1 00:00:00,240 --> 00:00:03,220 Imagine this. You're at the Hyatt Regency Chicago 2 00:00:03,439 --> 00:00:05,859 surrounded by the top minds in the ambulatory 3 00:00:06,160 --> 00:00:07,540 surgery center industry. 4 00:00:07,919 --> 00:00:10,960 Welcome to the Becker's 30th annual meeting, the 5 00:00:10,960 --> 00:00:14,259 business and operations of ASCs from October 30th 6 00:00:14,400 --> 00:00:15,705 to November 2nd 7 00:00:16,324 --> 00:00:19,285 2024. Picture the excitement as you collect business 8 00:00:19,285 --> 00:00:22,184 cards from over a 1000 executive level attendees 9 00:00:22,404 --> 00:00:23,945 forging priceless connections. 10 00:00:24,404 --> 00:00:25,864 Feel the buzz of conversations 11 00:00:26,164 --> 00:00:28,904 as you participate in more than 60 sessions 12 00:00:29,045 --> 00:00:29,969 led by over 13 00:00:30,849 --> 00:00:33,030 225 elite ASC speakers. 14 00:00:33,649 --> 00:00:37,090 Envision yourself gaining actionable insights on topics like 15 00:00:37,090 --> 00:00:38,390 private equity strategies, 16 00:00:38,929 --> 00:00:43,030 ASC business growth, and innovations in spine, orthopedics, 17 00:00:43,635 --> 00:00:45,734 GI, ophthalmology, and cardiology. 18 00:00:46,354 --> 00:00:49,954 Now imagine yourself listening to inspiring keynotes from 19 00:00:49,954 --> 00:00:53,094 Hall of Fame boxing world champion, Lila Ali, 20 00:00:53,155 --> 00:00:56,879 and professional basketball player, Caitlin Clark. Their stories 21 00:00:56,879 --> 00:00:59,199 will motivate you to take your business to 22 00:00:59,199 --> 00:01:01,600 new heights. You'll leave with a wealth of 23 00:01:01,600 --> 00:01:03,920 knowledge and a network of connections to help 24 00:01:03,920 --> 00:01:06,719 lead your ASC into the next year. Don't 25 00:01:06,719 --> 00:01:09,619 miss out. Get registered today. Visit beckershospitalreviewdot 26 00:01:10,834 --> 00:01:12,754 com and click on the events page to 27 00:01:12,754 --> 00:01:15,094 find the conference website. That's the beckershospitalreview.com 28 00:01:17,075 --> 00:01:19,094 events page. See you in Chicago. 29 00:01:19,954 --> 00:01:21,555 Well, thank you for tuning in again to 30 00:01:21,555 --> 00:01:24,810 the Becker's ASC podcast. This is Alan Condon, 31 00:01:24,810 --> 00:01:26,729 and I'm delighted to be joined today by 32 00:01:26,729 --> 00:01:29,849 doctor Neil Kaushal, who's the executive director of 33 00:01:29,849 --> 00:01:31,390 general GI and endoscopy 34 00:01:31,929 --> 00:01:33,789 at OU Health in Oklahoma 35 00:01:34,170 --> 00:01:36,569 City. Doctor Kaushal, pleasure to have you on 36 00:01:36,569 --> 00:01:38,584 the podcast with us. Before we dive in 37 00:01:38,584 --> 00:01:39,704 and pick your reins a little bit, I'd 38 00:01:39,704 --> 00:01:41,064 love to hand the floor over to you 39 00:01:41,064 --> 00:01:42,185 to just hear a little bit more about 40 00:01:42,185 --> 00:01:44,104 your role, your background, and what's going on 41 00:01:44,104 --> 00:01:45,084 at OU Health. 42 00:01:45,784 --> 00:01:47,545 Thank you so much for having me, Alan. 43 00:01:47,784 --> 00:01:49,625 As you mentioned, I am the director of 44 00:01:49,625 --> 00:01:50,524 general gastroenterology 45 00:01:50,825 --> 00:01:53,379 and endoscopy at OU Health, and I've been 46 00:01:53,379 --> 00:01:55,140 in this role for about a year now. 47 00:01:55,140 --> 00:01:58,340 I was recruited from California where I worked 48 00:01:58,340 --> 00:02:00,659 in a system level at Adventist Health as 49 00:02:00,659 --> 00:02:01,319 a gastroenterologist 50 00:02:01,859 --> 00:02:03,640 and a system level medical director. 