Latest / Becker’s Healthcare Podcast / Advancing Outpatient Joint Replacement and ASC Leadership with Dr. Martin Jenter

Transcript

Advancing Outpatient Joint Replacement and ASC Leadership with Dr. Martin Jenter · Becker’s Healthcare Podcast

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  - Just five years ago, a big portion of
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  - what's now being done in ambulatory surgery centers
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  - wasn't considered outpatient work. The cases have changed,
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  - the tech has changed, the patient expectations have
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  - changed, and the leaders who are thriving are
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  - the ones who saw it coming.
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  - Becker's twenty third annual Spine Orthopedic and Pain
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  - Management Driven ASC Conference
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  - exists for exactly that kind of forward looking
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  - practitioner.
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  - Here, Becker's hosts more than 1,000 attendees, 275
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  - physician and ASC speakers, and three days of
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  - sessions that move between the clinical, the operational,
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  - and the strategic, and the CME credits to
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  - show for it.
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  - It. Join us June eleventh through the thirteenth
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  - at the Swiss Hotel in Chicago, and come
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  - ready to think about what's next. Register on
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  - our events page at beckershospitalreview.com
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  - by clicking on the events tab in the
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  - upper right.
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  - This is Gracelyn Goller with the Becker's Healthcare
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  - podcast, and we are recording live at the
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  - twenty third annual Spine Orthopedic and Pain Management
• 1:00
  - Driven ASC Conference.
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  - I'm currently joined by doctor Martin Genter, who
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  - is an orthopedic surgeon with Inner Growth Orthopedic
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  - Specialists and Henry Ford Health System, and also
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  - the medical director at Michigan Outpatient Surgical Center
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  - ASC.
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  - So, doctor Gentry, thanks for joining me today.
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  - I'd love to have you start off by
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  - briefly introducing yourself and telling us more about
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  - your roles and the scope of your organizations
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  - and what's currently commanding most of your attention
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  - as a leader.
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  - Good morning, Grace.
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  - As you mentioned, my name is doctor Jenter.
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  - I am currently in private practice in Novi,
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  - Michigan.
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  - It's a suburb of Detroit. I have been
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  - there since 2003
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  - and
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  - and a variation of private practice, which I'm
• 1:43
  - in now, which I started out in,
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  - we became
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  - a PSA with the, at the time, Ascension,
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  - health system,
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  - which has since been acquired by Henry Ford
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  - Medical Center, which is a a regional,
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  - large facility
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  - with multiple hospitals associated in Southeast Michigan.
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  - Since that time, I broke off back into
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  - private practice
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  - and
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  - currently,
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  - am solo,
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  - but also
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  - co sharing my office with my former group
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  - called Beacon Orthopedics,
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  - which consists of
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  - five other surgeons who are employed by the
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  - Henry Ford system.
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  - That is my my current practice setting. I
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  - do total joints. I do elective
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  - total knees and total hips primarily.
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  - That's the focus of my procedures,
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  - and I've
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  - brought a lot of attention towards the outpatient
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  - surgical market
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  - since 2016.
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  - It was driven by no insurances in the
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  - Michigan
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  - market would allow outpatient total joints until 2016
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  - when Blue Cross allowed,
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  - first total knees.
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  - So I started at a surgical center I'd
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  - been doing arthroscopies
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  - at.
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  - That had it was called the Bone and
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  - Joint Center in Novi, Michigan,
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  - on the facility of our hospital.
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  - We did,
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  - our first outpatient joints in 2016.
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  - And then in 2018,
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  - I created
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  - a new surgical center in the same town,
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  - Novi, called Michigan Outpatient Surgical Solutions
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  - so that I could do total hip and
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  - total knees.
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  - Just different market factors led me to
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  - create that,
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  - surgical center. And then later,
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  - sometime around COVID,
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  - Medicare approved
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  - outpatient total knees and, eventually, outpatient total hips.
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  - So that has been the progress of the
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  - direction of my orthopedic practice and pretty much
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  - Michigan as well as United States driving this
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  - outpatient
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  - market business of total joints.
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  - So in a year marked by rapid change,
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  - what recent decision or pivot required the most
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  - leadership conviction from you, particularly when it came
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  - to aligning people, resources, or capabilities?
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  - So
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  - our our changes
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  - are
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  - some of which are insurance based, some of
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  - which are facility based.
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  - In my region,
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  - the Henry Ford Health System
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  - did take over our
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  - previous system, Ascension Health,
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  - which has
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  - changed a lot of things we do.
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  - We're changing to Epic from our previous system,
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  - which
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  - I have observed in the short time that's
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  - occurred.
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  - It's
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  - not
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  - focusing
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  - on
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  - patient satisfaction
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  - and patient care as much as we had
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  - been, so
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  - it appears we have to sacrifice a little
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  - bit of what
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  - we think and care about our patient management,
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  - satisfaction outcome while we're worrying about
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  - doing
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  - charting,
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  - writing orders, and how to document everything on
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  - Epic.
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  - To me, it's leading to a lot of
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  - physician
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  - dissatisfaction,
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  - physicians considering
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  - either leaving practice
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  - or just leaving that environment. In my world,
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  - I have a private surgical center,
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  - which does not use
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  - electronic records.
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  - We still have
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  - paper charts.
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  - Very simple.
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  - There's no
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  - preordering things you have to do the night
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  - before. You don't have to put in your
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  - IV orders. You You don't have to do
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  - anything that takes away from patient care. You
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  - show up. You see the patient.
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  - You do the surgery. They go home quickly.
