Children's Hospital of Colorado, doctor 75 00:02:58,985 --> 00:02:59,884 Sarah Sibyl, 76 00:03:00,504 --> 00:03:02,824 serve as the co directors for well-being for 77 00:03:02,824 --> 00:03:03,485 our department. 78 00:03:03,864 --> 00:03:05,864 So it's a it's an interesting role that's 79 00:03:05,864 --> 00:03:07,645 kind of always evolving. 80 00:03:08,569 --> 00:03:09,530 Yeah. I was about to say 81 00:03:10,090 --> 00:03:12,010 and, I mean, obviously, it's burnout being so 82 00:03:12,010 --> 00:03:13,530 rampant. And I know there are a lot 83 00:03:13,530 --> 00:03:17,770 of different headwinds facing spine surgeons. And I'm 84 00:03:17,770 --> 00:03:20,110 wondering, you know, how are you 85 00:03:20,409 --> 00:03:22,669 tackling those? How are you training, 86 00:03:23,335 --> 00:03:26,294 you know, your your students, your residents in 87 00:03:26,294 --> 00:03:27,194 spine and orthopedics 88 00:03:27,974 --> 00:03:31,034 to to face these headwinds, you know, without 89 00:03:31,094 --> 00:03:32,875 completely burning themselves out? 90 00:03:33,175 --> 00:03:35,495 Sure. I think that's a that's an important 91 00:03:35,495 --> 00:03:37,835 question, and I don't have all the solutions 92 00:03:37,895 --> 00:03:38,555 to that. 93 00:03:40,259 --> 00:03:41,719 Certainly, as you look at 94 00:03:42,580 --> 00:03:43,719 an older generation 95 00:03:44,020 --> 00:03:47,080 of surgeons and physicians and health care providers, 96 00:03:48,819 --> 00:03:50,500 I think we can all agree that the 97 00:03:50,500 --> 00:03:53,479 work life balance really was not there. 98 00:03:54,514 --> 00:03:57,074 It was kind of just a mentality of 99 00:03:57,074 --> 00:03:57,814 work, work, 100 00:03:58,275 --> 00:04:00,215 work. I'll relax when I retire. 101 00:04:00,754 --> 00:04:02,835 And then you've got a younger generation. So 102 00:04:02,835 --> 00:04:04,534 I'm I'm 41, 103 00:04:05,314 --> 00:04:06,775 or nearly 41. 104 00:04:06,995 --> 00:04:07,495 And 105 00:04:08,830 --> 00:04:11,629 kind of starting with my generation and those 106 00:04:11,629 --> 00:04:13,169 a little bit younger than me, 107 00:04:13,469 --> 00:04:16,289 I think they are much better suited 108 00:04:16,589 --> 00:04:18,990 to help maintain that kind of work life 109 00:04:18,990 --> 00:04:19,490 balance. 110 00:04:19,870 --> 00:04:21,810 And people in kind of their mid career 111 00:04:21,870 --> 00:04:24,495 are somewhat caught in between, but more and 112 00:04:24,495 --> 00:04:26,254 more now, now you see it at the 113 00:04:26,254 --> 00:04:27,314 university that, 114 00:04:28,254 --> 00:04:28,754 prioritizing 115 00:04:29,055 --> 00:04:31,694 that work life balance, especially in a state 116 00:04:31,694 --> 00:04:33,155 like Colorado where, 117 00:04:34,095 --> 00:04:35,155 outdoor activities 118 00:04:35,775 --> 00:04:39,055 are available to you essentially three sixty five 119 00:04:39,055 --> 00:04:39,930 days a year, 120 00:04:40,569 --> 00:04:42,729 people really wanna make sure that they're they're 121 00:04:42,729 --> 00:04:44,269 taking care of their own well-being 122 00:04:44,810 --> 00:04:46,990 in in conjunction with caring for patients. 123 00:04:47,850 --> 00:04:49,769 Got it. And I'd love to hear, you 124 00:04:49,769 --> 00:04:52,169 know, what are some other big trends you're 125 00:04:52,169 --> 00:04:53,949 following in health care today? 126 00:04:54,925 --> 00:04:55,745 Yeah. So 127 00:04:56,285 --> 00:04:59,485 we just had the North American Spine Society 128 00:04:59,485 --> 00:05:00,625 meeting last weekend. 