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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 recording live at the

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twenty second annual Spine Orthopedic and Pain Management

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Conference.

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I'm currently joined by Michael Boutros who serves

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as the clinical operations chief and medical director

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for pain services at the Keck School of

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Medicine of USC. So, Michael, thanks for joining

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me today. Would love to have you start

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off by introducing yourself and telling us a

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little bit more about what you do.

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Thanks so much, for having me on, Grace.

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So I'm the clinical operations

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and,

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medical director for pain services at the Keck

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School of Medicine of USC,

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as well as the pain fellowship director and

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the chair of the opioid stewardship committee.

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And so, you know, wearing a lot of

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hats, I'm involved with a lot of the

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outpatient,

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pain procedures

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as well as the care paths and protocols

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that involve patients and pain, whether it's postoperative

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or whether it's, chronic pain.

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Well, thank you for taking the the time

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to join me today. And let's start our

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conversation

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with what trends or shifts you're currently seeing

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right now in the industry that you think

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are most important for industry leaders to pay

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attention to.

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There's been an overall trend towards non opioid

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pain management strategies, and that includes

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medications as well as interventional approaches.

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When it comes to medications, there are newer

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medications that are coming out. For example, Suzetrajene

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was recently approved by the FDA as a

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non opioid based approach

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to taking care of acute pain

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episodes.

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It uses a novel

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mechanism, sodium subtype one point eight channel blockade.

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This is in a class in of itself

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and has opened a new

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genre and category of medications that can benefit

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patients

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postoperatively,

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for example, or after acute pain episodes

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where they're able to,

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help manage their pain without some of the

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typical

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side effects that we see with opioids like

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nausea and vomiting,

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typical questions about the risks of opioid addiction,

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constipation,

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all of these things. And and it's important

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because

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all of these things also

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cost both money and time from the perspective

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of efficiency planning, especially when it comes to

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an ASC

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trying to move things forward, next cases and

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whatnot.

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So having protocols and care pads in place

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that involve these types of medications upfront to

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move things forward is wonderful.

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And then from an interventional perspective, we have

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newer types of procedures

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that are more on the curative side of

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things rather than patchwork.

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So there's a trend away from things like

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epidural steroid injections, which we know don't last

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very long. They don't necessarily fix many things.

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They just sort of

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provide relief that we know can be mostly

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temporary,

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and that has been shifting away and moving

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towards

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more

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curative procedures like minimally invasive lumbar decompression, the

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mild procedure, or basivertebral

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nerve ablation,

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which provide longer lasting relief and more definitive

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approaches to taking care of what the actual

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problem is with the patient.

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And staffing and workforce challenges also continue to

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be a concern across health care. So what

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is your organization doing to navigate these pressures,

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and what strategies have you seen work well?

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So, so there are a number of different

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approaches

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that organizations can take when it comes to

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trying to retain and to attract

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staffing and and workforce,

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especially in today's day and age. So a

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number of different things that we've been, doing

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is

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providing,

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obviously, competitive pay and and flexibility focused benefits.

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But in addition to that, we're, as an

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academic institution,

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able to provide

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professional development opportunities

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for them as well as,

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technology

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that can help ease the administrative burdens.

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So we partner with different third party vendors

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and different companies

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to help from the preauthorization

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perspective for a lot of these procedures.

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So that offloads a lot of that kind

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of work from our specific group.

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And then in addition to that,

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USC

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provides

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the workforce

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a an opportunity

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to

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move forward with

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more educational

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opportunities.

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For example, like earn and learn programs.

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And that way,

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that allows them to

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want to retain them, you know, or want

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to stay on that on that workforce,

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because they know that they're gonna be able

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to to move up,

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that that that ladder.

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And as outpatient care continues to grow, how

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do you see the role of orthopedics,

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spine, ASCs, all those things evolving with the

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broader healthcare ecosystem?

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It's gonna be a deeper integration

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into that system because more and more

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procedures are

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coming out that

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do a pretty good job when it comes

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to reimbursement.

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But the key here is that as these

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are newer procedures, there's,

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more time required to get these things pre

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authorized. So there's a patience that needs to

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be put in play and and setting expectations

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for example with patients and and when they're

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gonna be able to get these things done.

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But,

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as more and more of these procedures are

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being developed

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more pain physicians, for example, are going to

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be incorporating this into their practice. And so

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now the real question is, how do we

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allocate resources more efficiently and effectively to allow

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for that limited resource of, for example, OR

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time

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to allow

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all these newer procedures

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to compete with preexisting

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procedures

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like neuromodulation,

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for example, or radio frequency ablation. And so

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how do we allocate these procedures to the

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appropriate domains?

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What needs to be done in an operating

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room? What can be moved to an outpatient,

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you know, procedure clinic, for example?

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I think that that obviously is going to

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be dependent on where you practice and the

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resources that you have, But I think it's

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a question that now needs to be asked,

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much more astutely

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to allow for these newer procedures to effectively,

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be implemented in the area that you work.

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And then finally, many organizations are exploring new

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technologies, partnerships, or care models to improve efficiency

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and outcomes. So are there any innovations or

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initiatives you found particularly promising?

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So there are a number of different things

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that we're doing essentially in terms of protocolizing,

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efficiency.

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So trying to incorporate

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specific medications,

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that are non opioid

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and getting them in the hands of patients

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before their procedure to make sure that they

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have it ready for them when they get

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discharged,

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is is essentially one component of this.

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And then on top of this, ensuring that

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we are staying up to date with the

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newest evidence based approaches that are available out

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on the market.

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And so we wanna make sure that we're

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providing

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patients

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with the things that can empower them to

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achieve the type of pain relief that they're

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looking for without necessarily,

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you know, staying in the in the in

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the dark ages

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with some of these older procedures that, you

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know, if you wanna call them bread and

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butter,

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remain sort of the the the

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the stable crop of procedures that have been

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historically used. We you have to be able

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to innovate. You have to be able to

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stay with the latest,

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innovative approaches

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to keep relevant

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with the industry

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and to allow more patients

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to want to be able to come in

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and and look at your organization

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as, you know, a beacon for,

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innovation and and options for them.

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Well, Michael, thanks so much for joining me

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today on the Becker's Healthcare Podcast. Again, we

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are recording live at the twenty second annual

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Spine Orthopedic and Pain Management Conference. Thanks so

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much for having me, Grace.