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This is Laura Dierda with the Becker's Healthcare
podcast.
I'm thrilled today to be joined by doctor
Mahdi Schnur, who is the neuromuscular
skeletal dyad leader and interventional pain physician at
Aspirus
St. Luke's Hospital. Doctor Schnur, it's a pleasure
to have you on the podcast today.
Yes. Great to be here.
Now I'm really looking forward to our conversation.
I know there's a lot, that you're doing
at Aspirus St. Luke's and really looking forward
to learning more about,
how you can really galvanize a physician team's
productivity.
But before we dive in, I was wondering
if you could tell us a little bit
more about yourself and your background.
Sure. So as, everyone heard, I'm doctor Mady
Schnur. I'm an interventional pain physician
with a background of anesthesia.
I work in a small Midwest city at
a hospital based practice, and I have an
administrative role at my hospital. And I'm quite
involved in several professional societies in my field,
including WIPA, which is the Society of Women
Innovators and Team Management, of which I'm one
of the founding members,
as well as a current board member and
treasurer.
I have my MBA from Cornell, and I'm
about 5 years post fellowship training,
which I did at Mayo Rochester.
And in my free time, I really enjoy
archery and running.
Well, it's fantastic. And, you know,
really cool to have those passions of archery
and running. I can imagine, you know, it
is really helpful after
a lot of, the clinical and administrative work
that you do.
Yes. I'm so excited
to watch the Olympics.
Really rooting for team USA.
Absolutely. It's going to be a a fun
summer here coming up. So,
from your perspective, what do you see as
being some of the biggest challenges for physician
productivity in 2024?
Yeah. So one of the biggest challenges is
honestly maintaining a consistent team around you. And
what I mean by that is it always
helps to have rad techs, nurses, medical assistants,
fillers
that really
know
your
practice
and can do their jobs well. And so
having this team and really convincing them to
stay with you for long time periods, I
think, is super important.
And second to this,
I think
also important, is really finding out what others
in the field are doing in terms of,
timing and number of procedures and clinic visits.
It's
really helped me so much to
really be able to go to, multiple conferences
a year
and to be part of,
professional societies.
When
I came from fellowship, it was easy to
kind of continue that routine that I had,
but I soon realized that if I did
that,
I wasn't going to make really my personal
productivity goals, and I wasn't gonna have good
patient access in my practice, particularly,
because I I live in a a small
town, and,
there aren't as many physicians as there would
be in really bigger cities.
That makes a lot of sense. And, certainly,
I can imagine a lot of,
physicians and organizations are in a similar situation.
So when you look at
the idea around productivity and how you can,
boost that within
the different hospitals and systems,
what do you do to design your productivity
targets?
Yeah. So, I use one of the big
databases, so NGMA,
really, as a guide.
I think not all of the databases are
correct in every aspect of, the data that
they use, but they're certainly quite useful.
Additionally, I have found it super helpful to
ask my close colleagues
and friends really what their goals are and,
you know, what are the number of procedures
they're doing in a day, and what are
the number of patients they're seeing in clinic
important to this? And something that I think
has taken me,
a bit of time to find out is,
you know, what what are the numbers of
ancillary staff, they use and the resources that
they have available.
I think we all know that if we
had an infinite team and infinite resources,
you know, we could all be quite productive.
But knowing the resources that you have and
what's feasible with that,
I think, is is good and then seeing
what other people are doing with similar resources.
That's fascinating to to hear about. And, you
know, I can imagine having those targets and
looking at, you know, what is available to
you. I I know a lot of organizations
are are in a similar
situation in in trying to understand, you know,
what makes the most sense for them so
they can continue to provide excellent patient care
even if
they're they're still trying to go through and
figure out exactly,
what that productivity looks like and how to
strengthen their teams. And so,
you know, what from your perspective, what are
the challenges that you see, especially in the
field of pain management over the next 2
to 3 years, and what are you really
focusing on?
