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forward slash beckers podcast.

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This is Gracelyn Keller with the Becker's Healthcare

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podcast, and we are live at the business

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and operations of ASCs.

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I'm currently joined by doctor Michael Stuntz, who

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is the chief medical officer and chairman of

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the board at Monterey Peninsula Surgery Center. Thanks

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so much for joining me today. I would

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love to have you introduce yourself and tell

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us a little bit more about your background

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and role in the industry.

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Hi. Thanks for having me. I always like

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to start out by saying my biggest credential

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for what I do is having been a

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patient at an early age.

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Around the age of 16, I was in

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a major car accident and spent a week

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in the hospital.

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And I think that to this day

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helps me in everything I've done. I'm trained

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as a oncologic surgeon. I did a general

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surgery residency and a surgical oncology fellowship, and

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I followed that with private practice for twenty

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five years in the Monterey area. While I

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was in private practice, I became involved in

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the surgery center and immediately

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saw how important that model is for surgery

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and how it has developed my career and

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been good for my patients.

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And then from there, I,

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got on the leadership

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of the surgery center on the board of

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directors

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and eventually became the chairman of that board.

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And now currently,

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I'm also the chief medical officer,

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in the facility.

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We we have,

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four different facilities

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over the Monterey Peninsula area and are doing

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most, if not

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90% of the outpatient surgery in our area.

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I also

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am on the California Ambulatory Surgery assent association

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board, as well. So I said, and I

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get to see what happens at a statewide

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level as well here. Wonderful. Well, thank you

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for being here to share your insights.

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And let's start our conversation here today with

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ASC volume.

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This is expected to increase by 16%

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across the country by the year 2032.

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So with this growth, what is the most

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pressing challenge to maintaining a positive patient experience?

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Well, I think the biggest challenge to ASC

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administrators

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is going to be maintaining

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what we have with,

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the challenge of having decreased

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or or flat reimbursement

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and dramatically climbing expenses

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and also

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anesthesia coverage. Just even covering

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at any level anesthesia can be challenging.

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And so you have to do all of

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those things together. If you can maintain all

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of that, hopefully, then you can maintain the

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patient experience. But

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there's all sorts of nonmonetary

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ways you can improve patient experience. And I

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also think you should be very patient focused

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on what goes on to the patient at

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their level,

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having patient surveys to see how their quality

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of their experiences

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and addressing any problems that comes up come

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up appropriately and quickly.

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And kind of going along with that, what

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strategies have worked for your organization as you

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tackle some of these challenges, and what is

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the recommendation you have for health care leaders

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to stay ahead?

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Well, we do a a patient,

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satisfaction survey, and we have a team of

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people that get together and go over the

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results. And so we do that. And I

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see so I think at that level, it's

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important. We also have our front facing

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people go through training to,

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interact with patients well.

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We've over the years made a lot of

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different,

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adjustments to how we present our financial information

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to the patients and how we collect and

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and the opportunities they have to pay their

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bills, things like that.

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I think, like, looking at your operations and

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its efficiency has become important.

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I think when we first started our surgery

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center, we had

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a relatively close market and and,

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we had

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we didn't have to be as efficient as

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we have to be in today's,

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environment.

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And

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I think you can look at all different

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aspects of where the inefficiencies

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are.

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The biggest one I see is scheduling your

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blocks,

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of time in your day. And it used

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to be we'd have seven patient seven rooms

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start at 07:30, and almost everybody was done

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by noon. And and the staff just hung

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out until three, and then that was the

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day, and you could afford that,

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in prior environments. Now it's not like that.

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You can't have everybody start at 07:30 and

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end at noon. They have to go the

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full day

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to pay for anesthesia,

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to pay for

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our staffing.

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And, so look at your blocks very carefully,

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see where patients who or doctors who are

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doing

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half volume, maybe give them every other week.

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Like, you could on Wednesday, you know,

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every Monday or every, first and third,

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of the first and third week of the

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month instead of every Monday of the month.

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So you could do things like that. You

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also have,

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some efficiencies you can garner in

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using not not using anesthesia, but having open

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local

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anesthesia. Or one thing we did was, we

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had our ophthalmologist,

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deliver their own

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sedation and anesthesia. And I think that has

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freed up

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a freed up a, anesthesiologist

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to cover our volume elsewhere.

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And shifting a little bit to the financial

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side,

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how can leaders ensure their staff are well

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equipped to help patients navigate financial aspects of

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care, and how does this benefit patient provider

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relationships?

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Well, I'll I'll tackle the second half of

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that first. The If if your patients are

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happy financially, they're happy patients.

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I can remember

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back when there was a much higher percentage

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of patients who are uninsured or who had

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issues with, the payment problems.

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It was very uncomfortable when a patient comes

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to you as a as a surgeon with

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a financial problem because you're not trained really

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in finance at all. And to help them,

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you're just trained to do their surgery, recognize

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their problem, and how to fix it.

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Whereas nowadays,

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I think,

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luckily, I think more people are insured, but

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there's the other issue is they have to

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pay their coinsurance. They have to pay their,

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deductibles. And so

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you they need to know in advance

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what they're gonna pay when they show up.

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So I think clearly communicating

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to the patient what they need in a

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timely manner, not,

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okay. You've showed up for your surgery. You

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need $5,000. Hand me your credit card. That's

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not gonna work, and that's gonna cancel a

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case, and that's gonna be inefficient for all

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of your other resources like we were discussing

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earlier.

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And as we wrap our conversation up, are

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there any parting words you'd like to share

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on the podcast today?

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I think the biggest one is that we

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are in a challenging environment, but I would

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like I look at it as an opportunity.

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We are seeing a dramatic shift in how

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things are done. We're seeing a massive migration

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into

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outpatient surgery

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environment, which I think is an appropriate shift

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in most cases with, the care going to

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where it should be. And,

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like, for me, I had to do my

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first cases at the surgery center because I

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didn't have any opportunity, but that made me

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shift to

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having those patients out of the hospital or

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and, well, in this case, the ASC

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fast. And so I had to do more

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local anesthesia blocks. I had to use less

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narcotics. I had to use less overall anesthesia.

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I had to have more efficient techniques.

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And so,

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that really forced me into this pattern of

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care, which I think is so much better

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where my patients recover so much faster. I

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don't use narcotics in most of what I

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do now. I use over the counter kind

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of medications like Advil and Tylenol.

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One out of ten of my I do

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mostly breast surgical oncology, and only one out

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of ten of my partial mastectomies gets a

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prescription. All the rest do fine without it.

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And so,

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I think, you know, view it as an

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opportunity because you might learn something.

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And in the process, you'll make the whole

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a whole,

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the whole enterprise

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more efficient.

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Absolutely. Well, thank you for taking the time

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to join me today on the Becker's Healthcare

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podcast. Again, we are live at the business

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and operations of ASCs. Thanks so much.