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Cast. This is Chanel Banger with the Becker's
Healthcare podcast, and I'm recording live at the
21st annual Spine Orthopedic and Pain Management Driven
ASC plus the Future of Spine Conference in
Chicago. Right now, I'm sitting with Tracy Young,
the co founder and COO of Essential Anesthesia
Management.
Tracy, thank you so much for joining me
today. Hi, Chanel. Thank you for having me.
Perfect. Well, to get us started, could you
please tell us a little bit about your
background and organization?
Sure. Absolutely. I'm a I'm a certified registered
nurse in Essentys, which is, advanced practice registered
nurse,
for 24 years now. And the last 20
years, I've been involved in anesthesia management,
groups. I founded a anesthesia management company back
in 2003.
And currently,
we're called Essential Anesthesia Management, and we we
provide outsource anesthesia services to about a 138
ambulatory surgery centers and hospitals across six states
with,
roughly 1400
anesthesia professionals working for us. Got it. Thank
you so much for that introduction.
Now to get us into the meat of
the podcast,
based on your experience, how has the patient
provider dynamic changed over time?
Yeah. This is a interesting question from an
anesthesia standpoint. I I think the biggest change,
in anesthesia and the patient provider relationship is
what we're seeing is more and more production
pressures
where we have less time to spend with
patients than we ever have before, and we
have to really spend that time building up
a trust relationship and and making sure that
patients feel comfortable with the care that we're
gonna provide,
all at the same time while doing an
anesthesia preoperative evaluation
to make sure that we know their their
comorbidities
and and understand and develop an anesthesia plan
of care
that that's gonna be tailored specifically for that
surgery and for that patient. So doing that
in a very brief period of time while
developing trust with the with the patient and
making sure they're comfortable that they know that
they'll be taken care of safely and that
we'll we'll take care of their postoperative pain
effectively as well too is really critical.
Absolutely. And from an organizational
standpoint, do you have any strategies
in place aimed at helping bring in patients
and retaining those patients?
Yeah. This this is a nuanced answer to
you as from an anesthesia standpoint. If we're
truly providing anesthesia services, we're an ancillary service.
So the majority of patients that come into
the ambulatory service centers aren't coming in because
of us. They're coming in because of their
surgeon relationship.
So for for us, it's all about keeping
the surgeon happy and making sure that their
patients have a really great experience because it
reflects back on the surgeon. And,
we're an invited guest quite frequently into ambulatory
surgery centers, and,
making sure that we understand that we're in
a service industry and that patients don't come
for us is is really critical.
From a retention standpoint, the things that we've
been focused on mostly mostly lately is is
retention of providers.
Severe shortage of anesthesia providers,
currently in the United States, and everybody's talking
about recruitment, recruitment, recruitment.
We're we're focused on retention. We wanna make
sure that we we keep the providers that
we have. We keep them happy, and we
we develop a culture,
where they serve those surgeons and their patients
to the best of their ability.
Absolutely. And why is that retention so important?
Well, every turnover of an anesthesia professional, 1,
is disruptive, and 2, it's very costly.
So if, we use a cRNA, for example,
if a cRNA gives their notice, call it
a 60 day notice,
more likely than that, there's gonna be an
interim locum CRNA that's gonna have to fill
a gap for 2, 3 months while we
recruit and be able to, refill that spot.
The premium on locums versus full time CRNA
is just 30, 40, sometimes up to 50%
increased premium it pays. So it is costly,
and it's disruptive to surgeons. Surgeons,
they wanna know who's at the head of
the bed. They like seeing familiar faces, especially
in ambulatory surgery centers. So,
retention is really critical for the success of,
anesthesia currently.
Absolutely. And kinda looking ahead a bit, if
the macroeconomic
challenges of care do not change, how do
you anticipate the industry will evolve? And will
care shift to more of a consumer based
service than a personal one? And how might
that impact care groups versus individual practices?
Look. The the macroeconomic
challenges are pretty clear. The the provider shortage
we're seeing in anesthesia is driving up compensation
of providers. And on the opposite side of
the equation, we're seeing decreased reimbursement. Medicare, cut
cut anesthesia reimbursement every year for the past
3 years,
and commercial payers are not really keen on
renegotiating
anesthesia anesthesia rates with the no surprise act
and the inability to be able to go
out of network and balance bill, which is
a whole separate topic. However, what it's done
is it's really
shifted the leverage away
from anesthesia groups, from payers, and it's it's
essentially pushing anesthesia to almost becoming a commodity
in the, in the AAC, in the hospital
marketplace.
And when when services become commoditized,
often you can lose that personal touch. So
what we need to do is we need
to fight back,
1, to make sure that we get fair
and equitable reimbursement,
but, 2, to make sure that we don't
lose that patient centered focus and that outcomes
are important,
but also especially in the ambulatory surgery environment,
it's a boutique and it's a niche service
where patients they they don't wanna feel like
their cattle being rushed in and rushed out.
They wanna have that unique touch, and anesthesia
plays such an important role in that. It's
important to, make sure that we don't lose
that, and we still spend those extra couple
of seconds to develop that trust and that
relationship with the patient.
Absolutely. Well, Tracy, I wanna thank you for
your time today. But before I let you
go, is there anything else that listeners should
know?
So I I think the the most important
thing right now in anesthesia
is making sure that your surgery centers and
your anesthesia group management are really aligned and
that there's honesty and transparency in those communications
so that the partnership
can strive as opposed to,
becoming adversarial and and making sure that all
the anesthesia providers are well taken care of.
10 years ago, it it it almost didn't
matter. Anesthesia was, there was a lot of
CRNAs, there were a lot of anesthesiologists,
ambulatory surgery centers were the desired place to
work, and the trends are shifting.
So I think the take home message for
for your listeners today is to make sure
that you have a partnership with anesthesia
that is built on honesty, transparency, and that
you're all aligned for the same goals to
to make sure that the patients have a
good experience.
Absolutely. Well, Tracy, I want to thank you
once again for your time today and for
joining me on the Becker's Healthcare Podcast. Thank
you. Thank you for having me.