← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Dr. Zeeshan Tayeb, Medical Director, Pain Specialists of Cincinnati
00:16:15
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- [00:00]
A
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B
Is Grace Lynn Keller with the Beckers Healthcare Podcast and we are live at the 22nd annual Spine, Orthopedic and Pain Management Conference. I'm currently joined by Zeeshan Tayeb, who is the Medical Director at Pain Specialists of Cincinnati. Thanks for being here and let's start our conversation off by having you tell us a little bit more about yourself, your background and your current role.
- [00:57]
C
Hello. Thank you Grace for having me over here and inviting me to be able to share a few ideas with the group at large. So a little background. About Me Dual board certified in Physical Med and Rehab and Pain Management. I've been practicing about 14 years now. I've been private practice since about 2016 with my own practice and I've been participating with Beckers on different levels since 2017. We started off with our original practice of a Pain specialists of Cincinnati in the Laser and Regenerative Center. Since then we have actually grown and have expanded out our practice model to be a little bit more holistic in nature. Now we're doing or we've started something known as our Region Life and then we're also expanding that into a surgical center that's going to be Region Life Surgical Center. Then we have also expanded out into some research so we've started an organization called Iqra Ichra. We've also expanded into having a nonprofit with all the other things we have going on and I could go on and on about that, but I will digress over there.
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B
Wonderful. Well, thank you for taking the time to be here. Let's start with some trends and shifts you're seeing right now in the industry. Things that you think are most important for industry leaders to pay attention to.
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C
Yes. So trends and shifts. Things are always trending and shifting and we just have to be able to adapt. So I would say probably the biggest thing right now that has really been accentuated over the last few years, especially since COVID are the fact that we continue to get hit with payers and you know, just the different things that are involved with that. So not only, you know, do costs or reimbursements continue to get cut, we also deal with, you know, increased denials and a lot more work to do for prior authorizations. So now what does that all translate into? It's not just less money or more work. It actually translates into maybe, maybe an opportunity. Right. So things don't happen necessarily to us. That's a victim mindset. Happens for us. So where do we go from here? So I've been thinking about this on multiple levels. There are shifts where, you know, things are going from, you know, hospitals or what we would consider more on an inpatient basis over to ASCs and some things in a private practice. But the other thing is happening also. So there's things that are happening in private practice that need to shift over into surgical centers, possibly hospitals. A lot of the reason for that is because of there's sometimes a lack of accountability. If you're just running your own practice, there's not as much oversight. And so some of these governing bodies are wanting to try to get more oversight over the different things that are coming about in our practice of medicine. So what does this force us to do? It forces us to basically become more multidisciplinary and what I mean by that, or even interdisciplinary. So I mean, it's not just going to be about filling a script or doing an injection. It's about working with people from different fields, not just our surgeons, but our doctors and all their different subspecialties. So in internal medicine, and I'll probably come back around to giving a couple examples about that, but also with some of our other folks that are also involved in pain management, so behavioral health, exercise therapists, physical therapists and so on, we were basically at one point, because of all the cuts, trying to make up for it by doing just more volume. And now it's not going to be enough just to do more volume because we're also being scrutinized for quality of care. So we're going to have to, the pendulum's going to swing. We're going to have to find that balance. And so there is a huge push now for, for value based care. And that's where AI then comes in. So AI is going to be sweep. It is sweeping us off of our feet. And if we don't get on board with that, we're going to get left behind. So with that said, AI, it can be as simple as just doing things for intake, but it's also going to Help with clinical decision making, crossing T's, dotting I's and helping to mitigate, hopefully some costs with, you know, how much it takes to staff a place or to be able to run a place. But it's all going to be about data. And AI is also being used for denials. So we talked about that just moments ago. So on the flip side, we're going to have to be able to use AI in a quote, unquote smart way so that we can start getting things to kind of swing back the other way.
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B
Absolutely. All great points. And let's touch on staffing and workforce challenges as these continue to be concerns across healthcare as well. So how is your organization navigating these pressures and what strategies have you seen work?
