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To learn 13 00:00:30,649 --> 00:00:32,929 more, visit carecredit.com 14 00:00:32,929 --> 00:00:34,789 forward slash beckerspodcast. 15 00:00:35,329 --> 00:00:37,509 Hello, and welcome to the Becker's Healthcare podcast 16 00:00:37,570 --> 00:00:39,649 recorded live at the thirty first annual business 17 00:00:39,649 --> 00:00:41,429 and operations of ASC's conference. 18 00:00:42,049 --> 00:00:44,689 I'm joined today by Bob Bishop, chief designer 19 00:00:44,689 --> 00:00:45,350 at JointSpace. 20 00:00:46,024 --> 00:00:47,384 Bob, to kick us off, can you share 21 00:00:47,384 --> 00:00:48,905 a little bit about yourself and your work 22 00:00:48,905 --> 00:00:50,204 in the ASC space? 23 00:00:50,744 --> 00:00:51,484 Sure. So, 24 00:00:52,265 --> 00:00:54,104 Jeremy, this is this is a picture of 25 00:00:54,104 --> 00:00:56,204 me in, like, 1959. 26 00:00:56,744 --> 00:00:58,825 This is my my sister and I in 27 00:00:58,825 --> 00:01:02,909 my grandma's backyard in Jackson, Michigan after she's 28 00:01:03,050 --> 00:01:03,870 just had 29 00:01:04,329 --> 00:01:07,390 her hips, which she was born with dislocated, 30 00:01:08,329 --> 00:01:09,870 reattached to the socket. 31 00:01:10,250 --> 00:01:11,069 And so 32 00:01:11,370 --> 00:01:13,390 I've literally been involved with 33 00:01:14,135 --> 00:01:14,635 ambulation 34 00:01:15,094 --> 00:01:15,995 and surgery 35 00:01:16,454 --> 00:01:18,534 for sixty five years now because I was 36 00:01:18,534 --> 00:01:20,855 about four or five then and we're now 37 00:01:20,855 --> 00:01:21,995 in 2025. 38 00:01:22,375 --> 00:01:22,875 So 39 00:01:23,334 --> 00:01:24,075 I've been 40 00:01:24,454 --> 00:01:26,234 deeply involved both 41 00:01:27,370 --> 00:01:30,090 with family results as well as I got 42 00:01:30,090 --> 00:01:31,870 involved scientifically and 43 00:01:32,810 --> 00:01:33,310 entrepreneurially 44 00:01:34,409 --> 00:01:34,909 involved 45 00:01:35,370 --> 00:01:37,370 in this whole space for a long, long 46 00:01:37,370 --> 00:01:37,870 time. 47 00:01:38,329 --> 00:01:40,650 So the ASC market in The US is 48 00:01:40,650 --> 00:01:43,114 projected to reach, 60,800,000,000.0 49 00:01:43,114 --> 00:01:45,994 by 2030 and continues to experience strong year 50 00:01:45,994 --> 00:01:48,015 over year growth. From your perspective, 51 00:01:48,314 --> 00:01:50,394 what would you say the most significant trends 52 00:01:50,394 --> 00:01:53,194 and market forces driving this expansion, and how 53 00:01:53,194 --> 00:01:55,295 should ASC leaders be preparing today? 54 00:01:56,269 --> 00:01:58,689 So I'm gonna give an answer that is 55 00:02:00,430 --> 00:02:02,829 very simple on one level and very complex 56 00:02:02,829 --> 00:02:05,549 on the other, and it's the advancement of 57 00:02:05,549 --> 00:02:06,049 knowledge. 58 00:02:07,229 --> 00:02:07,729 And 59 00:02:08,435 --> 00:02:10,514 by that, what I mean is something very 60 00:02:10,514 --> 00:02:13,014 specific, which is that we now 61 00:02:13,474 --> 00:02:14,534 know what we know 62 00:02:15,074 --> 00:02:17,574 and we know why we know it in 63 00:02:17,955 --> 00:02:19,974 ways that are exponentially growing. 64 00:02:21,715 --> 00:02:23,254 And that is the driver 65 00:02:23,639 --> 00:02:24,860 for why we are 66 00:02:25,879 --> 00:02:28,620 now labeling what we say as an ASC. 67 00:02:29,719 --> 00:02:31,400 And in most people here are going to 68 00:02:31,400 --> 00:02:33,259 think, Oh, that's a separate building, 69 00:02:33,879 --> 00:02:34,860 not the hospital 70 00:02:35,159 --> 00:02:37,319 where we do surgery. As far as I'm 71 00:02:37,319 --> 00:02:37,819 concerned, 72 00:02:38,775 --> 00:02:39,275 ambulatory 73 00:02:39,735 --> 00:02:40,235 surgery 74 00:02:40,534 --> 00:02:41,034 is 75 00:02:41,735 --> 00:02:42,235 not 76 00:02:42,694 --> 00:02:45,034 where you walk in or walk out. It's 77 00:02:45,735 --> 00:02:48,235 to actually change the ambulation of the patient. 