129 00:05:01,084 --> 00:05:03,084 It was the forty year anniversary of the 130 00:05:03,084 --> 00:05:03,584 organization. 131 00:05:04,605 --> 00:05:06,764 And to my knowledge, the first time that 132 00:05:06,764 --> 00:05:08,845 they had their annual meeting in Denver. So 133 00:05:08,845 --> 00:05:10,810 it was kinda nice to not have to 134 00:05:10,810 --> 00:05:11,930 get on a plane. I just woke up 135 00:05:12,090 --> 00:05:13,949 You have a little cold. Downtown. Yeah. 136 00:05:14,970 --> 00:05:17,230 But when you walk through the exhibit floor, 137 00:05:18,410 --> 00:05:20,430 it's really clear to me that, 138 00:05:21,290 --> 00:05:23,310 integration of kind of robotics 139 00:05:23,689 --> 00:05:24,590 and artificial 140 00:05:25,129 --> 00:05:25,629 intelligence 141 00:05:26,204 --> 00:05:29,024 and kind of patient specific surgical plans 142 00:05:29,564 --> 00:05:31,824 is where spine surgery is headed. 143 00:05:32,204 --> 00:05:33,584 You know, we've seen robotics 144 00:05:33,884 --> 00:05:36,544 in general surgery for quite a while now. 145 00:05:36,685 --> 00:05:38,604 You know, we've all heard about the da 146 00:05:38,604 --> 00:05:41,290 Vinci robot that's probably been around for fifteen 147 00:05:41,290 --> 00:05:42,269 to twenty years. 148 00:05:43,050 --> 00:05:46,170 Robotics and spine care is somewhat in its 149 00:05:46,170 --> 00:05:46,670 infancy, 150 00:05:48,250 --> 00:05:50,910 but when you start to integrate that with 151 00:05:51,209 --> 00:05:51,709 preoperative 152 00:05:52,009 --> 00:05:53,790 planning and using 153 00:05:54,644 --> 00:05:58,665 large scale database learning and artificial intelligence algorithms 154 00:05:58,964 --> 00:06:00,024 to help plan 155 00:06:00,805 --> 00:06:04,324 a patient specific surgery or even custom three 156 00:06:04,324 --> 00:06:06,745 d printed patient specific implants, 157 00:06:07,669 --> 00:06:09,669 it really begins to change the game in 158 00:06:09,669 --> 00:06:12,089 terms of what we can offer patients. And, 159 00:06:12,870 --> 00:06:14,169 right now the costs 160 00:06:14,550 --> 00:06:15,849 for some of those technologies 161 00:06:16,149 --> 00:06:17,289 are quite high, 162 00:06:17,669 --> 00:06:18,169 but 163 00:06:18,550 --> 00:06:20,089 as development progresses, 164 00:06:20,469 --> 00:06:22,824 like anything else, we expect those costs to 165 00:06:22,824 --> 00:06:23,564 come down, 166 00:06:24,024 --> 00:06:26,904 and hopefully, that translates to better value and 167 00:06:26,904 --> 00:06:28,365 better outcomes for patients. 168 00:06:29,064 --> 00:06:31,145 Definitely. And when you when you think about 169 00:06:31,145 --> 00:06:33,404 cost, what do you think it will take, 170 00:06:34,264 --> 00:06:37,029 from these companies without, like, you know, naming 171 00:06:37,029 --> 00:06:38,889 names? What do you think it'll take 172 00:06:39,430 --> 00:06:42,170 for these costs come down to make these 173 00:06:42,629 --> 00:06:45,750 technologies more accessible to any practice setting and 174 00:06:45,750 --> 00:06:46,410 to patients? 175 00:06:47,264 --> 00:06:49,525 Yeah. I think cost is at the forefront 176 00:06:49,585 --> 00:06:52,064 of everything we do in health care right 177 00:06:52,064 --> 00:06:52,564 now, 178 00:06:53,504 --> 00:06:55,425 and and we can certainly get into some 179 00:06:55,425 --> 00:06:58,245 of those issues later in our conversation. But, 180 00:07:00,270 --> 00:07:02,670 I work fortunately at a at a large 181 00:07:02,670 --> 00:07:03,889 academic institution. 