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A movement founded by doctors, for doctors, dedicated to empowering medical professionals to reclaim control over healthcare decisions and advocating for their fair share of the industry's resources.
00:00:04:00 - 00:00:28:17
Justin Nabity
This is the Doc Nation podcast. We are a movement founded by doctors for doctors dedicated to empowering medical professional to reclaim control over health care decisions and advocating for their fair share of the industry's resources. Please note the views expressed are those of Doc Nation and not necessarily those of our guests or referenced health centers.
00:00:28:19 - 00:00:46:20
Reid Lancaster
Welcome to our podcast with Adam Miller. I'll let Neil introduce him because they're really, really connected. But I just want to say, to all of our followers and the physicians who are looking to to join us at the signature member level. You know, it's cool to see Adam. He's an entrepreneur. He's a hard worker. He's committed to helping physicians.
00:00:46:20 - 00:01:03:07
Reid Lancaster
He's he's on a family trip right now, but he didn't want to miss this. And so we're thankful for that. Adam. Justin and I are oftentimes on the phone or driving in the car, taking meetings, and you might think that's dangerous. Maybe it is. Maybe it isn't. We're hands free. But, Thank you. Adam. We appreciate you.
00:01:03:12 - 00:01:07:14
Reid Lancaster
And, Neil, without further ado, would you please introduce him?
00:01:07:16 - 00:01:24:22
Neil Dougherty
This is...it’s be an honor to introduce Adam. Who, like, the more I get to work with him and and get to know him, I feel like we're cut from the same cloth and have a a pretty similar, background to arrive here at this Doc Nation podcast.
00:01:24:24 - 00:01:46:21
Neil Dougherty
And in podcasts in the past, we, I talked about myself saying, I wanted to help patients and be a part of health care in that way, and learning that helping patients meant I needed to figure out how to best assist doctors. I don't know if, I know I was a basketball player, so I say things like assists.
00:01:46:23 - 00:02:10:20
Neil Dougherty
At Adam didn't come from. Who said he's an athlete himself. But he if he was a basketball player, he'd be a point guard as well, because he is the assist man and he is. So I love a lot of his strategies and I love the, the company he's created, Algos Pathways. And how that is going to revolutionize, health care in a way.
00:02:10:20 - 00:02:37:23
Neil Dougherty
But, it starts with asking questions of doctors and being able to support them. So I loved that. The spirit of that. And I like where Adam's heart is as he approaches medicine as an entrepreneur. So, I don't know if that's the best introduction for you, Adam, but, the. I am just so thankful that you're here with us, to talk with us today.
00:02:38:00 - 00:03:07:04
Adam Miller
Well, I thanks, Neal. You're too kind, as always. And a good friend as well. And I really appreciate getting to know you and and, Doctor Giuffrida, over these last couple of years. My journey in healthcare really started, 2010. I started as a, Aquamantys rep at a company called Salient Surgical got into medical device and very quickly realized how many problems that there were in health care.
00:03:07:06 - 00:03:36:10
Adam Miller
It really it was very consistent. How many big incentive alignment issues there were between, administrators, physicians, reps, the industry, insurance. Everyone said, gosh, and no patients. And there's there was so much incentive alignment issue, so many incentive alignment issues. I felt like that weren't being addressed. It was easy to start a business, to try to align people.
00:03:36:12 - 00:03:57:10
Adam Miller
And, I originally started as a, distributor of spinal hardware. And, to start with a simple proposition. Hey, doc, if I could work with you to help Compliantly use medical education to build your business by educating patients about treatments that you offer for the pathologies they have. Do you think you'd be interested in working with somebody who is committed to that?
00:03:57:12 - 00:04:33:10
Adam Miller
And everyone says yes. And so I was able to build a build a nice business with that. And that led to me developing a reputation as somebody who was, there to help someone who was there to be symbiotically aligned with the physician around. How can we help you, help your patients? How can we help make patients aware of choices or the options that you provide them and Algos Pathways, a digital health company that I co-founded with Doctor Tyler Ptacek in 2020 is an extension of that where we're trying to do that at scale.
