← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
N. Nicole Moayeri, MD, MS, Neurological Surgeon at Cottage Health
00:16:40
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- [00:02]
A
This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.
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B
This is Carly Beam with the Beckard Spine and Orthopedics podcast. And today I'm thrilled to be joined by Dr. Nicole Moiri at Cottage Health. Dr. Moiri, thank you so much for being here today.
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C
My pleasure. Thank you for having me.
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B
And so, before we dive into our questions, could you just introduce yourself and tell us a bit about your background?
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C
Sure, yeah. I'm a neurosurgeon here in Santa Barbara, Cottage Health, for the last four years. I'm the director of neurosciences. My background really started years ago here in California at Stanford University, which drew me out from the East Coast. I got my bachelor's in medical degrees there and then went to Boston for my residency at mgh. That's how I met my colleague who is here in Santa Barbara, who has been practicing here a lot longer than I have. After a brief time in academia, I decided to come back to California and practice. Practiced in Northern California for over 20 years, developing my skills, and then got recruited here just about four years ago to develop their brain tumor and epilepsy program.
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B
That's awesome. So it sounds like you've really spanned the country in terms of your work and experience.
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C
Yeah, yeah, I have enjoyed the experience on both coasts, as they say.
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B
Yeah, definitely. And what are you most excited about right now in your work and in neuroscience and neurosurgery?
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C
Well, I think that there are really some interesting technologies that are evolving now as we all hear about AI all the time. I think in my experience, I've been fortunate to consult for a couple companies that are using AI in both medical imaging and with natural language processing to analyze radiology reports. And I think these technologies are really going to hold a lot of promise for us for our patients in terms of identifying diseases that might have been missed. The follow up that isn't happening and ensuring that it happens. Things of that nature are really going to transform medicine. Then there's biotechnology. That's going to be. It has been and will continue to transform how we care for our patients. And I'm particularly interested in how we can address malignant brain tumors with the new immunotherapies and engineered cells. So that's some research opportunities that we're exploring with the scientists at UCSB right now. And so it's those sort of forward looking developments are just really exciting for someone who has spent many years battling diseases that are difficult to, to battle. But I think in the future it will hold some promise for us.
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B
Absolutely. And you know, what you're saying about imaging too, especially. I've also heard from spine surgeons how AI has helped them with reading and understanding, MRI imaging, et cetera, reducing the need for radiation. And I'm wondering, can you give an example maybe of one way that AI has significantly improved how you're handling some of the clinical cases you're working with today?
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C
Yeah, like I was mentioning, the natural language processing technology, which is sort of the initial stages, which is now developed into our large language models, allows us to really look at huge amounts of data and say, you know, which patients have this diagnosis and what's the severity of their disease, and gathering that data, then we can actually analyze what's the best approach to their disease and how often do they need follow up and where are the higher risk categories for that disease. So I think just having that immense amount of data will really guide us into how we advise our patients and track them in a way that's really based on data and outcomes and not just on individual physician's impressions or experience. So, for example, for us, one thing that I've seen in my prior practice is that a patient might be diagnosed with a small brain aneurysm and that aneurysm is very unlikely to rupture. But if it's not monitored and followed, we don't know if that aneurysm is growing. And it's not uncommon for those patients to get lost to follow up. So if we can capture them, put them back into a surveillance system and make sure that they're not getting lost and that they do get the treatment before their aneurysm grows and ruptures, then I think we, you know, our system will be more fail proof and will be safer for our patients. And overall, I think that's a technology. Well, it's already in existence. I helped develop it with a company called Illuminated, and we just are presenting the data in the coming months at the International Stroke Conference. So I think, you know, this is a technology that could help health systems across the country to improve their surveillance of patients with otherwise small aneurysms that could in the future become significant to Their health.
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B
That's really fascinating. So it sounds like you're really using these tools to catch the problem and prevent it from becoming a bigger issue down the line.
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C
Exactly. That's my. You know, I believe in prevention. It's always better than treating the disease after it's happened. So we are definitely interested in identifying patients that we can treat when they're going to have a better outcome.
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B
Yeah. And, you know, a lot of my conversations with spine surgeons and pain management physicians this year, a lot of them emphasize just the importance of collaboration with other specialties, including. Including neurosurgery. And I'd love to know just kind of, to what extent have you been focusing on just collaborating not only with spine surgeons, but just other specialties as a whole and kind of taking that whole full patient approach to care?
- [07:04]
C
Yeah, that's a great question. I think collaboration is the most important part of medical care because none of us know everything. And increasingly, we're more and more specialized in our fields. So, for example, a patient with a pituitary adenoma, Pituitary tumor, is not going to be managed exclusively by me. It's going to be managed with the help of an endocrinologist, with the help of an ophthalmologist. And so we've really developed here at Cottage in just the last three and a half years, an outstanding team, a collaborative team that treats patients with those disorders. Similarly, for brain tumors, when you have someone with a metast tumor or primary tumor, the difference, of course, metastatic. It comes from elsewhere and goes to the brain. Primary tumors arise in the brain initially. Those patients are treated not just by the neurosurgeon, they're treated by neurologists, neuro oncologists, oncologists, radiation oncologists. So those collaborations are ongoing. Every single week, we have a tumor board, multidisciplinary tumor board. And the decisions that are made in that collaborative manner always are better. And so I think, you know, that's my joy is being able to have such great colleagues. It's been a really pleasant experience being here in Santa Barbara because the physician quality of physician care is exceptional. So that's one of the things we're trying to get the word out to our community to know that they don't have to travel to a major city. They can stay here and get the care they need.