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C
Well, great question. I think that's always been a plight. It's just different time, relatively the same issues, but with a different, a different hat or a different mask. So I think at this point we mentioned AI and I'll circle back around to that. I think right now we have to find people that have some heart and some soul. And so rather than just finding people that can just do a job, we need to start actually looking at people that actually share, actually that want to actually invest in your business or invest in your practice or your philosophy, and then also kind of share the mission and the goals that you have as an organization or as a provider. So that's one thing that we've been looking for. So for some of our, what I call like the quote, unquote, smaller jobs, those folks bring them in, share the philosophy, the vision, and they have their 90 days. On the flip side, if we're looking for people to try to direct programs like be like a director of a specific department that we have in place, those folks need to really kind of internalize that, take that in, and they're going to be looked at in a different way. But a lot of it in terms of trying to prevent turnover, providing a platform for people to be quote, unquote happy, I think it's imperative for us to try to do the due diligence upfront as opposed to just bringing people in and then hoping that they make it. Other things, I think some of the more practical things that I think we do as an organization, we're in a day and age where there's a lot of ADHD or add, a lot of people are bored. So there was a lot of value back in the day just to be able to kind of focus in on a task at a time. I think most people are designed now or have basically gone into a way of being able to multitask to an extent. And a lot of it has to do with the fact that we have technology, electronics, AI and things like that at our disposure. And so if one used correctly, those kind of things can be optimized. So it helps with the role optimization, but it also then helps with preventing burnout for everybody pretty much involved. I think it also provides flexibility for people. So when people can do things outside of the office, it also gives them that opportunity to still be able to do the work. But hey, I have a sick kid or I have something else popped up, my parent is sick, I can still get the job done and still provide the service and still get paid without necessarily being reprimanded to the point where I may lose my job. And then we'll probably circle back around to this as well, I believe. But outsourcing is becoming a huge thing. There's always people out there that want to continue or groups of people out there that want to try to provide services for us. So I think working with groups that are specialized in specific areas I think is very beneficial. And I've already used the buzz term AI at least twice, so I'll do it a third time now and just basically say that as we continue to work together with AI, I think we're going to actually continue to grow and prosper 100%.
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B
And as outpatient care continues to grow, how do you see the role of orthopedics and ASCs evolving within the broader healthcare ecosystem?
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C
So, like I mentioned before, there's a shift for things that were more on the inpatient end that were kind of shifting one direction, and then the things from the outpatient setting is shifting in the other direction. So again, things happen for us, not against us. And so it's about kind of going with the flow in some ways and trying to figure out, okay, well, this is where I'm at and this is what I need to do. So looking at it from. From that angle, with everything, with a lot more shifting to outpatient, that just means that there's going to be a lot more volume. So how are we going to be able to basically take that volume in? So in some ways it actually aligns with cms, Medicare guidelines, what insurance companies are looking for. So we're looking for cost efficiencies, patient satisfaction, aligning with the payers, and so on. You have to also understand that pain in orthopedics is one of the number one reasons why people actually even go and see a physician or provider or actually seek out help, period. So it gives us an opportunity in this specific field to actually become the quote, unquote, gatekeeper. Previously, primary care doctors were kind of looked at as the gatekeepers, but how often do they see their primary care doc? Maybe once every three months, six months, maybe once a year, depending on what's going on. But if you are working or if you're having an orthopedic issue or a pain issue, you're going to end up seeing those providers much more frequently. And so it gives us an opportunity not necessarily to do everything ourselves, but to be able to outsource to our behavioral health specialists, our exercise therapists, and so on. And so we have a huge opportunity here.
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B
Absolutely. And as we round out our conversation, you've touched on this throughout the conversation so far. But many organizations are exploring new technologies and partnerships and care models to improve efficiency and outcomes. So are there any other innovations outside of the ones you've already touched on or initiatives that you found particularly promising?