51 00:02:04,099 --> 00:02:06,314 And the main purpose of my recruitment to 52 00:02:06,314 --> 00:02:08,474 OU Health was a growth and development of 53 00:02:08,474 --> 00:02:09,134 the gastroenterology 54 00:02:09,594 --> 00:02:12,574 service line, especially from the general gastroenterology 55 00:02:12,955 --> 00:02:13,455 perspective. 56 00:02:13,754 --> 00:02:15,514 So what we're trying to do is optimize 57 00:02:15,514 --> 00:02:19,194 our current endoscopy lab operations and also lay 58 00:02:19,194 --> 00:02:20,735 the sound work for expansion 59 00:02:21,310 --> 00:02:23,810 around the Greater Oklahoma City area to ambulatory 60 00:02:23,949 --> 00:02:27,789 endoscopy centers, starting with our own satellite hospital, 61 00:02:27,789 --> 00:02:29,949 which we own, which is about 20 miles 62 00:02:29,949 --> 00:02:31,949 north of the city in a community called 63 00:02:31,949 --> 00:02:32,449 Edmond. 64 00:02:33,844 --> 00:02:35,605 Fantastic. Yeah. Thank you so much. So I 65 00:02:35,605 --> 00:02:37,605 think that's a great point for us to 66 00:02:37,605 --> 00:02:39,844 start. I think, obviously, you'd recruited out of 67 00:02:39,844 --> 00:02:42,245 Adventist Health, I believe, about a year ago. 68 00:02:42,245 --> 00:02:44,085 Now, Landon, though, all you helped the real 69 00:02:44,085 --> 00:02:46,805 intention to grow the the GI program, particularly 70 00:02:46,805 --> 00:02:48,819 in the outpatient space I gather. But we'd 71 00:02:48,819 --> 00:02:50,340 love to hear a little bit more about 72 00:02:50,340 --> 00:02:51,780 what you're focusing on right now and what 73 00:02:51,780 --> 00:02:53,860 are your, immediate intentions to grow the program 74 00:02:53,860 --> 00:02:55,319 over the next year or so? 75 00:02:55,939 --> 00:02:57,620 That's a great question. So our first and 76 00:02:57,620 --> 00:02:59,540 foremost goal is to take what we have 77 00:02:59,540 --> 00:03:03,000 currently, which is a large scale inpatient endoscopy 78 00:03:03,139 --> 00:03:06,544 unit where we conduct general GI procedures, interventional 79 00:03:06,844 --> 00:03:07,585 GI procedures, 80 00:03:08,125 --> 00:03:11,745 combined endoscopic and even minimally invasive surgical procedures 81 00:03:12,205 --> 00:03:14,125 and take a good look at that operation 82 00:03:14,125 --> 00:03:15,805 and figure out the things we do well 83 00:03:15,805 --> 00:03:17,485 and then figure out the things where there's 84 00:03:17,485 --> 00:03:19,959 opportunities to improve. And then once we do 85 00:03:19,959 --> 00:03:21,879 that, then we can use that as a 86 00:03:21,879 --> 00:03:23,180 framework and a template 87 00:03:23,479 --> 00:03:25,959 to then build in the outpatient setting. So, 88 00:03:25,959 --> 00:03:27,959 for example, one of the things we're doing 89 00:03:27,959 --> 00:03:30,379 on the inpatient side is creating a dedicated 90 00:03:30,599 --> 00:03:32,219 GI hospitalist program. 