Yeah. I think every year, and and, you
know, I'm only 5 years post fellowship, there
seem to be so many new technology and
procedures that,
we see being introduced into
the field of, pain management.
And
I personally have found it quite difficult to
know which ones are appropriate and feasible to
really bring into my everyday practice.
When I go
to conferences or when I, talk with my
colleagues, I find it helpful to really have
them talk about their experience with different
products and new techniques,
before I'm really able to to introduce that.
The other thing
is most companies
will provide training for a lot of these
procedures. And so,
you know, going to the trainings, whether it,
you know, be at a big conference like
NAMS, Aspen, WIPA,
or one of the the private trainings they
provide has been
quite helpful.
The other thing is knowing what resources these
companies have for you.
So being in a,
kind of small Woodwest town, I
wanna know if, the companies have reps that
can come out and be there when I
introduce their products or
be there for the patients if the patients
have questions,
you know, provide me with pamphlets
or,
guides, things like that.
I I definitely see where that would be
extremely helpful to have, you know, the the
companies and and make sure there's support on
their from the reps.
When you think about some of the different
technologies that you've seen and experiences that you've
had, is there anything that you're really excited
about?
So when I came out of
fellowship,
peripheral nerve stimulation
had
kind of had a moment where it was
starting to flourish,
and I really
took on to that and started using it
in my everyday practice even though in fellowship
I had really only done it a few
times.
One
one company in particular I found, quite easy
to use their
devices,
and,
I really started offering it almost as a
Hail Mary. And,
my patients have really loved it. It's really
given me something else I can offer to
them when there really isn't much else,
to be done.
And, you know, probably 50% or greater of
the time, I've had good success with it,
which for me is a big win. I
think my biggest worry when I'm
using products,
I worry that
the research and the promises that they're giving
to me just aren't
true.
And so if I'm using a product and
I've given it,
you know, several tries, I would say 5
to 10, and I haven't seen
the success that was touted, you know, I
I start to think to myself maybe it's
something that
I don't wanna continue on.
That's really helpful perspective and especially, you know,
wanting to make sure that you're actually seeing
the results as you said with your patients
and it's making sense for you. Now is
there anything else that you think about when
you're trying to decide which new procedures to
integrate into your practice?
Yeah. I I think that when new exciting
things come out, you're always in a rush
to,
you know, go do it. And I find
that giving yourself a little bit of time
before integrating into your practice is good.
1, because oftentimes, companies will develop parts of
their products that weren't there right at the
beginning stages, but, also, it gives you time
to see,
how other people have used the product or
the techniques
and really,
you know, kind of form a plan on
how you're going to,
integrate it in your everyday practice.
If
I feel like something looks feasible and I
wanna add it in,
one of the first things I do
is
I really get these sheets that the that
the reps can, give to you. They're almost
like pro little pro formas.
And then I bring it to
the value analysis committee at my hospital, which
I think is a a pretty common,
entity where you basically present the product you
wanna use
and talk about
how it's new and helpful for your patients
and, really, how it's
it's going to, you know, make money and
the value that you're gonna bring to your,
either hospital
or practice.
That makes a lot of sense. And, you
know, I'm glad you mentioned having that opportunity
to
show, the value
for any of the new types of procedures
you're trying to bring in. I can imagine
everything comes with a cost. And so when
you're you're looking at the value and thinking
about the value of what you're doing both
for the patient as well as, the organization
overall,
package that in a way that really resonates
within,
the committee leadership?
Yeah. So, 1, I usually tell them, you
know, these are the number of patients that
I think I'll have every month, every year.
And then oftentimes,
I've gotten buy ins from my partners,
as well as, some of the other services
that I work very closely with. So, for
example, neurosurgery
or, PM and R.
And, really, with their buy in, I have
found it's quite easy to move forward in
saying that,
this product or this technique is gonna be
useful
in the practice.
That's great advice. Doctor Cheniere, thank you so
much for joining us on the podcast today.
This has been a really fascinating conversation, and
I look forward to connecting with you again
soon.
Yes. Thank you for having me.