78 00:02:49,735 --> 00:02:51,974 And it's our knowledge about what makes that 79 00:02:51,974 --> 00:02:53,275 happen and what causes 80 00:02:53,629 --> 00:02:56,210 good results and bad results that's accelerating 81 00:02:57,150 --> 00:02:58,210 massively rapidly 82 00:02:59,150 --> 00:03:02,110 primarily through advanced technologies, but most of which 83 00:03:02,110 --> 00:03:03,650 are computer related. 84 00:03:04,669 --> 00:03:07,389 So from AI and robotic surgeries to advanced 85 00:03:07,389 --> 00:03:08,370 EHR systems, 86 00:03:08,805 --> 00:03:11,604 technology remains both a make or break factor 87 00:03:11,604 --> 00:03:14,425 and critical driver of ASC operations at scale. 88 00:03:15,044 --> 00:03:17,205 How do you see deeper tech integration shaping 89 00:03:17,205 --> 00:03:19,444 the way ASCs deliver care and manage their 90 00:03:19,444 --> 00:03:21,064 businesses over the next few years? 91 00:03:21,900 --> 00:03:22,400 So 92 00:03:22,939 --> 00:03:23,840 the distribution 93 00:03:24,620 --> 00:03:25,120 of 94 00:03:26,460 --> 00:03:26,960 incredibly 95 00:03:27,260 --> 00:03:28,240 powerful technology 96 00:03:28,939 --> 00:03:30,540 has gotten to the point where we all 97 00:03:30,540 --> 00:03:32,000 have it in our side pockets. 98 00:03:32,780 --> 00:03:33,280 And 99 00:03:34,060 --> 00:03:34,800 the availability 100 00:03:35,340 --> 00:03:35,840 of 101 00:03:36,245 --> 00:03:36,745 networks 102 00:03:37,365 --> 00:03:38,504 that can connect 103 00:03:39,444 --> 00:03:40,344 those devices. 104 00:03:40,805 --> 00:03:41,305 And 105 00:03:42,324 --> 00:03:44,324 regardless of where you are in space and 106 00:03:44,324 --> 00:03:44,824 time 107 00:03:45,125 --> 00:03:45,944 has just 108 00:03:47,444 --> 00:03:47,944 incredibly 109 00:03:48,885 --> 00:03:50,745 become ubiquitous with 110 00:03:51,360 --> 00:03:52,500 Musk putting up 111 00:03:53,280 --> 00:03:55,620 satellite systems that create 112 00:03:56,479 --> 00:03:57,299 a internet 113 00:03:57,599 --> 00:03:59,919 from the sky. This device I have in 114 00:03:59,919 --> 00:04:02,019 my pocket will connect to that satellite. 115 00:04:02,560 --> 00:04:04,479 Not all do, but this one does and 116 00:04:04,479 --> 00:04:06,659 all future ones will. So 117 00:04:07,094 --> 00:04:08,314 the connectivity 118 00:04:09,414 --> 00:04:09,914 of 119 00:04:10,215 --> 00:04:12,074 the power of Silicon 120 00:04:12,935 --> 00:04:13,435 calculations, 121 00:04:14,294 --> 00:04:15,754 which is incredibly 122 00:04:16,134 --> 00:04:16,634 powerful 123 00:04:17,175 --> 00:04:17,675 is 124 00:04:18,535 --> 00:04:20,875 everywhere all the time now. And 125 00:04:21,490 --> 00:04:23,029 that's the primary driver 126 00:04:23,649 --> 00:04:25,110 of what is 127 00:04:25,810 --> 00:04:28,610 changing things so quickly. And we're adjusting to 128 00:04:28,610 --> 00:04:29,829 all of the ramifications 129 00:04:31,089 --> 00:04:32,149 of how that 130 00:04:32,849 --> 00:04:35,110 was originally delivered and how it's evolving. 131 00:04:36,185 --> 00:04:37,964 So is there one particular 132 00:04:38,345 --> 00:04:41,224 technology or innovation that stands out to you 133 00:04:41,224 --> 00:04:42,764 as especially transformative? 