91 00:03:32,594 --> 00:03:35,254 So this is gonna be inpatient focused gastroenterologists 92 00:03:36,194 --> 00:03:38,754 who are pretty much solely devoted to providing 93 00:03:38,754 --> 00:03:42,215 inpatient GI care, which will then translate to 94 00:03:42,354 --> 00:03:44,055 our other complement of gastroenterologists 95 00:03:44,435 --> 00:03:46,730 being able to focus on outpatient work and 96 00:03:46,730 --> 00:03:48,830 more of the bread and butter general gastroenterology 97 00:03:49,210 --> 00:03:51,290 practice that we can then use to expand 98 00:03:51,290 --> 00:03:53,129 around the city. So it's kind of a 99 00:03:53,129 --> 00:03:55,949 2 part operation there that all really dovetails 100 00:03:56,010 --> 00:03:57,790 together organically very nicely. 101 00:03:58,875 --> 00:04:00,794 Gotcha. And I I guess when you came 102 00:04:00,794 --> 00:04:01,275 in, 103 00:04:01,674 --> 00:04:03,234 the last year or so, you you spoke 104 00:04:03,234 --> 00:04:05,215 a little bit about firstly identifying 105 00:04:05,834 --> 00:04:08,394 areas which OU Health does particularly well in 106 00:04:08,394 --> 00:04:10,074 the GI space and then some of the 107 00:04:10,074 --> 00:04:12,599 areas that you're particularly looking to improve. So 108 00:04:12,760 --> 00:04:14,120 could you give us a little bit more 109 00:04:14,120 --> 00:04:15,819 insight into what you're talking about there? 110 00:04:16,439 --> 00:04:19,240 Yes. Absolutely. So the particular areas that we 111 00:04:19,240 --> 00:04:21,100 do well are that we have some incredible 112 00:04:21,240 --> 00:04:21,740 endoscopists. 113 00:04:22,040 --> 00:04:24,120 We have are fortunate to have some of 114 00:04:24,120 --> 00:04:25,974 the most skilled professionals areas 115 00:04:26,514 --> 00:04:27,014 of 116 00:04:28,435 --> 00:04:29,048 interventional gastroenterology. We're really on the forefront and 117 00:04:29,048 --> 00:04:29,261 the cutting edge of a lot of technology 118 00:04:29,261 --> 00:04:31,074 in advanced therapeutic procedures. Some of the areas 119 00:04:31,074 --> 00:04:32,754 where we do have room for improvement in 120 00:04:32,754 --> 00:04:33,254 growth 121 00:04:40,180 --> 00:04:43,300 are improving inpatient length of stay for patients 122 00:04:43,300 --> 00:04:45,639 who are admitted to the hospital with especially 123 00:04:45,699 --> 00:04:48,279 general GI related admission DRGs. 124 00:04:48,819 --> 00:04:51,379 So taking this patient population, figuring out how 125 00:04:51,379 --> 00:04:52,120 we can 126 00:04:52,464 --> 00:04:55,264 improve their throughput, get them the essential care 127 00:04:55,264 --> 00:04:57,185 that they need and do that faster while 128 00:04:57,185 --> 00:04:59,204 still maintaining quality and high standing, 129 00:04:59,504 --> 00:05:00,884 and then developing 130 00:05:01,425 --> 00:05:03,745 methods to translate that to the outpatient setting 131 00:05:03,745 --> 00:05:04,404 as well. 132 00:05:05,620 --> 00:05:08,819 Gotcha. So it's certainly a exciting time to 133 00:05:08,819 --> 00:05:11,139 be in health care, but no doubt, particularly 134 00:05:11,139 --> 00:05:13,240 in the GI space when you think about, 135 00:05:13,620 --> 00:05:16,019 the advent of technology and on where things 136 00:05:16,019 --> 00:05:18,259 are going in the outpatient arena. But I 137 00:05:18,259 --> 00:05:19,639 guess when you think about 138 00:05:19,985 --> 00:05:21,904 health care or the GI space, is there 139 00:05:21,904 --> 00:05:24,245 any 2 or 3 trends that you're particularly 140 00:05:24,545 --> 00:05:26,704 focused on and thinking about for the future 141 00:05:26,704 --> 00:05:27,365 and why? 142 00:05:28,305 --> 00:05:31,185 Yes. Absolutely. The first and foremost trend that 143 00:05:31,185 --> 00:05:33,105 is really on our minds right now is 144 00:05:33,105 --> 00:05:34,324 colon cancer screening. 