1 00:00:00,080 --> 00:00:02,159 This is Carly Beam with the Becker Spine 2 00:00:02,159 --> 00:00:03,459 and Orthopedics podcast, 3 00:00:03,839 --> 00:00:05,759 and I'm thrilled to be joined today by 4 00:00:05,759 --> 00:00:07,540 doctor Robert Broad Orthosinci. 5 00:00:08,320 --> 00:00:10,559 He's gonna share some great insights about private 6 00:00:10,559 --> 00:00:11,059 practice, 7 00:00:11,439 --> 00:00:11,939 outpatient 8 00:00:12,719 --> 00:00:13,219 migration, 9 00:00:13,599 --> 00:00:16,035 among some other topics in orthopedics. 10 00:00:16,495 --> 00:00:18,095 So, doctor Roe, thank you so much for 11 00:00:18,095 --> 00:00:18,995 being here today. 12 00:00:19,375 --> 00:00:21,554 Carly, thanks for having me. Appreciate the opportunity. 13 00:00:22,015 --> 00:00:23,614 So before we dive into our discussion, I'd 14 00:00:23,614 --> 00:00:25,774 love if you could introduce yourself and tell 15 00:00:25,774 --> 00:00:27,074 us a bit about your background. 16 00:00:27,609 --> 00:00:30,170 Certainly. I'm doctor Rhode, Robert Rhode, and I'm 17 00:00:30,170 --> 00:00:32,829 in Cincinnati, Ohio. Our group is OrthoScentsy. 18 00:00:34,090 --> 00:00:36,649 I'm an orthopedic surgeon, and I specialize in 19 00:00:36,649 --> 00:00:38,350 hand, wrist, and elbow. 20 00:00:39,049 --> 00:00:40,510 My background is orthopedics 21 00:00:40,890 --> 00:00:41,390 and 22 00:00:42,145 --> 00:00:44,545 trained at University of Pennsylvania and then trained 23 00:00:44,545 --> 00:00:46,164 for David Green in San Antonio 24 00:00:46,625 --> 00:00:49,924 and came to Cincinnati where our group, Wellington 25 00:00:49,984 --> 00:00:51,524 Orthopedics, over the years 26 00:00:52,065 --> 00:00:53,445 merged into OrthoCinci 27 00:00:53,905 --> 00:00:56,250 to form a pretty good sized group in 28 00:00:56,250 --> 00:00:58,590 Cincinnati, Northern Kentucky, Indiana, 29 00:00:59,130 --> 00:01:01,149 and now also with a division in Louisville. 30 00:01:01,450 --> 00:01:03,690 So we've grown over time and hope to 31 00:01:03,690 --> 00:01:05,709 be able to stay independent as 32 00:01:06,010 --> 00:01:08,750 physician owned independent orthopedic group. 33 00:01:09,355 --> 00:01:09,855 Excellent. 34 00:01:10,234 --> 00:01:12,015 And so first, I want to touch on, 35 00:01:12,875 --> 00:01:15,055 outpatient migration in orthopedics. 36 00:01:15,674 --> 00:01:18,795 What is your outlook for that, and what's 37 00:01:18,795 --> 00:01:21,435 been working at your practice in this area, 38 00:01:21,435 --> 00:01:23,935 and where do you see things growing? 39 00:01:24,840 --> 00:01:27,479 Absolutely, Carly. You know, we, as an independent 40 00:01:27,479 --> 00:01:29,959 group here in Cincinnati area, we work with 41 00:01:29,959 --> 00:01:31,979 just about every hospital system around. 42 00:01:32,359 --> 00:01:34,599 Within all of that, there is definitely a 43 00:01:34,599 --> 00:01:36,700 steady trend of services moving 44 00:01:37,255 --> 00:01:40,055 from perhaps inpatient but to outpatient. That that 45 00:01:40,055 --> 00:01:40,795 would include 46 00:01:41,174 --> 00:01:43,594 from the inpatient hospital to an outpatient 47 00:01:43,895 --> 00:01:45,194 environment, but also 48 00:01:45,495 --> 00:01:48,234 to an ambulatory surgery center and then ultimately 49 00:01:48,534 --> 00:01:49,674 office based care. 50 00:01:50,310 --> 00:01:52,150 When considering that, as we know, one of 51 00:01:52,150 --> 00:01:54,069 the first questions we ask is, hey. Can 52 00:01:54,069 --> 00:01:55,290 we do this logistically? 53 00:01:56,150 --> 00:01:56,810 And then 54 00:01:57,109 --> 00:01:59,769 perhaps more importantly, can that be done safely 55 00:02:00,229 --> 00:02:02,969 with comparable or even improved outcomes? 