134 00:04:44,185 --> 00:04:45,884 So I think that 135 00:04:46,185 --> 00:04:46,685 the 136 00:04:47,224 --> 00:04:48,845 use of blockchain 137 00:04:49,704 --> 00:04:50,764 in the sense of 138 00:04:51,064 --> 00:04:51,564 what 139 00:04:52,480 --> 00:04:53,459 zero knowledge 140 00:04:54,000 --> 00:04:55,139 as they call it, 141 00:04:55,759 --> 00:04:56,259 platforms 142 00:04:57,919 --> 00:05:00,419 is going to drive a massive change. 143 00:05:01,199 --> 00:05:03,839 I created a company that I sold to 144 00:05:03,839 --> 00:05:04,339 Zimmer 145 00:05:04,959 --> 00:05:05,459 that 146 00:05:05,759 --> 00:05:06,259 collected 147 00:05:07,185 --> 00:05:07,685 x-ray 148 00:05:08,625 --> 00:05:11,205 that was originally when I started doing it 149 00:05:11,345 --> 00:05:12,645 using film and chemicals. 150 00:05:13,745 --> 00:05:15,685 And I conceived of 151 00:05:16,384 --> 00:05:18,725 transforming that to a digital acquisition 152 00:05:19,105 --> 00:05:21,779 and distribution of those x rays for reasons 153 00:05:21,779 --> 00:05:23,639 that had to do with the fact that 154 00:05:23,699 --> 00:05:24,839 I owned a distributorship 155 00:05:25,539 --> 00:05:28,500 in the Detroit area and I hire somebody 156 00:05:28,500 --> 00:05:30,360 that worked in Traverse City 157 00:05:30,819 --> 00:05:32,740 four and a half, five hours away in 158 00:05:32,740 --> 00:05:33,479 good weather. 159 00:05:33,964 --> 00:05:34,785 And I had 160 00:05:35,725 --> 00:05:37,345 at that time to buy 161 00:05:37,645 --> 00:05:39,665 my own implants and instruments, 162 00:05:40,764 --> 00:05:42,845 which is not the way things work now, 163 00:05:42,845 --> 00:05:45,004 but I had to make an investment in 164 00:05:45,004 --> 00:05:46,925 those and then hire people and had to 165 00:05:46,925 --> 00:05:50,410 have the whole operational environment for it. So 166 00:05:50,949 --> 00:05:51,449 I 167 00:05:52,310 --> 00:05:55,350 had seen the digital x-ray systems that were 168 00:05:55,350 --> 00:05:56,250 in hospitals. 169 00:05:57,189 --> 00:05:59,269 And the metaphor I use is I sort 170 00:05:59,269 --> 00:06:01,289 of took what was a 171 00:06:02,064 --> 00:06:03,444 digital imaging system 172 00:06:04,144 --> 00:06:05,605 designed as a Peterbilt 173 00:06:06,305 --> 00:06:07,764 and turned it into a bicycle 174 00:06:08,384 --> 00:06:10,805 where it could be used by everybody 175 00:06:11,185 --> 00:06:14,725 and yet still get the most incredible results. 176 00:06:15,019 --> 00:06:16,620 In fact, I just saw a thing on 177 00:06:16,620 --> 00:06:19,759 x yesterday showing that humans on a bicycle 178 00:06:20,779 --> 00:06:21,279 outperform 179 00:06:21,740 --> 00:06:23,040 every other animal 180 00:06:24,459 --> 00:06:25,199 in terms 181 00:06:26,060 --> 00:06:27,120 of the speed 182 00:06:27,555 --> 00:06:30,675 and distance that they can transport themselves. There 183 00:06:30,675 --> 00:06:31,735 is no other 184 00:06:32,355 --> 00:06:32,855 animal 185 00:06:33,235 --> 00:06:35,654 that we can't ultimately beat on a bicycle 186 00:06:35,955 --> 00:06:38,915 in terms of the thermodynamic efficiencies. And in 187 00:06:38,915 --> 00:06:39,654 the way, 188 00:06:39,955 --> 00:06:42,295 what I just did was take the systems 189 00:06:42,435 --> 00:06:43,175 that were 190 00:06:43,870 --> 00:06:46,850 in hospitals and moved it into the regular 191 00:06:46,910 --> 00:06:48,050 orthopedic office. 192 00:06:48,990 --> 00:06:49,490 So 193 00:06:49,870 --> 00:06:50,689 that became 194 00:06:51,629 --> 00:06:52,129 model 195 00:06:52,670 --> 00:06:53,410 in which 196 00:06:53,790 --> 00:06:55,310 while I was doing that, it was the 197 00:06:55,310 --> 00:06:56,610 eighties and the nineties. 