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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 Nikhil Shetty, who is

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the chief operating officer at Midwest Interventional Spine

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Specialists. So thanks so much for being here.

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Let's start off by having you introduce yourself

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a little bit further and tell us more

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about your role and organization.

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Well, thank you very much for having me.

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My name's Nikhil Shetty. I'm an interventional pain

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physician,

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and, I've been working at Midwest Interventional Spine

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Specialists in Northwest Indiana for the past eight

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years. It's my first job out of fellowship.

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I love the area. I love the region,

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and I love doing interventional pain. I have

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very good partners and very good colleagues in

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the area.

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And, we've been able to build a practice

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in a surgery center, just been growing over

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the past,

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several years, eight of which I've been a

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part of.

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And, it's a very fulfilling role,

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you know, treating patients in the Northwest Indiana

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area and the full region corridor

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from a full spectrum of interventional pain medicine.

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Well, thank you for joining me. And let's

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start with what trends and shifts you're seeing

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right now in the industry

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that you think are the most important for

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leaders to pay attention to.

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Well, I think, this conference being one, Becker's

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ASC,

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kinda highlights the importance

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and the trends of everything shifting to the

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outpatient setting in the ambulatory surgery center. The

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ambulatory surgery center model,

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allows for faster, more efficient,

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safer,

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delivery of health care. And some of the

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higher acuity procedures that previously were done only

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in the hospital to HOPD settings are now

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being transitioned to an ambulatory surgery center where

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we have more control

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of the throughput. And so our clinical staff,

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who we are very familiar

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working with, they understand how our ORs operate.

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They understand patient turnover. They understand OR turnover.

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And,

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it has allowed us to

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offer these therapies that weren't previously

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available to patients unless they went to a

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hospital, sometimes had to stay overnight in the

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hospital. A lot of times,

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these same procedures, namely interventional pain procedures and

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specifically neuromodulation

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or spinal cord stimulation can be delivered in

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the outpatient setting or in the ASC

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more efficiently.

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Absolutely.

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And staffing and workforce challenges also continue to

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be a concern across health care. So how

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is your organization

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navigating these pressures and which strategies have seemed

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to work well?

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Yeah. So staffing and workforce

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challenges are a concern across health care. And

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I think I share that with a lot

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of my colleagues here at Becker speaking specifically

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of anesthesia services.

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Anesthesia as a service line has been very

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difficult to obtain

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in the ambulatory surgery center setting as well

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as in the hospital.

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It's harder and harder to get anesthesiologists

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to cover or c r n a's to

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cover your cases.

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So we have turned in we have turned

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to

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temp agencies, other independent contractors to provide those

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anesthesia services. A lot of my anesthesia colleagues

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have given up a portion of their pain

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practice and are now doing anesthesia because of

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the high demand. And And so we've kind

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of been able to shift and provide those

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anesthesia services by reaching out to those

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resources.

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I mean, additional staffing and workforce challenges are

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always a challenge in the small business setting.

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There's obviously a lot of office turnover

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and,

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hiring.

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Our workforce

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is becoming more and more difficult and challenging.

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So we take it upon ourselves to educate

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from a top down perspective.

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All of our clinical staff, our APPs, our

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advanced practice providers,

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our medical assistants, our nursing staff, our front

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office staff that you know, us being a

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small practice, we're able to kind of control

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that environment a little bit more. And it

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is more of a family. You know? My

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practice is a little bit more of a

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family feel to it. And so when we

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foster that

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relationship and sort of nurture them, because a

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lot of times they're young, and we educate

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them as they grow into careers and they

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advance into other careers other aspects of their

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careers, we try and do everything that we

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can to retain that part of the work

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for

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workforce. And as these transitions happen as they

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naturally do, we establish a good training protocol

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so that as a person moves on to

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bigger and better things and we wish them

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well, part of their exit strategy is to

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help train the new person who's gonna assume

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that responsibility.

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Absolutely.

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And you touched on it a little bit.

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But as outpatient care continues to grow, how

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do you see the role of orthopedic spine

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and ASCs evolving within the broader health care

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ecosystem?

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Well, I think orthopedic spine and ASCs are

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going to become a bigger and bigger piece

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of the overall health care pie and taking

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up a bigger space within the health care

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ecosystem. I think it's because of our efficiencies.

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The fact that we are able to kinda

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limit waste, limit overhead,

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limit,

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unnecessary

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wastage that happens when you go to a

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hospital to do certain kinds of procedures. We're

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able to streamline those processes

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and sort of, you know, almost micromanage every

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level into an area where everybody has their

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own responsibilities. So we work as a well

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oiled machine. It's sort of like an f

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one team when the car stops in the

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pit stop. They change all their tires in

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seconds. And so everybody has a role. Everybody

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has a responsibility.

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We are all dedicated to our roles and

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our responsibility in service of the better outcome

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for the patient. And I think because that

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mindset starting from a small business mentality and

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then growing to a larger and larger ASC,

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that model is now being looked at by

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bigger health health systems who are now, in

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turn, acquiring ASCs for their efficiencies.

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And so I think

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as to answer your question, I think it's

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only begun going to become a bigger and

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bigger role and a bigger part of the

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ecosystem.

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And as we wrap up our conversation, many

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organizations are exploring new technologies, partnerships, or care

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models to improve

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efficiency and outcomes. So are there any innovations

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or initiatives that you found particularly promising?

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Yes. I think, through this conference,

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the utilization

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of artificial intelligence,

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particularly in the scrubbing down of our notes,

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making sure that our codes are appropriate,

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making sure that everything is submitted on time,

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this whole revenue cycle management or RCM process.

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There are many different aspects to what happens

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throughout the throughput of a patient's

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life cycle, so to speak, in as far

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as revenue cycle management is concerned. And the

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more of these processes that we are able

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to automate and

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capitalize on, I think that makes our practice

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run more efficiency. First,

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you know, it's been said before, but if

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you can't measure it, you can't really change

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it. And so it starts with data collection.

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And we're starting to be

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more aware of how much time

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of a person in our clinical staff is

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spending on a certain task. We quantify that,

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and we graph it out. And we are

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able to see how where the inefficiencies

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are lying.

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And if we can marry that with an

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adoption of artificial intelligence,

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we're able to possibly streamline those processes,

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making

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our already burdened

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workforce

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lives a little bit easier. And I think

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there will be and there are already

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companies that are employing and utilizing

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AI to streamline this workflow

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so that the patient's

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experience from start to finish,

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is a little bit more streamlined. And if

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we're able to capitalize on those processes

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and applications out there, that's something that I'm

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personally interested in, and that's one of the

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reasons I'm at this conference as well.

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Absolutely. Well, thank you so much for being

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here to share these insights today. Is there

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anything else you'd like to share that we

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didn't touch on?

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No. I think we touched on everything. I

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do think that,

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you know, two things are growing. One is

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that,

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outpatient ambulatory surgery centers, orthopedics, and spine, and

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particularly interventional pain management that practice because of

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the ASC ASC model is growing. And if

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even if we were to set that aside,

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the practice of interventional pain medicine is also

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growing in and of itself and in its

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own scope. And so as we adopt these

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newer and newer technologies,

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offer these newer therapies for newer indications capturing

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a bigger population of the patients,

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especially with chronic pain, we are able to

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see that, you know, we're both both fields

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are able to grow together and harmoniously.

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Wonderful. Well, thanks so much for being here.

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Again, we are recording live at the twenty

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second annual Spine Orthopedic and Pain Management Conference.

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Thank you. Lovely to be here.