182 00:07:04,270 --> 00:07:04,770 And 183 00:07:05,230 --> 00:07:07,629 when it comes to development of these new 184 00:07:07,629 --> 00:07:10,610 technologies, I really look at the larger centers 185 00:07:11,310 --> 00:07:13,310 as the ones that need to lead the 186 00:07:13,310 --> 00:07:16,665 charge. You know, being a big academic center, 187 00:07:16,665 --> 00:07:19,865 we have a robust portfolio of research projects 188 00:07:19,865 --> 00:07:20,685 that are ongoing. 189 00:07:21,865 --> 00:07:24,824 We have, an easier ability to get, 190 00:07:25,544 --> 00:07:28,925 large scale federal and and regional grant funding. 191 00:07:29,839 --> 00:07:31,439 And we need to be smart about how 192 00:07:31,439 --> 00:07:33,040 we use that money, and I hope that 193 00:07:33,040 --> 00:07:36,100 a portion of it is invested in advancing 194 00:07:36,240 --> 00:07:38,100 these types of technologies because, 195 00:07:39,279 --> 00:07:41,939 ultimately, I think that's gonna gonna benefit 196 00:07:42,314 --> 00:07:45,355 not just orthopedic patients but the broader healthcare 197 00:07:45,355 --> 00:07:46,415 system as a whole. 198 00:07:46,715 --> 00:07:47,694 Right? If we 199 00:07:47,995 --> 00:07:48,814 have technologies 200 00:07:49,194 --> 00:07:50,574 that allow us to do 201 00:07:51,435 --> 00:07:54,475 more or a broader spectrum of surgeries in 202 00:07:54,475 --> 00:07:55,375 a more ambulatory 203 00:07:55,915 --> 00:07:56,895 setting with 204 00:07:57,339 --> 00:07:59,759 smaller incisions and reduced recovery, 205 00:08:00,620 --> 00:08:03,019 that that's gonna change the game in terms 206 00:08:03,019 --> 00:08:04,240 of orthopedic care. 207 00:08:04,779 --> 00:08:06,379 Yeah. And it does it's cool that you 208 00:08:06,379 --> 00:08:09,259 do have that advantage being, in the academic 209 00:08:09,259 --> 00:08:10,240 center to really, 210 00:08:10,620 --> 00:08:11,600 make these changes. 211 00:08:12,095 --> 00:08:13,475 And then you mentioned, you know, 212 00:08:13,775 --> 00:08:16,675 government funding for research, for instance. I'm wondering 213 00:08:17,055 --> 00:08:19,395 how how have you been tracking these 214 00:08:19,855 --> 00:08:24,095 regular shifts and changes in government policies, whether 215 00:08:24,095 --> 00:08:25,235 it's with reimbursement 216 00:08:25,775 --> 00:08:26,275 or, 217 00:08:26,949 --> 00:08:29,269 this research funding you're talking about. How are 218 00:08:29,269 --> 00:08:30,410 you tackling those? 219 00:08:30,870 --> 00:08:32,230 Yeah. I think the one thing that we 220 00:08:32,230 --> 00:08:34,549 can probably be certain to certain of is 221 00:08:34,549 --> 00:08:35,049 that 222 00:08:35,429 --> 00:08:38,070 it's constantly going to change. Right? Hit in 223 00:08:38,070 --> 00:08:39,769 the American political system, 224 00:08:40,134 --> 00:08:42,054 it really doesn't matter what side of the 225 00:08:42,054 --> 00:08:43,194 aisle you sit on. 226 00:08:43,894 --> 00:08:46,934 We can expect that every two, four, eight 227 00:08:46,934 --> 00:08:49,014 years, there's gonna be a little bit of 228 00:08:49,014 --> 00:08:51,914 a shift in terms of which party maintains 229 00:08:51,975 --> 00:08:54,454 control, and that is gonna result in a 230 00:08:54,454 --> 00:08:54,870 shift 231 00:08:55,350 --> 00:08:55,850 in 232 00:08:56,149 --> 00:08:57,529 various types of funding. 233 00:08:57,990 --> 00:08:58,490 Mhmm. 234 00:08:58,950 --> 00:09:02,870 As providers and as academic institutions, you know, 235 00:09:02,870 --> 00:09:04,950 here at the University of Colorado, we have 236 00:09:04,950 --> 00:09:06,730 a new dean, Doctor. John Sampson, 237 00:09:07,909 --> 00:09:10,330 and he is really working hard to 238 00:09:10,754 --> 00:09:14,035 set up a financial structure that provides more 239 00:09:14,035 --> 00:09:17,154 stability across the entirety of the med school. 