145 00:05:34,810 --> 00:05:36,729 And this has been a a really nice 146 00:05:36,729 --> 00:05:40,410 development actually both in through social media, popular 147 00:05:40,410 --> 00:05:43,789 culture, and with the newish or newer guidelines 148 00:05:44,250 --> 00:05:47,050 advocating for colon cancer screening starting at age 149 00:05:47,050 --> 00:05:49,675 45 as opposed to age 50. So in 150 00:05:49,675 --> 00:05:51,834 terms of the technical aspects of this and 151 00:05:51,834 --> 00:05:54,875 the system level aspects of this, there are 152 00:05:54,875 --> 00:05:57,834 now more ways to for people to have 153 00:05:57,834 --> 00:06:00,475 access to colon cancer screening, whether that is 154 00:06:00,475 --> 00:06:02,555 via stool testing in the at home, in 155 00:06:02,555 --> 00:06:05,689 their own setting. There are now FDA approval 156 00:06:05,689 --> 00:06:06,829 coming in for 157 00:06:07,129 --> 00:06:10,110 serum blood work based colon cancer screening assays. 158 00:06:10,410 --> 00:06:12,569 And, of course, the the gold standard, which 159 00:06:12,569 --> 00:06:15,310 we consider so far being screening colonoscopy. 160 00:06:15,689 --> 00:06:17,069 And within screening colonoscopy, 161 00:06:17,675 --> 00:06:20,954 the world of artificial intelligence is now really 162 00:06:20,954 --> 00:06:22,975 playing a big role in polyp detection 163 00:06:23,514 --> 00:06:26,634 and increasing adenoma detection rates to provide better 164 00:06:26,634 --> 00:06:28,795 outcomes for patients. So now there is a 165 00:06:28,795 --> 00:06:30,475 lot of work being done on the outcome 166 00:06:30,475 --> 00:06:33,230 studies level to see how these new technologies 167 00:06:33,529 --> 00:06:36,250 are improving our colon cancer screening rates and 168 00:06:36,250 --> 00:06:38,329 our national programs and then how that can 169 00:06:38,329 --> 00:06:41,689 translate to better survival and and increased prevention 170 00:06:41,689 --> 00:06:43,689 for colon cancer. So that's really the main 171 00:06:43,689 --> 00:06:45,370 thing that we at OU Health are also 172 00:06:45,370 --> 00:06:47,644 focusing on in the outpatient setting as we 173 00:06:47,644 --> 00:06:49,264 look to grow our ambulatory 174 00:06:49,884 --> 00:06:51,185 endoscopy operations. 175 00:06:52,605 --> 00:06:55,004 Gotcha. So AI and colon cancer screening, we've 176 00:06:55,004 --> 00:06:56,365 heard a lot about this from, 177 00:06:57,165 --> 00:06:57,985 great gastroenterologists 178 00:06:58,365 --> 00:07:00,285 over the last couple of years or so. 179 00:07:00,285 --> 00:07:03,379 Are you someone who's particularly excited about AI 180 00:07:03,379 --> 00:07:05,220 in general? You want to think further afield 181 00:07:05,220 --> 00:07:06,920 and outside of the g GI space? 182 00:07:07,939 --> 00:07:10,259 Yes. I am. Overall, I am excited, but 183 00:07:10,259 --> 00:07:12,020 it does it does come with its share 184 00:07:12,020 --> 00:07:14,839 of challenges as well. So so far, artificial 185 00:07:14,980 --> 00:07:17,324 intelligence has been used as a as an 186 00:07:17,485 --> 00:07:20,365 adjunct diagnostic tool, and I think that that's 187 00:07:20,365 --> 00:07:21,824 where it can really excel. 188 00:07:22,205 --> 00:07:23,585 For example, there are 189 00:07:24,045 --> 00:07:27,264 there are vendors and the medical device companies 190 00:07:27,404 --> 00:07:30,705 that are really pushing AI and colon polydetection. 