198 00:06:57,074 --> 00:06:58,915 And we were just breaking into what we 199 00:06:58,915 --> 00:07:00,915 now call sort of web two. We moved 200 00:07:00,915 --> 00:07:02,855 to these dynamic web spaces, 201 00:07:03,314 --> 00:07:05,415 but they were wide open protocols 202 00:07:06,355 --> 00:07:09,074 that we ultimately then put security on and 203 00:07:09,074 --> 00:07:09,814 called them 204 00:07:10,830 --> 00:07:11,330 HTTPS, 205 00:07:12,910 --> 00:07:14,529 which became secure, 206 00:07:15,629 --> 00:07:16,529 still breakable. 207 00:07:17,149 --> 00:07:17,649 And 208 00:07:17,949 --> 00:07:19,490 what we have now are 209 00:07:19,790 --> 00:07:21,730 systems that do those computations 210 00:07:22,430 --> 00:07:22,930 locally 211 00:07:24,064 --> 00:07:25,204 and distributed 212 00:07:26,064 --> 00:07:26,564 simultaneously. 213 00:07:27,745 --> 00:07:31,764 And yet they're on secure protocols that are 214 00:07:31,904 --> 00:07:32,404 private 215 00:07:33,104 --> 00:07:35,425 from the beginning to the end where they're 216 00:07:35,425 --> 00:07:35,925 encrypted 217 00:07:36,305 --> 00:07:37,685 on device and decrypted 218 00:07:38,610 --> 00:07:40,850 later. Only if you have public and private 219 00:07:40,850 --> 00:07:42,149 keys that 220 00:07:43,009 --> 00:07:44,310 is going to change 221 00:07:45,169 --> 00:07:45,829 the game 222 00:07:46,129 --> 00:07:46,949 because the, 223 00:07:47,329 --> 00:07:47,829 the 224 00:07:48,689 --> 00:07:49,189 whole 225 00:07:49,729 --> 00:07:52,949 supply chain of moving all of the people, 226 00:07:53,074 --> 00:07:54,615 the equipment, the information, 227 00:07:55,634 --> 00:07:58,535 and the decisions that go into performing 228 00:07:59,074 --> 00:08:00,375 a, a, an operation 229 00:08:00,754 --> 00:08:01,254 successfully 230 00:08:02,754 --> 00:08:03,495 is being 231 00:08:03,954 --> 00:08:04,454 transformed 232 00:08:04,754 --> 00:08:05,254 into 233 00:08:05,560 --> 00:08:07,959 an infrastructure where you can not only collect 234 00:08:07,959 --> 00:08:08,699 that information, 235 00:08:09,160 --> 00:08:10,540 but process it 236 00:08:11,160 --> 00:08:12,699 and then still retain 237 00:08:14,039 --> 00:08:14,779 the privacy 238 00:08:15,319 --> 00:08:16,539 of everybody involved 239 00:08:17,079 --> 00:08:18,220 at their pleasure, 240 00:08:18,600 --> 00:08:19,339 not at 241 00:08:19,675 --> 00:08:22,235 the system's pleasure. Right. So I believe what's 242 00:08:22,235 --> 00:08:24,254 going to happen is that that will transform 243 00:08:25,115 --> 00:08:26,415 the system 244 00:08:27,275 --> 00:08:30,155 economically in ways that it will no longer 245 00:08:30,155 --> 00:08:31,775 be necessary to have 246 00:08:32,570 --> 00:08:33,710 a monopoly 247 00:08:34,889 --> 00:08:35,789 directed by 248 00:08:36,730 --> 00:08:38,509 striker Zimmer Depew 249 00:08:39,370 --> 00:08:39,870 owning 250 00:08:40,250 --> 00:08:41,389 a massive portion 251 00:08:42,009 --> 00:08:43,070 of the production 252 00:08:43,450 --> 00:08:44,269 in selling 253 00:08:44,730 --> 00:08:45,870 of total joints 254 00:08:46,194 --> 00:08:48,434 of spinal implants, etcetera. And there are a 255 00:08:48,434 --> 00:08:50,375 few other companies that fit into that category, 256 00:08:51,394 --> 00:08:54,214 but those technologies that they're actually delivering 257 00:08:55,315 --> 00:08:57,894 turned metal. Right. It's been around 258 00:08:58,919 --> 00:08:59,419 for 259 00:08:59,879 --> 00:09:01,100 nearly a hundred years. 260 00:09:02,039 --> 00:09:04,860 There's nothing very special about that. It's only 261 00:09:05,240 --> 00:09:06,059 the technology 262 00:09:06,519 --> 00:09:09,980 of the capture of that operating environment 263 00:09:11,320 --> 00:09:12,539 and its improvement 264 00:09:12,919 --> 00:09:13,419 that 265 00:09:13,914 --> 00:09:14,975 has become difficult. 