56 00:02:03,454 --> 00:02:05,534 And then finally, are the patients that we're 57 00:02:05,534 --> 00:02:08,254 treating very satisfied with the experience and their 58 00:02:08,254 --> 00:02:08,754 own, 59 00:02:09,615 --> 00:02:11,854 patient reported outcome and at the time of 60 00:02:11,854 --> 00:02:13,955 the procedure and then later looking back? 61 00:02:14,254 --> 00:02:16,895 So, obviously, that requires a lot of different 62 00:02:16,895 --> 00:02:18,914 change in delivery model, but, 63 00:02:19,430 --> 00:02:22,330 also insurance payers are definitely interested in that. 64 00:02:22,950 --> 00:02:24,010 In our organization, 65 00:02:25,189 --> 00:02:27,430 whether it's taking care of a wrist or 66 00:02:27,430 --> 00:02:30,069 a hand or a total shoulder, total knee, 67 00:02:30,069 --> 00:02:30,969 total hip, 68 00:02:31,504 --> 00:02:33,925 We wanna make sure we're improving and optimizing 69 00:02:34,064 --> 00:02:36,405 those patients before surgery and precare 70 00:02:37,025 --> 00:02:39,344 to make sure that these are appropriate patients, 71 00:02:39,344 --> 00:02:41,444 and and they're definitely viable 72 00:02:41,905 --> 00:02:43,284 for outpatient care. 73 00:02:43,665 --> 00:02:45,264 We also would say that we're looking to 74 00:02:45,264 --> 00:02:46,885 grow our in office services 75 00:02:47,560 --> 00:02:48,379 with time. 76 00:02:49,000 --> 00:02:50,680 Things that we can do such as in 77 00:02:50,680 --> 00:02:51,500 my practice, 78 00:02:52,039 --> 00:02:55,959 trigger fingers, carpal tunnels, even fingertip amputations for 79 00:02:55,959 --> 00:02:56,459 trauma, 80 00:02:56,919 --> 00:02:59,000 as opposed to in a larger hospital. Those 81 00:02:59,000 --> 00:03:00,680 are some of the things we're looking at, 82 00:03:00,680 --> 00:03:02,764 I think, around the all all across the 83 00:03:02,764 --> 00:03:03,264 country, 84 00:03:03,644 --> 00:03:05,104 very similar kind of trends. 85 00:03:05,724 --> 00:03:07,245 Yeah. I'd love to, you know, dive in 86 00:03:07,245 --> 00:03:09,884 a bit deeper about, specifically these office based 87 00:03:09,884 --> 00:03:12,444 procedures. How are you, you know, thinking about 88 00:03:12,444 --> 00:03:15,000 what you could, you know, potentially move to 89 00:03:15,000 --> 00:03:17,319 that setting suppose, say, you know, even in 90 00:03:17,319 --> 00:03:17,819 ARC? 91 00:03:18,759 --> 00:03:21,079 Well, definitely with patients, there are some that 92 00:03:21,079 --> 00:03:22,680 are going to be comfortable with that and 93 00:03:22,680 --> 00:03:24,519 some that may not. And so my own 94 00:03:24,519 --> 00:03:27,000 practice is I don't force that. But for 95 00:03:27,000 --> 00:03:27,900 some of the patients, 96 00:03:28,955 --> 00:03:30,655 who are looking for the convenience, 97 00:03:31,435 --> 00:03:34,155 the simple soft tissue hand cases are ideal 98 00:03:34,155 --> 00:03:35,835 for that. And if you have the right 99 00:03:35,835 --> 00:03:37,775 staffing and if you have the right patient 100 00:03:37,915 --> 00:03:38,635 and the right, 101 00:03:39,835 --> 00:03:41,615 safety level in a healthy individual, 102 00:03:41,960 --> 00:03:44,700 I think trigger finger carpal tunnel release 103 00:03:45,080 --> 00:03:47,319 and some small fists in the fingers can 104 00:03:47,319 --> 00:03:50,680 be done very safely with excellent outcomes just 105 00:03:50,680 --> 00:03:52,139 in the office based setting. 106 00:03:52,760 --> 00:03:54,300 Yeah. And then are there any 107 00:03:54,760 --> 00:03:55,580 key considerations 108 00:03:56,200 --> 00:03:56,700 that 109 00:03:57,995 --> 00:04:01,354 physicians and practice leaders should think about when 110 00:04:01,354 --> 00:04:02,175 it comes to, 111 00:04:03,114 --> 00:04:05,055 expanding what cases they 112 00:04:05,514 --> 00:04:06,495 offer outpatient? 