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Becker’s Healthcare Podcast
Michael Bottros, Clinical Operations Chief and Medical Director for Pain Services, Department of Anesthesiology, Keck School of Medicine of USC
00:08:52
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- [00:00]
A
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- [00:36]
B
Is Gracelyn Keller with the Becker's Healthcare Podcast and we are recording live at the 22nd annual Spine, Orthopedic and Pain Management Conference. I'm currently joined by Michael Boutros who serves as the Clinical Operations Chief and Medical Director for Pain Services at the Keck School of Medicine of usc. So Michael, thanks for joining me today. I would love to have you start off by introducing yourself and telling us a little bit more about what you do.
- [01:02]
C
Thanks so much for having me on Grace. So I'm the Clinical Operations and Medical Director for Pain Services at the Keck School of Medicine of usc, as well as the Pain Fellowship Director and the Chair of the Opioid Stewardship Committee. And so wearing a lot of hats, I'm involved with a lot of the outpatient pain procedures as well as the care paths and protocols that involve patients and pain, whether it's postoperative or whether it's chronic pain.
- [01:34]
B
Well, thank you for taking the time to join me today and let's start our conversation with what trends or shifts you're currently seeing right now in the industry that you think are most important for industry leaders to pay attention to.
- [01:46]
C
There's been an overall trend towards non opioid pain management strategies and that includes medications as well as interventional approaches. When it comes to medications, there are newer medications that are coming out. For example, Suzetragine was recently approved by the FDA as a non opioid based approach to taking care of acute pain episodes. It uses a novel Mechanism, sodium subtype 1.8 channel blockade. This is in a class in and of itself and has opened a new genre and category of medications that can benefit patients post operatively, for example, or after acute pain episodes where they're able to help manage their pain without some of the typical side effects that we see with opioids like nausea and vomiting, typical questions about the risks of opioid addiction, constipation, all of these things. And it's important because all of these things also cost both money and time from the perspective of efficiency planning, especially when it comes to an ASC trying to move things forward, next cases and whatnot. So having protocols and care paths in place that involve these types of medications upfront to move things forward is wonderful. And then from an interventional perspective, we have newer types of procedures that are more on the curative side of things rather than patchwork. So there's a trend away from things like epidural steroid injections, which we know don't last very long. They don't necessarily fix many things. They just sort of provide relief that we know can be mostly temporary and that has been shifting away and moving towards more curative procedures like minimally invasive lumbar decompression, the mild procedure, or BASI vertebral nerve ablation, which provide longer lasting relief and more definitive approaches to taking care of what the actual problem is with the patient.
- [03:55]
B
And staffing and workforce challenges also continue to be a concern across healthcare. So what is your organization doing to navigate these pressures and what strategies have you seen work?
- [04:03]
C
Well, so, so there are a number of different approaches that organizations can take when it comes to trying to retain and to attract staffing and workforce, especially in today's day and age. So a number of different things that we've been doing is providing obviously competitive pay and flexibility focused benefits. But in addition to that, we're as an academic institution able to provide professional development opportunities for them as well as technology that can help ease the administrative burdens. So we partner with different third party vendors and different companies to help from the pre authorization perspective for a lot of these procedures. So that offloads a lot of that kind of work from our specific group. And then in addition to that, USC provides the workforce a, an opportunity to move forward with more educational opportunities, for example, like earn and learn programs. And that way that allows them to want to retain them, you know, or want to stay on that, on that workforce because they know that they're going to be able to move up that, that, that ladder.
- [05:27]
B
And as outpatient care continues to grow, how do you see the role of orthopedics, spine, asc? It's all those things evolving with the broader healthcare ecosystem.
- [05:37]
C
It's going to be a deeper integration into that system because more and more procedures are coming out that do a pretty good job when it comes to reimbursement. But the key here is that as these are newer procedures, there's more time required to get these things pre authorized. So there's a patience that needs to be put in play and setting expectations, for example, with patients and when they're going to be able to get these things done. But as more and more of these procedures are being developed, more pain physicians, for example, are going to be incorporating this into their practice. And so now the real question is how do we allocate resources more efficiently and effectively to allow for that limited resource of, for example, or time to allow all these newer procedures to compete with pre existing procedures like neuromodulation, for example, or radio frequency ablation. And so how do we allocate these procedures to the appropriate domains? What needs to be done in an operating room? What can be moved to an outpatient, you know, procedure clinic, for example? I think that that obviously is going to be dependent on where you practice and the resources that you have. But I think it's a question that now needs to be asked much more astutely to allow for these newer procedures to effectively be implemented in the area that you work.
- [07:08]
B
And then finally, many organizations are exploring new technologies, partnerships or care models to improve efficiency and outcomes. So are there any innovations or initiatives you found particularly promising?
- [07:20]
C
So there are a number of different things that we're doing essentially in terms of protocolizing efficiency. So trying to incorporate specific medications that are non opioid and getting them in the hands of patients before their procedure to make sure that they have it ready for them when they get discharged is essentially one component of this. And then on top of this, ensuring that we are staying up to date with the newest evidence based approaches that are available out on the market. And so we want to make sure that we're providing patients with the things that can empower them to achieve the type of pain relief that they're looking for without necessarily, you know, staying in the, in the, in the dark ages with some of these older procedures that, you know, if you want to call them bread and butter, remain sort of the, the, the, the stable crop of procedures that have been historically used. You have to be able to innovate, you have to be able to stay with the latest innovative approaches to keep relevant with the industry and to allow more patients to want to be able to come and, and look at your organization as, you know, a beacon for innovation and options for them.
- [08:40]
B
Well, Michael, thanks so much for joining me today on the Becker's Healthcare Podcast. Again, we are recording live at the 22nd annual Spine Orthopedic and Pain Management Conference.
- [08:49]
C
Thanks so much for having me. Grace.