240 00:09:17,154 --> 00:09:17,654 So 241 00:09:18,035 --> 00:09:19,254 that if we encounter 242 00:09:20,035 --> 00:09:23,335 periods of time where federal funding is reduced, 243 00:09:23,830 --> 00:09:26,490 we have the reserves on hand so that 244 00:09:26,549 --> 00:09:28,649 we can maintain a robust faculty 245 00:09:28,950 --> 00:09:32,950 of not only providers but research staff as 246 00:09:32,950 --> 00:09:34,730 well. So hopefully, 247 00:09:35,509 --> 00:09:38,330 as, you know, endowments continue to grow, 248 00:09:39,215 --> 00:09:41,634 as we continue to grow our cash reserves, 249 00:09:42,175 --> 00:09:45,634 we're well suited to whatever weather, whatever storms 250 00:09:46,095 --> 00:09:46,995 we might face, 251 00:09:47,774 --> 00:09:50,595 as as political persuasions fluctuate. 252 00:09:51,490 --> 00:09:53,570 That's great to hear. And then I wanna 253 00:09:53,570 --> 00:09:56,290 ask you, how are you thinking about growth 254 00:09:56,290 --> 00:09:56,950 in the next 255 00:09:57,330 --> 00:09:59,410 twelve to twenty four months? You know, what's 256 00:09:59,410 --> 00:10:01,990 really exciting you in that realm? Yeah. 257 00:10:02,610 --> 00:10:03,509 You know, I 258 00:10:03,934 --> 00:10:06,174 I already have a robust practice. So when 259 00:10:06,174 --> 00:10:08,334 people ask me about growth, I think, well, 260 00:10:08,334 --> 00:10:10,414 gosh, there's only twenty four hours in a 261 00:10:10,414 --> 00:10:12,355 day. Right? Mhmm. But, 262 00:10:13,695 --> 00:10:15,475 kinda hearkening the conversation 263 00:10:15,855 --> 00:10:18,740 back to some of the artificial intelligence, 264 00:10:20,960 --> 00:10:22,899 the the large language models 265 00:10:23,600 --> 00:10:25,920 have pretty quickly found their way into health 266 00:10:25,920 --> 00:10:28,160 care. So one example I like to cite 267 00:10:28,160 --> 00:10:31,060 is that we now use an AI based, 268 00:10:32,084 --> 00:10:34,745 passive listening system in the clinic setting. 269 00:10:35,524 --> 00:10:37,064 And within mere seconds, 270 00:10:37,605 --> 00:10:40,485 the conversations I have with a patient are 271 00:10:40,485 --> 00:10:42,264 transcribed into a note. 272 00:10:42,725 --> 00:10:43,225 And 273 00:10:43,924 --> 00:10:46,105 like a lot of these systems like ChatGPT 274 00:10:46,404 --> 00:10:48,600 and others, the more you use it, the 275 00:10:48,600 --> 00:10:51,019 more it learns about your conversation style. 276 00:10:51,559 --> 00:10:53,399 And I've been using it now for about 277 00:10:53,399 --> 00:10:55,019 four or five months, and 278 00:10:55,399 --> 00:10:57,720 I can leave a patient's room, walk back 279 00:10:57,720 --> 00:10:58,539 to my workstation, 280 00:10:59,000 --> 00:11:00,919 and by the time I get there, my 281 00:11:00,919 --> 00:11:03,455 note is written. I do a quick review 282 00:11:03,595 --> 00:11:05,615 and boom, the note is signed. 