113 00:04:07,754 --> 00:04:08,735 Well, I think certainly 114 00:04:09,034 --> 00:04:11,675 if you have the space and you have 115 00:04:11,675 --> 00:04:12,334 the staff 116 00:04:12,930 --> 00:04:14,150 and then you have 117 00:04:14,530 --> 00:04:18,209 gone through a developmental program to look at 118 00:04:18,209 --> 00:04:19,509 the different important 119 00:04:20,129 --> 00:04:21,589 parameters of safety. 120 00:04:22,129 --> 00:04:22,610 And, 121 00:04:23,490 --> 00:04:25,730 I would recommend that when somebody is looking 122 00:04:25,730 --> 00:04:27,185 to do so is visiting 123 00:04:27,564 --> 00:04:29,264 an established, well run, 124 00:04:29,724 --> 00:04:30,224 and, 125 00:04:30,685 --> 00:04:31,185 mature 126 00:04:31,884 --> 00:04:35,264 office based program to really look, watch, learn, 127 00:04:35,485 --> 00:04:38,704 and get an understanding of equipment, staffing, practices, 128 00:04:39,884 --> 00:04:41,584 before diving in. 129 00:04:42,490 --> 00:04:44,250 Yeah. And can you talk about, you know, 130 00:04:44,250 --> 00:04:46,490 a lot of these orthopedic practices, you guys 131 00:04:46,490 --> 00:04:49,129 are adding, you know, walk in services, and 132 00:04:49,129 --> 00:04:50,769 I wanna hear what you think is Mhmm. 133 00:04:50,969 --> 00:04:52,409 Really driving this, 134 00:04:52,810 --> 00:04:53,550 this trend. 135 00:04:54,394 --> 00:04:57,055 Certainly. Well, with regards to walk in service, 136 00:04:57,194 --> 00:04:57,514 we, 137 00:04:58,634 --> 00:05:01,694 we definitely know that from a a standpoint 138 00:05:01,834 --> 00:05:03,055 of convenience 139 00:05:03,754 --> 00:05:06,714 and cost, these are main drivers with walk 140 00:05:06,714 --> 00:05:07,214 ins. 141 00:05:07,750 --> 00:05:09,589 When we talk to our patients, a lot 142 00:05:09,589 --> 00:05:11,529 of them are very eager to avoid 143 00:05:11,990 --> 00:05:13,990 physically being in an emergency room. And if 144 00:05:13,990 --> 00:05:15,669 they have a a sprain or a strain 145 00:05:15,669 --> 00:05:17,910 or something that doesn't require being in a 146 00:05:17,910 --> 00:05:20,169 hospital, they'd like to stay away from 147 00:05:21,074 --> 00:05:23,555 contact with illness, but they also value the 148 00:05:23,555 --> 00:05:26,754 shorter wait times and pretty quick access to 149 00:05:26,754 --> 00:05:28,375 specialists in those offices. 150 00:05:29,154 --> 00:05:31,175 I can tell you, Carly, as a consumer, 151 00:05:32,274 --> 00:05:34,194 each of my three adult sons at one 152 00:05:34,194 --> 00:05:37,180 point in his years has utilized our services. 153 00:05:37,180 --> 00:05:39,580 And and I can say from that customer 154 00:05:39,580 --> 00:05:42,639 perspective, it's a pretty effective and efficient 155 00:05:43,180 --> 00:05:44,720 service for any age group. 156 00:05:45,259 --> 00:05:48,080 Absolutely. And, you know, we think about the 157 00:05:48,139 --> 00:05:49,439 orthopedic landscape 158 00:05:50,194 --> 00:05:51,574 as a whole, are you 159 00:05:52,035 --> 00:05:52,535 optimistic 160 00:05:52,915 --> 00:05:55,235 or nervous when it comes to just thinking 161 00:05:55,235 --> 00:05:58,035 about independent groups like, like, where you work 162 00:05:58,035 --> 00:05:58,535 at? 163 00:05:59,555 --> 00:06:00,055 Certainly. 164 00:06:00,355 --> 00:06:03,074 I think that we've seen pendulum swings over 165 00:06:03,074 --> 00:06:03,735 the years. 166 00:06:04,089 --> 00:06:05,789 And, certainly, for some time, 167 00:06:06,329 --> 00:06:07,949 orthopedic surgeons would 168 00:06:08,490 --> 00:06:09,949 gear towards employment 169 00:06:10,250 --> 00:06:12,810 and then in the years more recently, private 170 00:06:12,810 --> 00:06:13,310 equity. 