- [10:37]
C
Yeah, absolutely, 100%. I think this is actually an opportunity for us to be able to see, like, how we can kind of look at things a little bit more holistically. So, number one, one of the reasons we actually shifted our pain practice and our regenerative practice, which were actually two separate entities under one umbrella, or to try to have an umbrella organization for all of it, was so that we could provide that holistic care. And so what I mean by that is I'm actually running lab tests and things like that on people to see where their kidney and liver is. I'm also looking to see, like, where some of their hormonal or nutritional imbalances or deficiencies are. And so this gives us an opportunity now to actually send them back to their primary care doctor or to their rheumatologist or endocrinologist or a GI specialist or whatnot. The other thing that we also saw as an opportunity here was to actually then start up our own little primary care clinic so that we can start that and be able to streamline that without necessarily taxing the current providers that are doing the traditional pain management and orthopedics. So that's from that one angle. So basically, in a nutshell, there we're looking at trying to get people more care and optimize their conditions so that no matter what procedure, medication, or innovations are being recommended to them, they'll be in a good place to be able to receive. Receive it not just physically, but also on multiple levels, be it spiritually, mentally and so on. Now in terms of just, I'll call the next part innovative interventions. So we have now not just opioids. When opioids first came out, it was like, like a godsent. Now we're amidst a pandemic or an epidemic of, or people call it like the opioid crisis. And so now we're looking for other things to try to help mitigate those issues. And so medications that are sodium or specific sodium channel blockers, I. E. Genavics, there's an opportunity to help with something like that. And there's many other examples just like that. And then of course, the field is also continuing to blow up in the sense that we have all of the different interventional procedures all the way from SI joint fusions, facet fusions, minimally invasive lumbar decompressions, basal vertebral nerve ablations. We still have our traditional stem, we have our peripheral nerve stem. And then I saved talking about pain pumps for last because they have been around for a little while. But pain pumps have actually become a huge thing because it helps mitigate the opioid crisis. And we've actually grown our practice significantly with that technology. And we started doing microdosing. And this is a big thing now. Not only is the research supporting a lot of it, but we also have been able to get that out onto a larger form forums and we're able to present this information at other big society meetings as well. Then the last thing I'm going to mention is not just the clinical aspect, but you actually have a team that is has to be, I guess, optimized. And that means we talked about multitasking, but you can also overdo it. And that can result in burnout and people getting stressed and wanting to leave their jobs and not having a work life balance and so on. And so this is where I'm going to circle back around and just highlight the importance of outsourcing. And so we have teams now outside different places in the United States and even outside of the United States that actually work with us to be able to do things like remote patient monitoring, therapeutic monitoring, chronic care management. We even have like another team dedicated to handling all of our durable medical equipment. And then we have people also helping with our revenue cycles, scribing and prior authorizations. Now with all of that said, that's still a lot of manpower in a sense or people power. This is also as AI is involved with this process, hopefully we'll be able to mitigate some of the issues of cost in that regard and also help streamline processes that are already pretty much simple. They just need to have some form of organization and if it's where it doesn't involve, say as much thought and it's something that just needs to be done in terms of from an algorithm, algorithmic standpoint, that's where AI can actually really come in and fit in until it quote, unquote gets smarter.
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B
Absolutely. Well, Zeeshan, thank you so much for joining me today. Is there anything else you'd like to touch on that we didn't get to?
- [15:15]
C
Just a shout out to all of our organizations that have been working with us and all of the societies that continue to support us in our endeavors to try to further basically everything that we do and our patient care that includes ipsis, asip, NASS and I could go on and on, aapm, abpm, all of our different boards. And then one other thing I would like to just have a little personal. If you have enjoyed any of this, you can just, you know, reach out and find out from us on how we have been trying to utilize all of these services. Because a lot has changed in the last, like, year, year and a half and things are going at a very fast pace. And also I am actually a new author of a book. And so if you'd like to check that out, it's called Reversing Osteoarthritis and it can be found on Amazon.
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B
Wonderful. Well, thanks for being here again. We are recording live at the 22nd annual Spine, Orthopedic and Pain Management Conference.