00:04:33:12 - 00:05:00:07
Adam Miller
How can we help bridge that gap between where a patient who's been to the physician's office three times or four times and had two procedures and isn't having relief? How can we fill that education gap so that patients know that there's more options out there than what they've already had done, even though the physician shared that with them in the room, told them, but hey, if this injection doesn't work, come back.
00:05:00:09 - 00:05:27:18
Adam Miller
They just don't. I think it's easy for physicians to forget that you may do 20 injections a day, but this is the only injection this patient's going to get for the next three months. This is important to them. And so it's easy as a physician, I think, to get in a groove. And as the patient is laying down and you're lining up your, spinous processes and figuring out what level you're going to inject to say, hey.
00:05:27:18 - 00:05:43:21
Adam Miller
And by the way, if this doesn't work for you, give me a call another week or two. If this pain comes back, give me another call. We have more options. The patient doesn't hear that. The patient is just thinking, I'm laying prone on a cold table. There's an X ray machine over me. I hope this works. I hope I'm okay.
00:05:43:23 - 00:05:59:00
Neil Dougherty
And so Algos Pathways works to connect with the physicians EMR, identify those patients that have been treated and engage them with educational material in an opportunity to go back to the physician's office. And close that loop to get them closer to pain away.
00:05:59:02 - 00:06:07:18
Neil Dougherty
So how does it go about that? How does it, doctor, know that that's a, an an issue?
00:06:07:20 - 00:06:17:12
Adam Miller
That's that's a great point. So one of the the absolute coolest thing, by the way, they don't know it's an issue and they don't even think it's a problem. I got to.
00:06:17:14 - 00:06:18:01
Dr. Anthony Giuffrida
That’s what I was gonna say, Adam.
00:06:18:06 - 00:06:19:03
Adam Miller
Yeah. Right.
00:06:19:04 - 00:06:39:07
Dr. Anthony Giuffrida
We don't know. And you guys are there helping the patient, which helps us. Which is the point I was trying to make. If so many people in medicine, when I have their hand to help a physician, quote, unquote. But they're not actually helping, right? They're just trying to make something for themselves. You guys are helping the patient more than anyone, which helps the physician tenfold.
00:06:39:09 - 00:07:05:02
Adam Miller
Right. Exactly. It's it can't. Again, it's about incentive alignment. I have to do what's right for everybody, not what's right for someone. And so, you mentioned Neal. How does the physician know? And of course, that they don't. I could give you umpteen examples, but here's an easy one. We worked with a practice in Arizona that had that was in, major metropolitan.
00:07:05:04 - 00:07:21:16
Adam Miller
They had an office on the north side and they said, hey, we just opened an office on the east side. And we have an ASC there. We'd love to use your tool to figure out how many patients we treated on the North side that we've lost, to follow up and see if we can get them scheduled on the East side, try to reengage them.
00:07:21:18 - 00:07:49:21
Adam Miller
I ran a report in the practice in two years, had lost 2986 patients, 2986 people had come to their office, been treated within the last two years, had come to their office, been treated and then never scheduled to be seen again. Well, the nature of chronic pain is that only 10% of patients on a year over year basis are able to effectively, quote unquote, defeat chronic pain.
00:07:49:23 - 00:08:27:10
Adam Miller
If I if a physician performs an injection today, a year from now at the most, that pain should and most scenarios return. Same thing with an RFA. Same thing with any of these treatments. So when I say a patient is lost to follow up, I do want to clearly delineate what that means. The way we define it is a patient who has been seen in your practice, who has not had what we would consider a durable therapy, like a spinal cord stimulator or a SI fusion or, a minute man, a product that you would anticipate that patient would have a resolution of symptoms and not require further intervention.
00:08:27:12 - 00:08:55:02
Adam Miller
So when we look in the EMR, typically what I found is that between 20 to, 26%, usually of the total patient census meets that criteria is lost to follow up. We know physicians don't know this because they're currently spending money, good money, trying to, market their practice to acquire new patients. You don't have a new patient problem, sir or ma'am.
