Latest / Becker’s Healthcare Podcast / Dr. Nikhil Shetty, Chief Operating Officer, Midwest Interventional Spine Specialists

Transcript

Dr. Nikhil Shetty, Chief Operating Officer, Midwest Interventional Spine Specialists · Becker’s Healthcare Podcast

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