283 00:11:06,315 --> 00:11:08,014 That has given me back 284 00:11:08,955 --> 00:11:11,514 upwards of ninety minutes a day, and for 285 00:11:11,514 --> 00:11:12,654 my nurse practitioner, 286 00:11:13,355 --> 00:11:15,595 she's getting ninety minutes back on her day 287 00:11:15,595 --> 00:11:16,654 as well. And 288 00:11:16,955 --> 00:11:19,149 that can be used a variety of different 289 00:11:19,149 --> 00:11:20,589 ways. You know, we talked a little bit 290 00:11:20,589 --> 00:11:22,509 about wellness. Well, you can get some of 291 00:11:22,509 --> 00:11:24,669 your personal or family time back, which is 292 00:11:24,669 --> 00:11:28,049 fantastic. Or I see. Yeah. Or, you know, 293 00:11:28,190 --> 00:11:29,649 based on our clinic schedules, 294 00:11:29,950 --> 00:11:32,425 that might open up availability for two to 295 00:11:32,425 --> 00:11:35,065 four patients a week and that that adds 296 00:11:35,065 --> 00:11:37,545 up quickly, you know, 200 to 300 patients 297 00:11:37,545 --> 00:11:40,365 a year that otherwise might have to wait 298 00:11:40,504 --> 00:11:42,205 months to get in to see us 299 00:11:42,825 --> 00:11:44,985 now can get in to to get their 300 00:11:44,985 --> 00:11:45,805 care sooner, 301 00:11:46,779 --> 00:11:49,600 and that's all on the backs of technological 302 00:11:49,899 --> 00:11:52,460 advancement and artificial intelligence. So when I think 303 00:11:52,460 --> 00:11:53,600 about growth, 304 00:11:54,300 --> 00:11:57,120 I think more about efficiency. How can 305 00:11:57,660 --> 00:12:00,240 I personally better use my time? And then 306 00:12:00,379 --> 00:12:02,774 how is an entire health care system 307 00:12:03,315 --> 00:12:06,355 can we better better optimize the time we 308 00:12:06,355 --> 00:12:08,534 spend with patients and taking care of them? 309 00:12:08,995 --> 00:12:10,434 Yeah. And I really love that how you're 310 00:12:10,434 --> 00:12:12,595 describing AI as a tool. Probably, you know, 311 00:12:12,595 --> 00:12:15,894 the Ambient AI probably helps you stay present 312 00:12:16,355 --> 00:12:19,820 in visits, gets brings in more access for 313 00:12:19,820 --> 00:12:22,480 patients. It sounds like a real win win. 314 00:12:22,620 --> 00:12:25,820 Yep. Absolutely. I mean, in instead of staring 315 00:12:25,820 --> 00:12:28,000 down at a piece of scratch paper or 316 00:12:28,299 --> 00:12:29,840 typing notes into a computer, 317 00:12:30,460 --> 00:12:32,240 I'm really focused on 318 00:12:32,795 --> 00:12:34,254 what the patient is saying, 319 00:12:35,035 --> 00:12:37,934 and and can develop that more personalized interaction 320 00:12:38,315 --> 00:12:38,975 as opposed 321 00:12:39,595 --> 00:12:41,595 to staring at a computer screen or staring 322 00:12:41,595 --> 00:12:42,735 at a piece of paper. 323 00:12:43,355 --> 00:12:45,929 Definitely. And, you know, obviously, AI is, you 324 00:12:45,929 --> 00:12:47,870 know, one of the biggest disruptors 325 00:12:48,649 --> 00:12:50,990 to health care and definitely spine surgery. 326 00:12:51,450 --> 00:12:52,750 Are there any other 327 00:12:53,210 --> 00:12:55,610 key disruptors that you'll be watching in the 328 00:12:55,610 --> 00:12:57,070 spine space next year? 329 00:12:58,730 --> 00:12:59,470 You know, 330 00:13:01,625 --> 00:13:05,325 conversations about declining reimbursements are not isolated 331 00:13:06,585 --> 00:13:09,804 to spine surgery. It's across the board. 332 00:13:11,225 --> 00:13:13,464 A close colleague and friend of mine wrote 333 00:13:13,464 --> 00:13:15,085 a paper in the journal of arthroplasty 334 00:13:15,945 --> 00:13:18,820 last year that said, you know, orthopedic surgeons, 335 00:13:19,920 --> 00:13:21,759 have taken a 31% 336 00:13:21,759 --> 00:13:22,259 hit, 337 00:13:22,960 --> 00:13:25,840 on inflation adjusted income over the last quarter 338 00:13:25,840 --> 00:13:26,340 century. 