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forward slash beckerspodcast.
This is Gracelyn Keller with the Becker's Healthcare
Podcast, and we are recording live at the
thirty first annual business and operations of ASCs.
I'm currently join joined by doctor Nikhil Shetty,
who is the chief operating officer at Midwest
Interventional Spine Specialists. Doctor Shetty, thanks for being
here. To kick us off, can you please
share a little bit more about your work
in the ASC space?
Thank you for having me. Nikhil Shetty, interventional
pain physician, Midwest interventional spine specialist,
chief operating officer there, and I've been with
that practice for the past eight and a
half years in Northwest Indiana.
We're single specialty interventional pain practice. I have
a couple of partners, three nurse practitioners,
and we've really been able to build and
grow that area over the last twenty years.
It's very satisfying treating patients in Northwest Indiana
and also being able to live in Chicago,
And it's good to be back on the
podcast.
Wonderful. Well, thanks for being here. And let's
start with the ASC market, because in The
US, this is projected to reach
$60,800,000,000
by 2030, and it continues to experience strong
year over year growth. So from your perspective,
what are the most significant trends in market
forces driving this expansion, and how should ASC
leaders be preparing today?
Well, I think it's a very good question,
and, that's an astounding figure, 60,800,000,000.0
by the year 2030.
I would say the ASC space continues to
grow because it solves a very real problem.
Hospitals are overburdened.
Patients are demanding transparency and efficiency.
The biggest trend I see is the migration
of higher acuity cases into the ASCs
supported by improvements in anesthesia, imaging, and technology.
That's a personal,
interest of mine being an interventional pain. We've
been able to see how we're able to
take certain cases, quicker turnover, faster turnaround,
minimally invasive
procedures that we're able to do in a
safer controlled environment where we lower our infection
risk, we improve our quality of outcomes,
we restore function in a faster way.
And, we're also seeing,
this reflect in the landscape. The ASCs are
growing. Hospitals have caught on to that. Major
health players have caught on to that and
are partnering with,
other physicians in the area looking to build
their own ASC.
I would say that we're also seeing increasing
payer consolidation and contract pressures.
That's where independent
ASCs like ours feel the squeeze.
We're not just competing on outcomes anymore. We're
navigating policy structures that were never designed with
small physician owners in mind.
It puts us
sometimes at a disadvantage when we're playing the
same game with the major hospital institutions
that are spending, like you said, that 60,800,000,000.0
by 2030.
Though I think it's great for the country,
ASCs
are able to,
service patients in a faster, safer, more efficient,
and streamlined
process.
And with advance of technology,
leveraging that technology into the ASC, we're able
to do more sophisticated procedures that weren't otherwise
or previously
able to be done in a quick outpatient
surgery center.
And from AI and robotic surgeries to advanced
EHR systems, technology remains both a make or
break factor and a critical driver of ASC
operations at scale. So how do you see
deeper tech integration shaping the ways that ASCs
deliver care and manage their business over the
next few years?
Well, I'd say technology is a massive enabler
for physician independent physician centers.
We're using AI driven tools in everything from
patient education to workflow optimization.
I'll just give you a quick example. I'm
a big fan of the,
application called Sora, where we're able to use
video
AI generation. And so I've been able to
do that in my practice using my likeness
to explain
interventional pain procedures to the patients in a
quick,
shareable video form contact content that the patient
can review before their procedure. So we hand
that to them in a in a tablet
while they're in the waiting room, and the
patient's able to review
my instructions on the procedures that they're about
to get
before they we bring them back into the
pre op area. These are the same conversations
I have with the patient
in the clinic when I'm evaluating them. However,
it's always good to have that refresher.
AI has made that process so much easier,
and applications video applications like Sora, for example,
make that so much more streamlined.
They're able from the patient perspective, it makes
them feel comfortable because they're seeing the physician
that's about to perform the procedure
go through once again explaining to the patient
what exactly is gonna be done, answering some
of those last minute questions that sometimes can
cause log jams or slow up the throughput
of the ASC. I think that's a very
good tech that we're now starting to leverage
in our ASC.
And
with 60% of health systems considering ASC joint
ventures,
many ASCs are already partnering with systems in
their communities.