171 00:06:13,850 --> 00:06:15,769 Right now, I think that there is an 172 00:06:15,930 --> 00:06:18,970 a very heightened interest in remaining independent as 173 00:06:18,970 --> 00:06:21,485 our group is. Mhmm. Within that, 174 00:06:22,024 --> 00:06:23,004 it takes some 175 00:06:23,464 --> 00:06:25,644 extra work and it takes some ingenuity. 176 00:06:26,665 --> 00:06:27,884 Our group and myself, 177 00:06:28,264 --> 00:06:30,024 I am one of the representatives to our 178 00:06:30,024 --> 00:06:30,845 board with, 179 00:06:31,305 --> 00:06:34,205 PELTO, which is an organization that really empowers 180 00:06:34,264 --> 00:06:35,759 independent groups from, 181 00:06:36,639 --> 00:06:38,639 East to West Coast, and and that's been 182 00:06:38,639 --> 00:06:40,500 an exciting opportunity for us. 183 00:06:40,879 --> 00:06:42,720 Yeah. And can you dive more into your 184 00:06:42,720 --> 00:06:43,220 partnership 185 00:06:43,680 --> 00:06:46,000 with Kaltel and where you've seen some of 186 00:06:46,000 --> 00:06:48,879 the most benefits from them compared to, you 187 00:06:48,879 --> 00:06:50,980 know, out of you are ever considering 188 00:06:51,794 --> 00:06:53,014 other types consolidations, 189 00:06:53,475 --> 00:06:53,975 etcetera? 190 00:06:55,314 --> 00:06:57,154 Sure. And and, again, I think that the 191 00:06:57,154 --> 00:06:59,314 way I look at it is preserving position 192 00:06:59,314 --> 00:07:01,014 independence overall. And 193 00:07:01,314 --> 00:07:03,875 every area, every group will have its own 194 00:07:03,875 --> 00:07:04,375 culture. 195 00:07:05,129 --> 00:07:07,530 But with the group Palta, which which stands 196 00:07:07,530 --> 00:07:11,129 for physician empowered leadership of transformational organizations, which 197 00:07:11,129 --> 00:07:12,990 is a mouthful, but the organization, 198 00:07:13,689 --> 00:07:16,569 we're able to, you know, allow groups with 199 00:07:16,569 --> 00:07:19,774 help and collaboration to maintain their independence if 200 00:07:19,774 --> 00:07:21,555 that's what they so wish to do. 201 00:07:21,935 --> 00:07:23,714 We can leverage some of the collective 202 00:07:24,175 --> 00:07:26,735 different resources, whether that be ingenuity, whether it 203 00:07:26,735 --> 00:07:27,394 be brainstorming, 204 00:07:27,935 --> 00:07:29,475 shared services, etcetera. 205 00:07:30,160 --> 00:07:32,639 And sometimes when I'm in meetings, I think 206 00:07:32,639 --> 00:07:34,240 of this as we're serving as a think 207 00:07:34,240 --> 00:07:37,379 tank for other similar minded independent groups. And 208 00:07:37,519 --> 00:07:39,459 each group may have their own 209 00:07:39,920 --> 00:07:42,180 business focused challenge or opportunity, 210 00:07:42,724 --> 00:07:44,884 and we can share innovation and ideas. We 211 00:07:44,884 --> 00:07:47,125 we do carry then a pretty deep bench 212 00:07:47,125 --> 00:07:49,925 of expertise where we can offer advice and 213 00:07:49,925 --> 00:07:52,024 leadership, even some fractional services. 214 00:07:52,884 --> 00:07:53,384 And, 215 00:07:53,685 --> 00:07:54,345 you know, 216 00:07:54,724 --> 00:07:57,689 these are definitely some growing areas of interest, 217 00:07:57,689 --> 00:07:59,850 and and we see that organization growing. It's 218 00:07:59,850 --> 00:08:02,270 been it's been exciting as we figure out 219 00:08:02,330 --> 00:08:03,930 a lot of ways we can help people 220 00:08:03,930 --> 00:08:05,790 achieve what their goals are independently. 221 00:08:06,569 --> 00:08:08,410 I like the idea of, like, a a 222 00:08:08,410 --> 00:08:10,814 think tank and learning from just all the 223 00:08:11,295 --> 00:08:14,995 other leaders at orthopedic practices across the country, 224 00:08:15,055 --> 00:08:15,555 really. 