- [08:52]
B
Absolutely. And, you know, I'm wondering, just kind of sticking on the same kind of track, what's an interesting lesson that you learned from working with spine surgeons? Spinal neurosurgeons or orthopedic spine surgeons, and then vice versa. What is something that you think, you know, spine surgeons and orthopedic spine surgeons should really be kind of aware of in terms of what you're doing your end?
- [09:18]
C
Well, I work very closely with my orthopedic spine colleagues here. We share cases. When there's an area of specialization, such as a spine tumor issue that arises, the orthopedic spine surgeons will get me involved. If I have a traumatic spine injury that I'm not doing the level of fusions that they're doing, instrumented fusions, then I will get them involved. And that way together, if it requires both of our specialization, then we, you know, we will do the cases together. And I think that's really the key is everyone knows what they're good at and has a level of confidence and comfort that they can provide that exceptional care to their patient. And then together we can do the parts that we're really best equipped to do. And so those sort of relationships are critical. And you know, I have, I have those great relationships with our orthopedic spine colleagues here, as well as other neurosurgeons in our group.
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B
Definitely. And I'd love to hear, besides AI, what are some other big healthcare trends that you're going to be following headed into 2026?
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C
Yeah, so as I mentioned, the biotechnology trends and I think financial trends are really interesting to me these days as I left a prepaid health care system and entered into private practice and now in a group practice. I think what we can do in terms of negotiating contracts directly with employers would be a really interesting avenue that I'd like to explore further. And we're just starting those conversations now at Cottage Health because I think there is a great opportunity there for patients and employers to get a real clear idea of what care is available to them in their communities and for us to improve cost savings for them and for us to become more efficient. There's so many layers that are now put on physicians and physicians offices to provide additional information for insurance companies and pre authorizations, et cetera, which really is unnecessary work, I believe. And I think it is just detracting from the delivery of healthcare. So direct contracting with employers is of interest. And I think another development that is really important is the human side of healthcare, which we can never lose sight of. So, you know, the kindness, compassion, mindfulness that not just for the patients, but also for the physicians and providers, because it's, it's how we make it sustainable and our palliative care program at Cottage and in the community has really, I think, helped our patients a lot to help determine what's the best way for them to live their life and the remaining time they have left, especially our patients with brain tumors. So, yeah, I think those are two really interesting trends to follow in healthcare is the direct contracting and the development of palliative care in medicine.
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B
Absolutely. And then my last question for you. I was wondering, how are you thinking about growth in the next 12 to 24 months?
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C
Oh, yeah, well, we're planning on a lot of growth in the next 12 to 24 months. So we just recruited a neuro oncologist and we're looking for two new neurologists to join our group. The access for patients in our community, like many, many communities across the country, has been very difficult in certain specialties, neurology being one of them. So we're trying to reduce those weights and get patients in quickly so they can then, if they need, go on to see the neurosurgeon in a timely fashion or not continue in the care, the excellent care with the neurologist. And so those sort of collaborations with the other specialties that we need to develop in the community, that's one area of growth. The other is the sort of opportunities with, like I mentioned that the companies that have some interest in translational research and also clinical research. And so I think with our new neuro oncologists, we're going to have some great opportunities, opportunities for that that we previously haven't had at this institution. And the final thing, I think, is really just getting the word out. We're going to be doing a major sort of, you know, PR campaign, developing our website so patients can find us and our, you know, referring doctors can find us so that we can ensure that patients get the care they need right here, close to home. Because, you know, we know our organization has the. The skill set and the technology, but I don't think everyone in the community knows that yet. Those are, I think, going to help us grow our practice and our service to our counties, both north and south of us and not just in Santa Barbara county.
- [14:57]
B
Sounds like some exciting things coming ahead for y'.
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C
All. Yeah, very exciting. We do have an intraoperative MRI at Cottage. We have technologies that haven't, you know, typically been found in community hospitals. So this is sort of a. It's an academic hospital in that we have residents, but we don't have, you know, research laboratories. So the idea is that we want to deliver that level of academic medicine care with the technologies that we have with intraoperative mri, lit, navigation, ultrasound, all the robots, everything that you would see at an academic center. But we don't have the residents. We have experienced surgeons treating patients. And so we're hopeful that patients will recognize that this is a level of care that they can't, they really can't get at just any community hospital and that they end up deciding it is best to stay closer to home with their. Their families and their loved ones.
- [16:03]
B
Absolutely. Well, Dr. Moiri, thank you for joining our podcast today. I hope you have a great rest of your day, and I hope that we can connect again down the line.
- [16:12]
C
Appreciate it. Nice to talk with you. Take care, Sam.