266 00:09:15,674 --> 00:09:17,914 This will help resolve that in a massive 267 00:09:17,914 --> 00:09:19,934 way. So I think that's gonna transform 268 00:09:20,475 --> 00:09:21,855 the economics massively. 269 00:09:22,235 --> 00:09:24,475 And I just wanna rewind a little bit 270 00:09:24,475 --> 00:09:24,975 and 271 00:09:25,274 --> 00:09:26,254 say so, 272 00:09:26,660 --> 00:09:29,059 you know, Blockchain, it was the big buzzword 273 00:09:29,059 --> 00:09:31,139 a few years ago. I think, you know, 274 00:09:31,139 --> 00:09:32,660 you you hear it a little bit less, 275 00:09:32,660 --> 00:09:34,500 but I think, you know, maybe a lot 276 00:09:34,500 --> 00:09:36,200 of people listening to this podcast 277 00:09:36,660 --> 00:09:37,940 are gonna have kind of, like, well, I've 278 00:09:37,940 --> 00:09:39,540 heard the term. Yeah. I know it has 279 00:09:39,540 --> 00:09:42,065 to do with Bitcoin or not Bitcoin, but, 280 00:09:42,144 --> 00:09:45,585 digital cryptocurrencies in that space. But can you 281 00:09:45,585 --> 00:09:47,184 give a very kind of high level and 282 00:09:47,184 --> 00:09:49,285 easy to digest overview of, 283 00:09:49,664 --> 00:09:52,085 you know, how blockchain works and and, 284 00:09:52,785 --> 00:09:54,465 just kind of, like, as it pertains to 285 00:09:54,465 --> 00:09:56,725 what you're talking about? Yeah. So 286 00:09:57,410 --> 00:09:59,330 you know what? When I was a very 287 00:09:59,330 --> 00:10:01,269 young kid, I got a 288 00:10:02,450 --> 00:10:03,190 bank account 289 00:10:03,649 --> 00:10:05,570 and it only had a couple bucks in 290 00:10:05,570 --> 00:10:08,549 it, but they gave you that savings account 291 00:10:08,610 --> 00:10:12,264 booklet that somebody actually wrote in it how 292 00:10:12,264 --> 00:10:13,545 much was in the bank that I had 293 00:10:13,545 --> 00:10:15,085 given them. And 294 00:10:15,465 --> 00:10:17,785 when I went to get money back, they 295 00:10:17,785 --> 00:10:18,985 would not only give me the money, but 296 00:10:18,985 --> 00:10:20,985 they would scratch in there on what was 297 00:10:20,985 --> 00:10:21,884 called a ledger, 298 00:10:22,589 --> 00:10:24,829 which looks just like a spreadsheet. It's just 299 00:10:24,829 --> 00:10:25,409 a grid. 300 00:10:25,789 --> 00:10:28,110 And it would say how much money I 301 00:10:28,110 --> 00:10:30,269 had, how much I took out, what was 302 00:10:30,269 --> 00:10:32,669 the net and what date it was. That 303 00:10:32,669 --> 00:10:33,169 information 304 00:10:34,269 --> 00:10:35,649 is the essence of 305 00:10:36,284 --> 00:10:38,625 the currency environment of Bitcoin. 306 00:10:39,565 --> 00:10:41,264 It's simply a ledger, 307 00:10:41,884 --> 00:10:44,304 but what's different is that it's digital. 308 00:10:45,245 --> 00:10:46,544 That's not magical, 309 00:10:47,084 --> 00:10:49,664 but what gets magical is that it's encrypted, 310 00:10:50,490 --> 00:10:53,710 meaning that simply that it has a, a 311 00:10:54,090 --> 00:10:56,649 hash up of the information in such a 312 00:10:56,649 --> 00:10:59,389 way that if you don't know what the 313 00:11:00,009 --> 00:11:01,790 key is that unlocks it, 314 00:11:02,184 --> 00:11:04,184 you can't see what it is. And that 315 00:11:04,184 --> 00:11:06,825 key system is just like if you go 316 00:11:06,825 --> 00:11:08,745 to that same bank and you put money 317 00:11:08,745 --> 00:11:10,285 in the safety deposit box, 318 00:11:10,745 --> 00:11:13,004 the bank has a key to your box 319 00:11:13,465 --> 00:11:15,705 and you have a key. Without both of 320 00:11:15,705 --> 00:11:17,245 them, you can't get in it. 321 00:11:18,240 --> 00:11:19,840 You can't get in it because you don't 322 00:11:19,840 --> 00:11:21,440 have the bank's key. They can't get it 323 00:11:21,440 --> 00:11:23,860 because they don't have your key. That's how 324 00:11:24,000 --> 00:11:25,299 the encryption works. 