191 00:07:31,470 --> 00:07:32,830 And some of that, I think, is a 192 00:07:32,830 --> 00:07:35,550 really good thing because it could possibly lead 193 00:07:35,550 --> 00:07:36,689 to better screening 194 00:07:37,069 --> 00:07:40,029 and improve adenoma detection rates. However, at the 195 00:07:40,029 --> 00:07:43,250 same time, it should we should exercise caution 196 00:07:43,310 --> 00:07:46,725 as as the GI community in implementing these 197 00:07:46,725 --> 00:07:47,225 technologies 198 00:07:47,845 --> 00:07:50,324 system wide or even nationwide and and almost 199 00:07:50,324 --> 00:07:51,925 even leaning on them a little bit too 200 00:07:51,925 --> 00:07:54,024 much and maybe using them as a crutch 201 00:07:54,324 --> 00:07:58,324 rather than continuing to develop educational pathways to 202 00:07:58,324 --> 00:08:00,024 improve colonoscopy techniques 203 00:08:00,389 --> 00:08:01,050 and improve the 204 00:08:01,350 --> 00:08:04,009 the manual both art and science of colonoscopy. 205 00:08:04,629 --> 00:08:06,329 So it is kind of a a two 206 00:08:06,389 --> 00:08:07,990 sided coin there that we have to be 207 00:08:07,990 --> 00:08:09,209 mindful of in general. 208 00:08:10,229 --> 00:08:12,389 Yeah. Yeah. Certainly interesting to see where we 209 00:08:12,389 --> 00:08:14,564 where we will be in 2, 3, 4, 210 00:08:14,564 --> 00:08:16,245 5 years down the line with the just 211 00:08:16,245 --> 00:08:18,645 the rapid pace of AI in all in 212 00:08:18,645 --> 00:08:20,725 all sorts of industries, particularly in the health 213 00:08:20,725 --> 00:08:21,545 care space. 214 00:08:22,085 --> 00:08:24,564 Doctor Kaushal, I'd love to hear, outside of 215 00:08:24,564 --> 00:08:26,564 GI, is there any other trend that you're 216 00:08:26,564 --> 00:08:28,470 particularly focused on in health care? 217 00:08:29,029 --> 00:08:31,050 Yes. Absolutely. I think the reimbursement 218 00:08:31,350 --> 00:08:33,370 is it's kind of always at the forefront 219 00:08:33,429 --> 00:08:35,110 of health care around this time of year. 220 00:08:35,110 --> 00:08:37,529 But in terms of growth and development, 221 00:08:37,909 --> 00:08:40,149 the financial piece of that is really important. 222 00:08:40,149 --> 00:08:42,889 So reimbursement is not only from the physician 223 00:08:42,950 --> 00:08:45,004 perspective, but from the institutional 224 00:08:45,305 --> 00:08:46,684 and ASC perspective, 225 00:08:46,985 --> 00:08:48,825 are going to be really important to to 226 00:08:48,825 --> 00:08:50,504 keep an eye on over the next 12 227 00:08:50,504 --> 00:08:52,585 months. One of the things that really ties 228 00:08:52,585 --> 00:08:55,305 into that is actually interest rates and what 229 00:08:55,305 --> 00:08:57,404 the what the national financial 230 00:08:57,865 --> 00:09:00,360 markets are looking like. And a lot of 231 00:09:00,360 --> 00:09:02,040 times, we think of interest rates and we 232 00:09:02,040 --> 00:09:05,080 think of home buying and consumer price index 233 00:09:05,080 --> 00:09:07,340 and a lot of these economic trends. But 234 00:09:07,480 --> 00:09:09,799 in addition, health care is really no exception. 