225 00:08:16,014 --> 00:08:17,394 Are there any particular 226 00:08:18,254 --> 00:08:21,295 changes that you or anything you've any changes 227 00:08:21,295 --> 00:08:24,735 you made in response to something you've learned 228 00:08:24,735 --> 00:08:25,875 from another group? 229 00:08:26,670 --> 00:08:28,509 Well, let's see. I I can think off 230 00:08:28,509 --> 00:08:30,350 the cuff. I I think that we are 231 00:08:30,350 --> 00:08:33,330 definitely interested in some of the cutting edge, 232 00:08:34,029 --> 00:08:35,970 opportunities to use our collective 233 00:08:36,750 --> 00:08:39,629 involvement. And some sometimes that can be just 234 00:08:39,629 --> 00:08:40,850 innovation, whether 235 00:08:42,225 --> 00:08:43,205 bouncing ideas 236 00:08:43,904 --> 00:08:45,365 in terms of back office, 237 00:08:46,304 --> 00:08:47,284 artificial intelligence, 238 00:08:48,144 --> 00:08:49,205 even utilizing, 239 00:08:49,904 --> 00:08:53,924 fractional advising between smaller groups, and then development 240 00:08:54,144 --> 00:08:57,850 of other ancillary enterprises such as helping someone 241 00:08:58,549 --> 00:08:59,610 build an ASC. 242 00:09:00,149 --> 00:09:02,570 And I think that sometimes within our organization, 243 00:09:02,949 --> 00:09:03,929 if we're evaluating 244 00:09:04,629 --> 00:09:07,110 an opportunity, if we're evaluating a service or 245 00:09:07,110 --> 00:09:08,089 even a technology, 246 00:09:08,870 --> 00:09:09,769 having this 247 00:09:10,144 --> 00:09:10,725 trustworthy organization 248 00:09:11,504 --> 00:09:13,985 where we can, you know, like we were 249 00:09:13,985 --> 00:09:15,825 saying, just sort of bounce an idea off 250 00:09:15,825 --> 00:09:18,705 one another, but get a good founding board 251 00:09:18,705 --> 00:09:19,845 can be really valuable. 252 00:09:20,705 --> 00:09:22,465 Got it. And, you know, do you think 253 00:09:22,465 --> 00:09:22,965 collaborations 254 00:09:23,665 --> 00:09:26,860 like this will become inevitable for 255 00:09:27,559 --> 00:09:30,940 any, spine orthopedic independent group to thrive? 256 00:09:32,120 --> 00:09:33,480 I don't know. And I think it probably 257 00:09:33,480 --> 00:09:36,679 depends on what's the goal and the nature 258 00:09:36,679 --> 00:09:38,894 of each group. And if the goal is 259 00:09:38,894 --> 00:09:41,695 to remain independent and maybe you're in an 260 00:09:41,695 --> 00:09:44,975 area where you don't necessarily have the scale 261 00:09:44,975 --> 00:09:46,815 or the size to have some of those 262 00:09:46,815 --> 00:09:47,315 services, 263 00:09:48,095 --> 00:09:51,059 this would be an opportunity for someone to 264 00:09:51,379 --> 00:09:53,399 gain the expertise, the assistance, 265 00:09:54,179 --> 00:09:54,679 or 266 00:09:55,220 --> 00:09:57,059 join in to be able to kind of 267 00:09:57,059 --> 00:10:00,120 enjoy a larger scale. This is maintaining independence, 268 00:10:00,259 --> 00:10:02,679 not another private equity venture, but 269 00:10:03,139 --> 00:10:05,434 it allows a group to reach out and 270 00:10:05,434 --> 00:10:07,495 have some of the, 271 00:10:08,315 --> 00:10:11,375 different value areas where it'd be purchasing power, 272 00:10:11,835 --> 00:10:12,975 strategic resources, 273 00:10:14,554 --> 00:10:17,675 and and still maintain that physician led kind 274 00:10:17,675 --> 00:10:18,415 of structure. 275 00:10:19,240 --> 00:10:21,720 Got it. Very well said. And then, doctor 276 00:10:21,720 --> 00:10:24,200 Rhode, I was wondering, you know, in upper 277 00:10:24,200 --> 00:10:25,960 extremity care, what are some of the most 278 00:10:25,960 --> 00:10:28,059 exciting innovations that you've been watching? 