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- Welcome everyone to the Becker's

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Healthcare podcast series.

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I'm Mariah Mohammed, writer

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and moderator with Becker's Healthcare,

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and I'm absolutely thrilled
to have with me today Dr.

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Freya Schnebel, director

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of Breast Cancer at NYU
Lone Medical Center.

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Doctor, it's very nice to
have you on the podcast today.

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To get us started, would
you mind please introducing

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yourself and telling us a
bit about your background?

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- Thank you so much for having me.

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And I, I am the director

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of breast surgery here at NYU Langone

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Health in, uh, New York.

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So in terms of background,
I am, um, an a OA alum

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of the NYU School of Medicine,

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and I completed my surgical
training here at NYU.

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Um, after doing a research
fellowship, I spent the

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more than 15 years at the
Columbia University Medical

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Center, and at the end of
that time, I was the chief

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of the section of breast surgery

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before coming back here to NYU

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to assume a leadership
role in breast surgery.

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Since 2007, my clinical

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and research interests
include both breast cancer

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and women at high risk for the disease.

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- Wonderful. Thank you
so much for giving us

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that background about what you do.

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Um, and to jump right
into the first question,

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the first thing I wanted to ask you is

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what are your top priorities right now?

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- So I, I think it's
a really good question

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because obviously healthcare is so, uh,

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rapidly evolving right
now, and breast cancer, um,

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and high risk patients per se,

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are a very rapidly evolving
area of healthcare.

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So I, I think our top priorities
right now are spending time

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concentrating on how to increase
the efficiency of the way

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that we deliver care in diagnostic workup

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and management and so on.

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Um, and of course treatment
while maintaining high

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patient satisfaction.

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So we wanna be as efficient
as we can for our processes,

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but we wanna make sure that
our patients feel like we are

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paying good attention to them

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and they are being well
cared for at the same time.

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And I think that is
really our top priority.

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In addition, like a lot
of healthcare systems

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around the country, our system
is growing all the time.

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We're adding new locations,
we're adding new practices,

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we're adding new facilities.

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And so, uh, an enormous
challenge for us right now is how

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to, um, create standard processes across

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this large and enlarging
network to make sure

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that patients get the
same high standard of care

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wherever they are in our, uh, enterprise.

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- Got it. Got it. Yeah, thank you so much

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for giving us that explanation.

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And how are your organ organization
evolve over the next two

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to three years, would you say?

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- So I think just as a
segue to the last comment

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that I made, we really
are working on this idea

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of standardization across the network.

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Um, everyone has to be on the
same electronic medical record

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to allow for, uh, information
sharing in a seamless way.

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We wanna make sure that patients
have equal access across

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all of our sites to the
same, um, interventions,

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the same imaging, the the
same biopsy interventions,

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the same level of care,

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including things like clinical trials

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across the entire enterprise.

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And that's a big job.

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That's not, uh, it doesn't sound easy

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and it's certainly not
even as easy as it sounds.

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So anticipating even further
growth across this enterprise

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within the next several years,
we have to make sure that

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as we grow, we create
consistency, good access to care.

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Everybody can get

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what they need when they need
it at an appropriate site

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for them to seek and get their care.

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- Yeah, yeah, absolutely,
definitely sounds very essential

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and, you know, impactful

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to what's happening right now in society.

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Doctor, the last thing I wanted to ask you

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before I let you go is,
what is one change you

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or your team has made that
yielded great results?

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- So I, I love that question

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because we make a lot of changes

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and changes so often
incrementally done, um,

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where you see small improvements that, um,

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it's a great thing to
think about what we did

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that created really big wins.

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So one improvement

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that we've made over the
last several years has to do

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with the conduct of, uh,

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breast surgery when we're
operating on patients

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who have problems within their breasts

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that are not palpable, that
are not clinically evident,

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that we cannot find, um, by
palpating the breast, and that

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therefore require a process
called localization prior

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to their surgery to make sure

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that the surgeon can target
the correct area in the breast.

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Uh, the old method for localization

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involved a pretty involved
process that patients had to go

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through on the day of their surgery,

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and that wasn't optimal from an

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efficient process perspective.

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It required patients to go

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to multiple locations
within the institution prior

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to their surgery and all of this

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at a time when they're fasting
in advance of their surgery.

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So a number of years ago,
we were very early adopters

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of a technique of wire free localization

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where we decoupled this
localization process from the day

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of surgery so that patients could have a,

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a localization process done

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with inserting what's called
a reflector into the area

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that needed to be operated on,

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on a different day when
they weren't fasting,

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when they could do it at
their own convenience.

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And this uncomplicated the day
of surgery for the patient,

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it made our overall process more efficient

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by reducing delays in the operating room,

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which are certainly costly
and not patient friendly.

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Um, and it allowed us to make
our entire process easier

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and simpler for people on
the day of their surgeries.

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That was a big win.

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Another, uh, process improvement
that we made that I think,

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um, is gonna be expanded,

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but has certainly been
another big win, is to

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simplify the process of
genetic testing, especially

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for patients with new
breast cancer diagnoses,

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where the results of testing
can be really critical in

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decision making for their treatment.

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So we've gone to, uh, a simplified point

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of care testing process,
which, um, has allowed us

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to really jumpstart getting
samples drawn as submitted

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for testing, which the turnaround
can take up to 10 days.

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So we, uh, simplified that process,

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put it back into the surgeon's offices,

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and, uh, allowed our patients
to then get that information,

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um, already pending

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and cooking so that by
the time we're ready

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to confirm our surgical decision making,

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the results are available.

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Um, that's been really
very doctor friendly

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and very patient friendly,

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and it's something that I,

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I think we're gonna see expanded

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throughout our entire network.

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- Yeah, for sure. Thank you so, so much

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for giving us tho those great insights

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and for those final thoughts, doctor,

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it's definitely been an amazing
and informative discussion.

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So again, I wanna thank you so much

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for coming on Becker's Healthcare.

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We really do appreciate it

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and I look forward to
connecting with you again soon.

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- Thank you very much.
A pleasure to be here

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and uh, I'd love to
connect with you again soon

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as well. Have a great day.

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- Thank you.