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  - There's no delays and no compromise in patient
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  - care because you're trying to comply with a
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  - electronic health record that a hospital system is
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  - mandating you to do. Yesterday, I was doing
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  - surgery,
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  - and
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  - surgery was delayed because
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  - me, the surgeon, hadn't put in the correct
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  - dose
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  - of my local injection I wanted to use
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  - in surgery.
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  - And the nurse
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  - stated she was unable to enter any orders,
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  - so I had to work with a resident
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  - to figure out exactly how to enter this
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  - order in the computer just to be able
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  - to take my patient back. So hospital based
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  - medicine, I think,
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  - is
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  - disadvantage
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  - to both the surgeon and the patient,
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  - and I think this is going to drive
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  - continued
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  - patient flow and care amongst the surgeons
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  - to the surgical center,
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  - locations.
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  - And so with that,
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  - challenge that you were just describing with electronic
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  - health records
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  - and the switchover that you are currently in
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  - the midst of. How does that change your
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  - approach to decision making
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  - or organizational
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  - readiness
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  - as you work through that problem?
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  - So
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  - all of us that have gotten comfortable with
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  - outpatient total joints and in my region in
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  - Michigan,
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  - for example, 2016
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  - forward,
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  - we've
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  - grown accustomed to the idea of looking at
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  - every patient as a potential outpatient surgery patient.
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  - And then
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  - the further
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  - triage is, can they be done safely
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  - in a outpatient facility that has no overnight
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  - capacity,
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  - or do they need to be considered outpatient
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  - at the hospital with the chance they could
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  - spend the night? So I think myself,
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  - partners, and other surgeons in my region, at
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  - least,
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  - are looking a lot more critically as to
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  - who can I possibly take to my freestanding
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  - surgical center, go home same day, versus who
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  - really has to go to the hospital
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  - for many reasons? But mainly, it's for patient
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  - safety
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  - is the main reason we worry about whether
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  - they should be done in a hospital
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  - or in an outpatient center.
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  - And I think
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  - factors like
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  - complicating the whole pre op, intra op, post
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  - op mix with order entries and
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  - information gathering from the the hospital system
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  - is driving all of us to look closely
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  - as to
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  - why do they have to be done at
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  - the hospital.
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  - And shifting gears slightly, when you think about
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  - the forces reshaping health care right now, where
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  - do you believe leaders like yourself need to
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  - be more decisive, especially as you're balancing speed,
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  - risk, and having the right teams in place?
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  - So
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  - for better or worse, the individual physician has
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  - very little
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  - control,
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  - say,
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  - or ability to change things in the medical
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  - facility that they do not own.
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  - So namely,
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  - I am at Henry Ford Health System.
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  - It is a big conglomeration.
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  - Since they took over our Ascension Health System,
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  - we have lost a lot of our ability
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  - to,
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  - do it our way. We used to have
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  - a complete joint program run between our two
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  - hospitals
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  - that was
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  - seamless,
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  - errorless
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  - with great outcomes.
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  - Now that we have been attached to a
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  - larger
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  - regional health system,
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  - we don't have the ability to implement,
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  - control,
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  - or almost
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  - say anything about how that works.
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  - So losing that control in the hospital
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  - makes it very hard to continue with that.
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  - I was the department chairman of orthopedics for
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  - two years,
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  - over a year ago with the Ascension system.
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  - I had a lot of ability
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  - to affect change,
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  - lower costs,
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  - implement new programs.
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  - That does not exist with this new
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  - hospital merger system.
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  - So
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  - I'm driven to make my surgical center
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  - more successful,
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  - more popular,
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  - and a better place for people to go
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  - for their care. As the medical director since
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  - we opened in 2018,
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  - I've managed to sit in front of that,
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  - look at every cost, look at every potential
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  - complication,
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  - everything
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  - positive and negative to try to affect change,
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  - for the betterment of the patient.
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  - And as uncertainty has become the norm in
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  - this space, what leadership habits or mindset have
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  - been the most critical in keeping your organization
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  - and your people moving forward?
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  - I think
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  - looking at my two systems, looking at the
• 10:19
  - hospital system,
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  - I think it's been
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  - sad to see
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  - leadership changes constantly,
• 10:26
  - CEOs change constantly.
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  - Within six years, I think we had four
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  - CEOs
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  - prior to this,
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  - so called merger,
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  - however it was described, with Henry Ford taking
• 10:38
  - over Ascension.
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  - Now that has become more of a centralized,
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  - untouchable
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  - element.
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  - So in my surgical center world,
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  - I affect leadership. I bring in others and
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  - the other surgeons.
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  - We try to make leaders and
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  - offer them roles, board positions.
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  - And getting other physicians involved
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  - has really helped
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  - us work to better
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  - the facility and the patient care.
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  - Wonderful. Well, thank you so much for joining
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  - us today on the Becker's Healthcare Podcast. Again,
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  - we are recording live at the twenty third
• 11:12
  - annual Spine Orthopedic and Pain Management driven ASC
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  - conference. Thank you. Thank you, Grace.