279 00:10:29,000 --> 00:10:31,080 Sure. I there's so many different things every 280 00:10:31,080 --> 00:10:33,240 year. You know, we we're always changing. We're 281 00:10:33,240 --> 00:10:35,054 always looking for something new. But 282 00:10:35,615 --> 00:10:37,774 one of the things, Carly, I've seen in 283 00:10:37,774 --> 00:10:39,934 the last few years that I think has 284 00:10:39,934 --> 00:10:40,434 really 285 00:10:41,214 --> 00:10:43,315 impacted patients has been the opportunity 286 00:10:45,134 --> 00:10:48,115 to maintain a pretty active lifestyle, 287 00:10:49,259 --> 00:10:50,860 especially when we consider the 288 00:10:51,580 --> 00:10:54,379 our senior population. So with fracture care, with 289 00:10:54,379 --> 00:10:55,840 injuries, with treating 290 00:10:56,300 --> 00:10:57,279 some of the issues, 291 00:10:57,899 --> 00:11:00,220 I think we're seeing great evidence, and we 292 00:11:00,220 --> 00:11:00,720 are 293 00:11:01,485 --> 00:11:03,024 personally seeing excellent 294 00:11:03,485 --> 00:11:03,985 experiences 295 00:11:04,605 --> 00:11:07,424 where our senior population now has the opportunity 296 00:11:08,365 --> 00:11:09,985 to be sometimes considering 297 00:11:10,605 --> 00:11:12,845 what might be what might be thought of 298 00:11:12,845 --> 00:11:15,884 as a more aggressive younger person's procedure such 299 00:11:15,884 --> 00:11:16,625 as fracture, 300 00:11:17,070 --> 00:11:19,149 fixation, and care with the goal of getting 301 00:11:19,149 --> 00:11:19,889 people back 302 00:11:20,269 --> 00:11:22,350 to an activity that's really important. That could 303 00:11:22,350 --> 00:11:25,170 be music. It could be golf, tennis, pickleball, 304 00:11:25,389 --> 00:11:26,450 yoga, Pilates. 305 00:11:26,910 --> 00:11:29,090 And I think what we're realizing here now 306 00:11:29,230 --> 00:11:31,330 is that these are not just healthy lifestyles, 307 00:11:31,389 --> 00:11:32,210 but they're also 308 00:11:32,774 --> 00:11:33,274 one's 309 00:11:34,054 --> 00:11:35,995 quality of life, social interactions. 310 00:11:36,375 --> 00:11:36,875 And, 311 00:11:37,574 --> 00:11:39,355 you know, when we talk to our patients, 312 00:11:39,735 --> 00:11:41,334 what are they missing? Well, they miss the 313 00:11:41,334 --> 00:11:43,595 physical activity, but they're missing sometimes 314 00:11:44,134 --> 00:11:46,694 that really crucial social interaction that they get 315 00:11:46,694 --> 00:11:47,674 with those activities. 316 00:11:48,149 --> 00:11:50,490 And so if we can stabilize a wrist 317 00:11:51,029 --> 00:11:53,050 or a metacarpal fracture 318 00:11:53,430 --> 00:11:57,050 and and offer a rapid return within reason, 319 00:11:57,430 --> 00:11:59,750 then oftentimes just that quality of life and 320 00:11:59,750 --> 00:12:02,410 their enjoyment of life and those human interactions 321 00:12:03,304 --> 00:12:05,544 get back to, you know, what they're looking 322 00:12:05,544 --> 00:12:07,304 for as well. I think that's been really 323 00:12:07,304 --> 00:12:10,024 exciting and not just because we like to 324 00:12:10,024 --> 00:12:11,865 operate, but we can bring that to the 325 00:12:11,865 --> 00:12:12,365 patient. 326 00:12:13,544 --> 00:12:15,544 Got it. And, well, doctor Rowe, thank you 327 00:12:15,544 --> 00:12:16,524 so much for 328 00:12:17,009 --> 00:12:19,169 taking the time to talk on today's podcast. 329 00:12:19,169 --> 00:12:21,330 It's been a great conversation. I look forward 330 00:12:21,330 --> 00:12:23,490 to connecting again in the future. Thank you 331 00:12:23,490 --> 00:12:24,690 so much. It was an honor to be 332 00:12:24,690 --> 00:12:25,269 with you.