325 00:11:25,919 --> 00:11:29,200 There is a public key that everybody can 326 00:11:29,200 --> 00:11:29,700 see 327 00:11:30,134 --> 00:11:32,455 And then there's just your private key. So 328 00:11:32,455 --> 00:11:33,894 is it like in the movies where there's, 329 00:11:33,894 --> 00:11:35,495 like, a nuclear launch code and it takes 330 00:11:35,495 --> 00:11:37,654 two people to turn the key? You got 331 00:11:37,654 --> 00:11:38,154 it. 332 00:11:38,535 --> 00:11:40,315 Just like if you were watching 333 00:11:41,975 --> 00:11:44,699 exactly. Denzel Washington. Right. Right. Right. Right. That's 334 00:11:44,699 --> 00:11:46,000 what you're thinking, Don. Yep. 335 00:11:46,379 --> 00:11:46,879 Yep. 336 00:11:47,419 --> 00:11:48,559 Yeah. Exactly. 337 00:11:49,019 --> 00:11:51,360 That's it. That's awesome. That complicated 338 00:11:51,899 --> 00:11:55,339 until you let it be. Mhmm. Otherwise, it's 339 00:11:55,339 --> 00:11:58,319 just plain old simple easy stuff. Okay. 340 00:11:58,855 --> 00:11:59,355 Okay. 341 00:11:59,975 --> 00:12:02,855 Well, with 60% of health systems considering ASC 342 00:12:02,855 --> 00:12:03,595 joint ventures 343 00:12:03,975 --> 00:12:06,455 and many ASCs already partnering with systems in 344 00:12:06,455 --> 00:12:09,014 their communities, what opportunities do you see for 345 00:12:09,014 --> 00:12:09,514 collaboration 346 00:12:09,894 --> 00:12:13,129 whether with other providers or vendors to strengthen 347 00:12:13,129 --> 00:12:15,470 patient care and operational efficiency? 348 00:12:16,090 --> 00:12:19,450 Okay. So I think that what's happened from 349 00:12:19,450 --> 00:12:20,350 when I was 350 00:12:20,889 --> 00:12:22,649 describing to you when I was a little 351 00:12:22,649 --> 00:12:23,149 kid, 352 00:12:23,769 --> 00:12:24,269 this 353 00:12:25,294 --> 00:12:25,794 surgeon 354 00:12:26,334 --> 00:12:27,714 whose name was doctor Stolberg 355 00:12:28,574 --> 00:12:29,074 and 356 00:12:29,534 --> 00:12:31,875 my mom and dad and my sister 357 00:12:32,254 --> 00:12:34,815 had a deep relationship with. Mhmm. And it 358 00:12:34,815 --> 00:12:35,315 was 359 00:12:36,414 --> 00:12:38,674 one of trust. And it was 360 00:12:39,200 --> 00:12:41,519 one where there were almost, there was almost 361 00:12:41,519 --> 00:12:42,019 nobody 362 00:12:42,559 --> 00:12:43,460 between them. 363 00:12:44,559 --> 00:12:45,059 Today, 364 00:12:46,240 --> 00:12:49,139 I just had lunch with a surgeon who 365 00:12:50,160 --> 00:12:51,460 basically started 366 00:12:51,865 --> 00:12:53,004 the spine business 367 00:12:53,705 --> 00:12:56,184 with a company called sophomore organic that became 368 00:12:56,184 --> 00:12:57,485 a Medtronic company 369 00:12:58,024 --> 00:12:59,325 at Texas back Institute. 370 00:12:59,945 --> 00:13:00,445 And 371 00:13:01,384 --> 00:13:03,804 he's 83 I think he told me now. 372 00:13:04,279 --> 00:13:05,720 And we were talking about this a little 373 00:13:05,720 --> 00:13:07,480 bit and I said, yeah, what I want 374 00:13:07,480 --> 00:13:09,399 to do is get all those people out 375 00:13:09,399 --> 00:13:10,379 from in between 376 00:13:10,759 --> 00:13:13,320 the surgeon and the patient because that's what's 377 00:13:13,320 --> 00:13:13,820 changed 378 00:13:14,279 --> 00:13:15,980 is that at this point 379 00:13:16,875 --> 00:13:19,774 there are so many players entailed 380 00:13:20,394 --> 00:13:21,375 in having 381 00:13:21,835 --> 00:13:22,335 a 382 00:13:22,715 --> 00:13:23,934 simple conversation. 