339 00:13:27,200 --> 00:13:27,700 And 340 00:13:28,320 --> 00:13:30,660 nobody really wants to hear an orthopedic surgeon 341 00:13:30,720 --> 00:13:31,220 complain, 342 00:13:31,600 --> 00:13:33,644 and I'm not complaining on a personal level, 343 00:13:33,644 --> 00:13:34,144 but 344 00:13:34,764 --> 00:13:37,024 what this has led to in other specialties 345 00:13:37,325 --> 00:13:40,384 are care deserts. So here in Colorado, 346 00:13:41,485 --> 00:13:43,745 a health care system that covers the Gunnison 347 00:13:43,804 --> 00:13:46,705 Valley if anybody's ever been to Gunnison, Colorado 348 00:13:46,764 --> 00:13:49,139 or Crested Butte, we're talking about 349 00:13:49,519 --> 00:13:52,480 some pristine areas of the state and pristine 350 00:13:52,480 --> 00:13:53,620 areas of the country. 351 00:13:54,240 --> 00:13:57,059 But those health care systems, because of declining 352 00:13:57,200 --> 00:13:57,700 reimbursements, 353 00:13:58,399 --> 00:14:00,799 have had to shut down their obstetrics and 354 00:14:00,799 --> 00:14:02,100 gynecology programs, 355 00:14:02,554 --> 00:14:04,495 and that's leaving countless women 356 00:14:04,954 --> 00:14:07,214 and their their babies without, 357 00:14:08,235 --> 00:14:10,014 a place to receive their care. 358 00:14:10,394 --> 00:14:11,694 And if we're not careful, 359 00:14:12,154 --> 00:14:14,634 we're gonna see those same trends trickle over 360 00:14:14,634 --> 00:14:15,774 into other specialties. 361 00:14:16,949 --> 00:14:18,949 We've seen it in primary care. We're seeing 362 00:14:18,949 --> 00:14:19,929 it in OBGYN. 363 00:14:20,709 --> 00:14:21,029 And, 364 00:14:22,149 --> 00:14:24,490 I I'm concerned that 365 00:14:25,029 --> 00:14:27,370 not enough red flags are popping up 366 00:14:27,909 --> 00:14:29,449 amongst the individuals 367 00:14:29,829 --> 00:14:30,649 and organizations 368 00:14:31,269 --> 00:14:33,725 that have the ability to influence 369 00:14:34,345 --> 00:14:36,745 how funding is allocated and how these decisions 370 00:14:36,745 --> 00:14:39,144 are made. So I'm gonna be watching that 371 00:14:39,144 --> 00:14:39,884 really closely, 372 00:14:40,824 --> 00:14:44,549 especially as we learn more about the 2026 373 00:14:44,789 --> 00:14:47,209 CMS fee schedule and how that might affect, 374 00:14:48,709 --> 00:14:51,929 practices and and patients' ability to access care. 375 00:14:52,629 --> 00:14:54,470 Definitely. It sounds like you have a real 376 00:14:54,470 --> 00:14:56,149 emphasis on just, like, kind of the need 377 00:14:56,149 --> 00:14:58,884 to speak out and add in for physicians 378 00:14:58,884 --> 00:15:00,345 to advocate for themselves. 379 00:15:01,044 --> 00:15:03,365 Yeah. I I think the onus is on 380 00:15:03,365 --> 00:15:04,184 us to 381 00:15:05,284 --> 00:15:06,824 try to get a seat at the table. 382 00:15:06,884 --> 00:15:07,865 Right? You know, 383 00:15:08,324 --> 00:15:10,084 I've I've mentioned a lot that I work 384 00:15:10,084 --> 00:15:12,404 at an academic institution, but at the same 385 00:15:12,404 --> 00:15:12,904 time, 386 00:15:14,129 --> 00:15:16,389 I'm I'm not that big on on research. 387 00:15:17,169 --> 00:15:20,309 I like the advocacy side of things. 388 00:15:21,250 --> 00:15:23,570 I sit on the executive board for the 389 00:15:23,570 --> 00:15:25,909 Colorado Orthopedic Society, which is 390 00:15:26,254 --> 00:15:28,654 actually a really fun and rewarding role. You 391 00:15:28,654 --> 00:15:29,475 know, we're 392 00:15:29,774 --> 00:15:32,335 always keeping a pulse on what's going on 393 00:15:32,335 --> 00:15:32,835 within, 394 00:15:33,695 --> 00:15:36,575 the state of Colorado political scene, but also 395 00:15:36,575 --> 00:15:38,195 at the national level. And 396 00:15:38,549 --> 00:15:41,590 there have been numerous instances where I feel 397 00:15:41,590 --> 00:15:43,529 like we've really made a difference, 398 00:15:44,870 --> 00:15:48,570 in terms of how health care is regulated 399 00:15:48,950 --> 00:15:49,450 and, 400 00:15:50,950 --> 00:15:53,129 distributed within our own state's borders. 