235 00:09:09,799 --> 00:09:12,679 And the borrowing power of institutions and the 236 00:09:12,679 --> 00:09:15,100 ability for institutions to conduct business 237 00:09:15,485 --> 00:09:17,725 is going to be really important to see 238 00:09:17,725 --> 00:09:19,904 how much that can drive growth and development, 239 00:09:19,964 --> 00:09:22,684 especially a new service line rather than sort 240 00:09:22,684 --> 00:09:26,784 of trying to optimize existing service lines. So 241 00:09:26,845 --> 00:09:28,764 to see to monitor what the Fed does 242 00:09:28,764 --> 00:09:30,784 with interest rate is gonna be really important 243 00:09:30,870 --> 00:09:32,330 over the next 12 months. 244 00:09:33,350 --> 00:09:35,929 You know, one other trend that we're following 245 00:09:36,070 --> 00:09:39,110 is not just in GI, but other specialties 246 00:09:39,110 --> 00:09:41,509 like orthopedics and whatnot, for example, is just 247 00:09:41,509 --> 00:09:44,149 the rise in consolidation and no doubt a 248 00:09:44,149 --> 00:09:45,914 rise in competition as well. 249 00:09:46,475 --> 00:09:47,115 Could you, 250 00:09:47,595 --> 00:09:49,034 give us a little bit of insight into 251 00:09:49,034 --> 00:09:50,875 the market in which you operate? Is what 252 00:09:50,875 --> 00:09:51,695 does consolidation 253 00:09:52,154 --> 00:09:54,235 competition look like in the GI space there 254 00:09:54,235 --> 00:09:54,975 in Oklahoma? 255 00:09:55,995 --> 00:09:59,274 In Oklahoma City, the there is definitely a 256 00:09:59,274 --> 00:10:00,014 a large 257 00:10:00,410 --> 00:10:02,910 presence of both private gastroenterology 258 00:10:03,290 --> 00:10:05,389 groups, like large scale private groups, 259 00:10:05,769 --> 00:10:08,570 and the academic medical center, which is the 260 00:10:08,570 --> 00:10:10,330 side that I'm on. At the end of 261 00:10:10,330 --> 00:10:12,649 the day, Oklahoma City itself is a it's 262 00:10:12,649 --> 00:10:13,470 kind of a 263 00:10:14,014 --> 00:10:16,654 smaller, larger city. So a lot of the 264 00:10:16,654 --> 00:10:17,154 physicians 265 00:10:17,855 --> 00:10:20,595 know each other personally. Many of physicians who 266 00:10:20,735 --> 00:10:22,815 are in private practice are part of large 267 00:10:22,815 --> 00:10:25,394 scale GI groups actually trained at OU. 268 00:10:25,774 --> 00:10:28,815 So it is definitely, in my experience, a 269 00:10:28,815 --> 00:10:29,315 generally 270 00:10:29,669 --> 00:10:31,129 teamwork friendly environment. 271 00:10:31,509 --> 00:10:34,230 We do have patients who get their care 272 00:10:34,230 --> 00:10:37,269 at private GI offices and then come to 273 00:10:37,269 --> 00:10:40,549 OU for their subspecialty care and vice versa. 274 00:10:40,549 --> 00:10:41,929 Sometimes patients identify 275 00:10:42,345 --> 00:10:44,345 1 or 2 providers in the community that 276 00:10:44,345 --> 00:10:46,605 patients may be really comfortable with and then 277 00:10:46,745 --> 00:10:48,904 other things they get at o u. Thankfully, 278 00:10:48,904 --> 00:10:51,245 we're all connected in in our information 279 00:10:51,625 --> 00:10:53,544 our our IT based system, so we are 280 00:10:53,544 --> 00:10:55,564 able to share health information 281 00:10:55,865 --> 00:10:57,404 securely and and openly. 282 00:10:58,110 --> 00:11:00,830 But overall in the general landscape across the 283 00:11:00,830 --> 00:11:02,990 US, I think you're right in saying that 284 00:11:02,990 --> 00:11:05,089 the competition has increased significantly 285 00:11:05,789 --> 00:11:07,809 not only for recruiting gastroenterology 286 00:11:08,269 --> 00:11:08,769 physicians 287 00:11:09,149 --> 00:11:12,285 but also competing for patient business. And this 288 00:11:12,285 --> 00:11:15,165 is where we see large scale consolidation efforts 289 00:11:15,165 --> 00:11:17,345 with health systems even 290 00:11:18,044 --> 00:11:20,524 buying out other health systems or hospitals. Like, 291 00:11:20,524 --> 00:11:22,705 Tenant Health, for example, on the West Coast 292 00:11:22,910 --> 00:11:25,470 has been really active in hospital transactions over 293 00:11:25,470 --> 00:11:27,009 the past few months. 