383 00:13:25,355 --> 00:13:26,894 Was that going to get repaid? 384 00:13:27,915 --> 00:13:30,174 Is it my deductible met yet? Because 385 00:13:30,970 --> 00:13:32,889 on January 3, I'm going to have to 386 00:13:32,889 --> 00:13:35,289 start all over again. But on December 28, 387 00:13:35,289 --> 00:13:36,429 if I can get in, 388 00:13:36,970 --> 00:13:39,870 it's free. Right, right. How does that make? 389 00:13:40,809 --> 00:13:43,289 I want to know is, is it okay 390 00:13:43,289 --> 00:13:46,045 for me to play tennis? Right. Right. Right. 391 00:13:46,045 --> 00:13:48,065 Right. What the hell? And so 392 00:13:48,764 --> 00:13:51,345 we need to find ways to remove 393 00:13:51,725 --> 00:13:52,545 all of those 394 00:13:53,644 --> 00:13:56,879 intermediaries. And Mhmm. That's what I think the 395 00:13:57,120 --> 00:13:58,019 massive opportunity 396 00:13:58,559 --> 00:14:00,960 of the technology change that's beginning to happen 397 00:14:00,960 --> 00:14:03,539 is we're going back to that possibility again 398 00:14:03,919 --> 00:14:04,419 where 399 00:14:04,799 --> 00:14:07,220 we can reinitiate a relationship 400 00:14:07,919 --> 00:14:09,779 between the patient and the doctor. 401 00:14:11,445 --> 00:14:14,404 Those same doctors don't want all those people 402 00:14:14,404 --> 00:14:15,144 in between, 403 00:14:15,845 --> 00:14:17,764 come to the Becker meeting and come to 404 00:14:17,764 --> 00:14:20,184 any others. You will hear them all 405 00:14:21,205 --> 00:14:23,205 say things like that over and over again. 406 00:14:23,205 --> 00:14:24,665 And when you talk to the patients, 407 00:14:25,750 --> 00:14:27,990 they're so frustrated. They don't know what's up 408 00:14:27,990 --> 00:14:30,809 and what's down. A 100%. And it's primarily 409 00:14:30,949 --> 00:14:33,610 because they can't go talk to a trusted 410 00:14:34,389 --> 00:14:35,529 doctor Mhmm. 411 00:14:36,069 --> 00:14:37,049 And have a conversation 412 00:14:37,429 --> 00:14:39,585 without a whole bunch of people being in 413 00:14:39,585 --> 00:14:41,925 between for reasons that seem 414 00:14:42,865 --> 00:14:43,365 unexplainable 415 00:14:44,225 --> 00:14:46,144 other than for the fact that that's how 416 00:14:46,144 --> 00:14:47,125 it accidentally 417 00:14:47,425 --> 00:14:49,445 evolved over the period of the last 418 00:14:49,825 --> 00:14:50,965 two or three decades. 419 00:14:51,429 --> 00:14:53,529 Right. It hadn't been that way before 420 00:14:54,309 --> 00:14:55,990 then, but it was the initiation of this 421 00:14:55,990 --> 00:14:56,970 web two world 422 00:14:57,670 --> 00:14:59,210 where we had these 423 00:15:00,389 --> 00:15:00,889 expectations. 424 00:15:01,990 --> 00:15:03,750 You may not be old enough to remember, 425 00:15:03,750 --> 00:15:06,149 but we were told the electronic medical record 426 00:15:06,149 --> 00:15:07,215 is going to revolutionize 427 00:15:09,355 --> 00:15:11,434 and make so efficient. And all it has 428 00:15:11,434 --> 00:15:14,235 done is resulted in the exact opposite of 429 00:15:14,235 --> 00:15:16,075 that for most people who are in the 430 00:15:16,075 --> 00:15:16,575 system. 431 00:15:16,955 --> 00:15:18,815 It's web three or blockchain 432 00:15:19,940 --> 00:15:20,759 sort of reinitiating 433 00:15:21,940 --> 00:15:22,759 that opportunity, 434 00:15:24,019 --> 00:15:26,919 but changing the inertia of the culture, right? 