So what opportunities do you see for collaboration,
whether with other providers or vendors, to strengthen
patient care and operational efficiency?
Yeah. I think collaboration can be powerful,
but it has to be equitable.
Independent ambulatory surgery centers bring agility, flexibility,
local insight, and hospitals bring scale and infrastructure.
The challenging is ensuring these partnerships don't erode
physician autonomy or innovation.
I've seen great models where hospitals
offload their lower acuity cases to the ASCs,
improving throughput on both sides, but that only
works of reimbursement and governance are structured fairly.
I'll say this,
using the example of the pandemic.
During the pandemic, about five and a half
years ago now, when everything was shut down,
hospital outpatient departments were completely shut down, everybody
was under these government mandated
shutdowns, including our own practice, and we were
abiding by the CDC guidelines.
With time, we were able to open up,
and those lower acuity cases that were getting
pushed back by the big hospitals
big hospital or health care systems, we were
now able to open up our doors for
them. We take that same
mindset into 2025 now where we're able to
transition these higher acuity cases into the surgery
center. And when the patient checks in with
us, it's a quick and easy process. I
explained to you already how the pre op
area works. The patient's reviewing a tablet that
has, once again, my instructions on the procedures
that the patient's about to get. They get
brought back to the preop area. And by
the time they're in the PACU,
everybody knows their name. We're familiar. We're able
to control that environment and streamline that process,
making it so much more comfortable for the
patient. My number one comment that I hear
is patients
that previously were done at bigger health systems
transition to the ASCs as well. You guys
really know my name. You remember I like
one cream, one sugar in my coffee. And
when I came back for my second procedure,
it was ready waiting for me after my
procedure.
This level of touch points, this level of
patient interaction and patient,
care is something that's unique in a in
a system
like our surgery center where we're able to
streamline that flow.
We're able to work in a lean fashion,
and we're able to be flexible to accommodate
the needs of the patient. Whereas
if you wanna add on a case at
the hospital, it'll take you a week or
two before they give you OR time. Whereas
with us, we'll open up. I'll open up
early. Like I did, for example, this morning
before coming to the conference. We opened up
our surgery center early this morning to accommodate
some patients to come in sooner. That level
of flexibility is just something that's not achievable.
Too many moving parts in a major health
system.
And so this flexibility,
this lean operating structure makes it very convenient
for the patients to come in and get
their procedures done. That's the number one comment
I hear from patients who have had the
same procedure done at two different institutions, one
of them being our ASC. That's our number
one comment. And then if we're gonna go
deeper into this, one of the my biggest
passions is price transparency.
Make prices of procedures transparent across our surgery
center,
landscape as well as the overall major health
system landscape. As patients start to see exactly
what they're getting charged in major health care
systems
compared to what there are ASCs
overall cost is, When we make those prices
transparent,
ASCs will win. And I think the country
is seeing that, and that's where that 60,000,000,000
figure is going by the year 2030.
It saves,
health care dollars across the country.
Price transparency make sort of levels the playing
field, and so that insurers can see that
ASCs, these independently physician owned ASCs, are faster,
more efficient,
safer, number one, and our outcomes prove that
more volume will be driven to the ASC,
and I think which overall lowers cost
and
streamlines
that health that health care efficiency throughput,
especially for these lower acuity, minimally invasive procedures
that don't need hospital OR time and can
be done in the surgery center.
Well, doctor Shetty, thanks so much for joining
me today on the podcast. Is there anything
we didn't touch on or any final thoughts
you'd like to share before we wrap up?
Thank you very much for having me. I
I think Becker's is a very important conference
for
independent practices,
ASC leaders to come together,
talk policy,
learn more about the environment that we're in,
and learn how we can make our system
better.
We're always focused on focusing on how can
I be, number one, a better physician, better
for my patients,
but also better for my employees,
my staff that I work with? What are
some of the trends out there
in in a different ASC
market that they are employing that I can
now employ in our practice? I do appreciate
Becker's for being a good host for that.
I do appreciate the,
the panels that we have and I've been
a part of as well as this podcast.
So thank you for having me.
Wonderful. Well, thanks for being here. And again,
we are recording live at the thirty first
annual business and operations of ASCs.