294 00:11:27,389 --> 00:11:30,350 And also there is a big presence of 295 00:11:30,350 --> 00:11:33,309 private equity within the GI space with large 296 00:11:33,309 --> 00:11:35,950 scale GI groups like GI Alliance or One 297 00:11:35,950 --> 00:11:37,090 GI, for example. 298 00:11:37,549 --> 00:11:39,754 There all of a sudden these GI groups 299 00:11:39,754 --> 00:11:42,475 have access to private equity based capital, which 300 00:11:42,475 --> 00:11:44,794 can then drive growth and development. Now I 301 00:11:44,794 --> 00:11:46,315 think the key in all of this is 302 00:11:46,315 --> 00:11:49,034 that patient care always has to come first. 303 00:11:49,034 --> 00:11:50,815 So even though gastroenterology 304 00:11:51,195 --> 00:11:53,774 on a national landscape is very much about 305 00:11:53,899 --> 00:11:56,320 a business issue and business development, 306 00:11:56,700 --> 00:11:58,379 I think it it should also be about 307 00:11:58,379 --> 00:12:00,779 patient care first and foremost. And if we 308 00:12:00,779 --> 00:12:02,620 are to consolidate, then how do we do 309 00:12:02,620 --> 00:12:04,639 that in a manner that provides the best 310 00:12:04,700 --> 00:12:07,340 quality and and safety for our patients in 311 00:12:07,340 --> 00:12:09,600 addition to business growth and development? 312 00:12:10,674 --> 00:12:12,514 Yeah. Yeah. Such an important point when it 313 00:12:12,514 --> 00:12:14,434 comes to just really putting the patient first. 314 00:12:14,434 --> 00:12:15,954 And you'd like to your point as well, 315 00:12:15,954 --> 00:12:19,154 we're seeing consolidation on the independent private side 316 00:12:19,154 --> 00:12:20,914 and then also on the health system side. 317 00:12:20,914 --> 00:12:23,315 Like you alluded, the the Tenet transaction, I 318 00:12:23,315 --> 00:12:25,990 believe your previous health system, Advent, has just 319 00:12:25,990 --> 00:12:28,309 acquired 2 hospitals from Tenet in California not 320 00:12:28,309 --> 00:12:29,209 too long ago. 321 00:12:29,750 --> 00:12:31,269 Certainly interested to keep an eye on over 322 00:12:31,269 --> 00:12:33,589 the next coming quarters that we see, really 323 00:12:33,589 --> 00:12:35,509 just a bill in consolidation, it seems like, 324 00:12:35,509 --> 00:12:37,190 after a bit of a lull during the 325 00:12:37,190 --> 00:12:37,690 pandemic. 326 00:12:38,945 --> 00:12:41,585 Doctor Kosho, it's fascinating to to talk to 327 00:12:41,585 --> 00:12:43,585 you so far. I guess, last question before 328 00:12:43,585 --> 00:12:45,345 I let you go. You've you've kinda shed 329 00:12:45,345 --> 00:12:46,545 light on a lot of things so far 330 00:12:46,545 --> 00:12:48,225 in terms of some of the trends you're 331 00:12:48,225 --> 00:12:50,004 talking about in GI reimbursement, 332 00:12:50,465 --> 00:12:52,165 AI, and colon cancer screening. 