435 00:15:27,299 --> 00:15:30,519 Getting all of those systems back into place 436 00:15:31,459 --> 00:15:34,065 where I literally can communicate directly with my 437 00:15:34,065 --> 00:15:36,085 doctor and not have to tell anybody else. 438 00:15:36,705 --> 00:15:38,225 There are some people who want to say, 439 00:15:38,225 --> 00:15:39,345 you know, you shouldn't be able to do 440 00:15:39,345 --> 00:15:41,445 that. Right. And I say, 441 00:15:42,065 --> 00:15:43,745 well, exactly who the hell do you think 442 00:15:43,745 --> 00:15:46,230 you are? Right. That you should tell me 443 00:15:46,230 --> 00:15:48,389 what I can do with my life. And 444 00:15:48,389 --> 00:15:49,750 I think we just went through a whole 445 00:15:49,750 --> 00:15:50,250 transition 446 00:15:52,230 --> 00:15:53,129 of my body, 447 00:15:53,829 --> 00:15:54,649 my decision. 448 00:15:56,149 --> 00:15:58,870 And I think that's the essence of this 449 00:15:58,870 --> 00:16:00,409 is that we all have 450 00:16:01,045 --> 00:16:03,524 a responsibility to ourselves to take care of 451 00:16:03,524 --> 00:16:05,845 ourselves. Mhmm. And if we need help, we 452 00:16:05,845 --> 00:16:08,004 should find somebody who we trust, and nobody 453 00:16:08,004 --> 00:16:09,865 else should be a part of that. Right. 454 00:16:09,925 --> 00:16:12,004 Right. Right. Well, Bob, you know, this has 455 00:16:12,004 --> 00:16:13,065 been a great conversation. 456 00:16:13,930 --> 00:16:15,450 Is there anything we didn't touch on or 457 00:16:15,450 --> 00:16:16,810 any final thoughts you'd like to leave with 458 00:16:16,810 --> 00:16:17,870 our audience today? 459 00:16:18,649 --> 00:16:19,149 Well, 460 00:16:19,529 --> 00:16:21,470 I like to say that 461 00:16:21,850 --> 00:16:22,350 the 462 00:16:22,970 --> 00:16:24,269 opportunity for 463 00:16:24,730 --> 00:16:26,830 the progression and innovation 464 00:16:27,769 --> 00:16:28,590 is infinite. 465 00:16:30,355 --> 00:16:31,815 And that's not to say 466 00:16:32,274 --> 00:16:35,095 that what will happen will be good. Mhmm. 467 00:16:35,475 --> 00:16:35,975 But 468 00:16:36,514 --> 00:16:39,095 my perspective is that the growth of knowledge 469 00:16:40,034 --> 00:16:40,855 is unstoppable. 470 00:16:41,315 --> 00:16:42,694 Mhmm. And that 471 00:16:43,120 --> 00:16:44,340 can also mean 472 00:16:45,360 --> 00:16:47,620 that people with bad intentions 473 00:16:48,000 --> 00:16:49,860 can capture that knowledge 474 00:16:50,800 --> 00:16:53,440 and do things. So that's not to say 475 00:16:53,440 --> 00:16:55,954 that everything will turn out well, but it 476 00:16:56,254 --> 00:16:57,634 can. It is possible. 477 00:16:58,574 --> 00:17:00,274 And that to me 478 00:17:00,894 --> 00:17:02,194 is why I'm optimistic. 479 00:17:02,975 --> 00:17:04,994 It's not that it is certain, 480 00:17:05,855 --> 00:17:08,434 it's that I can decide 481 00:17:09,200 --> 00:17:11,539 to have an impact in a positive way. 482 00:17:11,920 --> 00:17:14,019 And when I see things that aren't right, 483 00:17:14,480 --> 00:17:15,619 I can speak about 484 00:17:16,079 --> 00:17:18,079 it and I can change it. And that's 485 00:17:18,079 --> 00:17:20,180 kinda where I'm at with this is 486 00:17:20,559 --> 00:17:22,339 I would like to see the reconnection 487 00:17:23,279 --> 00:17:23,779 of 488 00:17:24,454 --> 00:17:26,694 a doctor and a patient in a trusted 489 00:17:26,694 --> 00:17:27,194 relationship 490 00:17:27,815 --> 00:17:29,595 in which there are not impediments 491 00:17:29,894 --> 00:17:30,795 that are artificial 492 00:17:31,174 --> 00:17:33,174 Mhmm. To people being able to take care 493 00:17:33,174 --> 00:17:33,835 of themselves 494 00:17:34,214 --> 00:17:36,795 with a trusted adviser. Mhmm. Mhmm. 495 00:17:37,258 --> 00:17:39,018 Well, Bob, thank you again for the great 496 00:17:39,018 --> 00:17:41,178 conversation today. And, again, thank you for joining 497 00:17:41,178 --> 00:17:42,218 us, and I hope you have a lovely 498 00:17:42,218 --> 00:17:43,838 rest of your day. Thanks, sir.