401 00:15:54,115 --> 00:15:56,674 That's very well said. And doctor Wessel, was 402 00:15:56,674 --> 00:15:58,674 there anything else you wanted to discuss before 403 00:15:58,674 --> 00:15:59,735 we wrap this podcast? 404 00:16:01,154 --> 00:16:02,674 You know, not really. I think, 405 00:16:04,754 --> 00:16:07,475 hopefully, more and more people tune in and 406 00:16:07,475 --> 00:16:08,934 and subscribe and listen. 407 00:16:09,539 --> 00:16:12,500 And and I would love to see our 408 00:16:12,500 --> 00:16:14,039 podcast reach beyond 409 00:16:14,580 --> 00:16:17,080 other health care providers. Right? I think 410 00:16:17,620 --> 00:16:19,620 we need to have open and honest discussions 411 00:16:19,620 --> 00:16:20,519 with our patients 412 00:16:21,059 --> 00:16:23,720 about what the health care climate is like, 413 00:16:25,695 --> 00:16:26,195 And 414 00:16:26,815 --> 00:16:29,555 and if we can bend the ear of 415 00:16:29,695 --> 00:16:30,195 patients 416 00:16:31,055 --> 00:16:33,715 hopefully we can bend the ear of 417 00:16:34,654 --> 00:16:35,394 our politicians 418 00:16:35,774 --> 00:16:36,274 to 419 00:16:37,055 --> 00:16:39,569 start to move towards a more sensible 420 00:16:40,350 --> 00:16:41,569 policy that 421 00:16:42,029 --> 00:16:42,929 really improves, 422 00:16:44,269 --> 00:16:46,110 the the value of the care that we 423 00:16:46,110 --> 00:16:48,429 provide and helps us to improve outcomes for 424 00:16:48,429 --> 00:16:49,089 our patients. 425 00:16:49,709 --> 00:16:52,449 Yeah. It's like a real collaborative effort. Absolutely. 426 00:16:52,829 --> 00:16:54,610 Absolutely. We don't need to be 427 00:16:55,014 --> 00:16:56,394 pitted against one another, 428 00:16:57,574 --> 00:16:59,274 one side versus the other. 429 00:17:00,615 --> 00:17:01,674 You know, the the 430 00:17:02,294 --> 00:17:03,735 99.9% 431 00:17:03,735 --> 00:17:05,595 of health care providers I know, 432 00:17:05,894 --> 00:17:08,855 they they genuinely care about the well-being of 433 00:17:08,855 --> 00:17:10,075 their patients, and 434 00:17:10,700 --> 00:17:13,579 they're doing their best, usually far above and 435 00:17:13,579 --> 00:17:15,440 beyond what patients even realize, 436 00:17:16,220 --> 00:17:18,640 to to help deliver the best care possible 437 00:17:18,700 --> 00:17:21,259 and and help people return to a quality 438 00:17:21,259 --> 00:17:22,394 of life that they want. 439 00:17:23,355 --> 00:17:25,355 And I think a lot of patients really 440 00:17:25,355 --> 00:17:27,695 understand that. And the more people who 441 00:17:29,195 --> 00:17:29,695 intellectualize 442 00:17:30,075 --> 00:17:31,055 with that concept, 443 00:17:31,674 --> 00:17:34,234 I think the the better we are all 444 00:17:34,234 --> 00:17:35,375 going to be served, 445 00:17:36,110 --> 00:17:38,930 with with adapting and modifying 446 00:17:39,549 --> 00:17:41,490 our current health care delivery systems. 447 00:17:42,110 --> 00:17:44,110 It's very well said. Well, thank you so 448 00:17:44,110 --> 00:17:46,430 much for joining us today, doctor Wessel. It's 449 00:17:46,430 --> 00:17:48,190 been a pleasure speaking with you, and I 450 00:17:48,190 --> 00:17:50,369 look forward to connecting again down the line. 451 00:17:50,464 --> 00:17:52,065 Yeah. Thank you very much. I'm happy to 452 00:17:52,065 --> 00:17:53,845 join you anytime. This was fun.