333 00:12:52,669 --> 00:12:54,909 Is there one thing that you're particularly excited 334 00:12:54,909 --> 00:12:56,269 about when you think about the future of 335 00:12:56,269 --> 00:12:57,009 health care? 336 00:12:57,870 --> 00:13:00,129 You know, I'm most excited about the people 337 00:13:00,190 --> 00:13:01,809 the people aspect because 338 00:13:02,269 --> 00:13:04,190 as you sort of alluded to with with 339 00:13:04,190 --> 00:13:07,365 the pandemic, there were so many changes and 340 00:13:07,365 --> 00:13:08,985 on a massive scale, 341 00:13:09,605 --> 00:13:11,764 especially in health care, but in other industries 342 00:13:11,764 --> 00:13:14,404 as well. And as far as GI care 343 00:13:14,404 --> 00:13:14,904 goes, 344 00:13:15,365 --> 00:13:17,784 like many other companies in many other industries, 345 00:13:17,924 --> 00:13:18,745 this whole 346 00:13:19,284 --> 00:13:21,524 revolution of virtual care has now 347 00:13:22,480 --> 00:13:24,240 it's come to the forefront and it's now 348 00:13:24,240 --> 00:13:26,559 here to stay. And there are so many 349 00:13:26,559 --> 00:13:27,860 brilliant people who 350 00:13:28,240 --> 00:13:30,399 I never knew of or never got the 351 00:13:30,399 --> 00:13:33,519 chance to work with pre pandemic or even 352 00:13:33,519 --> 00:13:35,539 within the past few years that I'm now 353 00:13:35,784 --> 00:13:38,424 learning about and all these new technologies and 354 00:13:38,424 --> 00:13:41,164 devices and innovative companies that have now developed 355 00:13:41,384 --> 00:13:44,264 in the post pandemic era. I'm really excited 356 00:13:44,264 --> 00:13:46,264 about what kind of leaders we are seeing 357 00:13:46,264 --> 00:13:48,345 emerging on on the health care and the 358 00:13:48,345 --> 00:13:49,164 GI landscape. 359 00:13:49,465 --> 00:13:51,164 I'm fortunate to work with several 360 00:13:51,500 --> 00:13:54,159 really brilliant people at my own institution, but 361 00:13:54,460 --> 00:13:57,259 even when I travel to national conferences and 362 00:13:57,259 --> 00:13:58,799 engage with national societies, 363 00:13:59,339 --> 00:14:01,820 it seems like there are so many really 364 00:14:01,820 --> 00:14:04,159 smart people who are devoted to innovation 365 00:14:04,460 --> 00:14:04,960 and 366 00:14:05,414 --> 00:14:08,695 preserving the the sanctity of doing what's best 367 00:14:08,695 --> 00:14:10,154 for the patient, but also 368 00:14:10,534 --> 00:14:12,375 doing so in a way that is really 369 00:14:12,375 --> 00:14:14,154 at the forefront of new technologies, 370 00:14:14,695 --> 00:14:17,195 new growth opportunities, and business development. 371 00:14:17,610 --> 00:14:19,529 And it really that is really what drives 372 00:14:19,529 --> 00:14:21,289 me every day is to work with such 373 00:14:21,289 --> 00:14:24,009 brilliant people on both a local and national 374 00:14:24,009 --> 00:14:26,649 scale in order to problem solve and usher 375 00:14:26,649 --> 00:14:28,490 in this this brand new era of health 376 00:14:28,490 --> 00:14:29,629 care that we have here. 377 00:14:30,464 --> 00:14:32,865 I think that's a perfect little nugget to 378 00:14:32,865 --> 00:14:35,664 end our podcast today. Doctor Kausch, a real, 379 00:14:35,664 --> 00:14:38,384 real pleasure, to make your debut appearance on 380 00:14:38,384 --> 00:14:39,764 the Becker's ASC podcast. 381 00:14:40,065 --> 00:14:41,824 Look forward to certainly connecting with you again 382 00:14:41,824 --> 00:14:42,644 down the line. 383 00:14:43,216 --> 00:14:44,816 Thank you so much. I really enjoyed it, 384 00:14:44,816 --> 00:14:46,256 and I look forward to talking to you 385 00:14:46,256 --> 00:14:46,756 soon.