00:08:55:04 - 00:09:19:00
Adam Miller
You have a optimization problem. It when you think about how expensive it is to acquire a new patient, you should be on the other side, spending some low amount of money on the retention portion. If you don't, it's a bit like buying fertilizer for a tree, but then never watering. You've done the first part really well. You just you've not done the maintenance to help facilitate its growth.
00:09:19:02 - 00:09:27:22
Justin Nabity
Where are these patients going that there's 2000 some. You said you identify what's happening them. Are they going somewhere else to get follow up care or what's happening to them?
00:09:27:24 - 00:09:44:15
Adam Miller
Yeah. If they're it depends on how motivated that patient is. Right. That's a great question. So some of the time that patients, motivated in pain and they feel like the first provider they went to has done two injections and, it didn't work. And they think that doctor doesn't know what they're doing. And if they did, I wouldn’t still be in pain.
00:09:44:17 - 00:10:05:16
Adam Miller
Again, that highlights not only an education gap, not because the provider or the physician didn't share it correctly, but the patient didn't hear it correctly. There's a big distinction between but I told the patient and the patient understanding that's that's the gap we're trying to solve for. And so let's pretend that patients motivated, they're going to go establish with a new provider.
00:10:05:22 - 00:10:32:24
Adam Miller
And you as a physician have just worked up a patient for your competitor. So that's what's happened in that scenario. In another scenario, or maybe that patient's not as motivated, right. Like they've what we find is that patients start to make manage down their active daily life, and begin to guard. And so rather than saying it's a big deal that they can't ride any more than 30 minutes in a car without having pain that causes them to have to pull over and stand up and get out.
00:10:33:01 - 00:10:49:06
Adam Miller
They just stopped driving anywhere greater than 30 minutes. So you're either going to see that patient try to reestablish to get a solution with your competition, or you're going to see that patient guard and sort of have a greater degradation of life associated with their inability to function.
00:10:49:12 - 00:10:50:13
Justin Nabity
That sucks, that sucks.
00:10:50:15 - 00:11:07:24
Neil Dougherty
And in my head, in my head, I'm imagining the patient that's guarding and and kind of gearing down their activity, their their life, their are they then maybe blaming the health care system or physician? Are they hopeless? What...
00:11:09:01 - 00:11:26:01
Adam Miller
I had, I had a friend who was telling me about a consult consult yesterday that really bothered him. And I talked to him for about 30 minutes about it, and he said, you know, this lady came in who I had done an ACDF on three years ago. She had, she came in with an MRI that was greater than a year old.
00:11:26:07 - 00:11:47:06
Adam Miller
She said she's in terrible pain. I looked at her, I looked at her, chart. She'd been discharged from a hospital two days earlier. She had, different issues, that weren't related to a cervical, dermatome And he said to the woman, you know, it seems like you have a lot of really important things that may be going on.
00:11:47:06 - 00:12:04:13
Adam Miller
I think it's wise that you schedule a consultation with neurology. And he made some suggestions, and the the lady said, I'm here to schedule surgery. I want the pain to stop. I think the and then he got very sideways with her because he was like, ma'am, I don't even have the correct imaging to be able to make a decision about whether or not you need surgery.
00:12:04:13 - 00:12:24:15
Adam Miller
And I think you have problems that are bigger than this that need to be managed. And, oh, she was also on OxyContin that she was getting from a, primary care doctor. So this patient comes in and they're mad as hell and they're in pain and they hurt. And this physician wants to help them, but that patient can't hear.
00:12:24:17 - 00:12:42:06
Adam Miller
So when we talk about attribution of blame, I think I think patients just want an answer. I don't really think they care. I think they just want to feel better. They just want to be better. They want to go back to who they are. And, whose fault that is isn't nearly as important as them getting closer to.
00:12:42:06 - 00:13:03:21
Adam Miller
Yes. And I think the nature of health care is that, you know, any well-meaning provider is going to stay within their specialty lane, and then they're going to out. They're going to consult where appropriate for, you know, problems that are bigger than the one they're responsible for treating. So, it's not so much about patients being wanting to blame people, in my opinion, as it is about patients.
00:13:03:21 - 00:13:19:13
Adam Miller
Patients just want care for and they don't want to have to chase. They don't want to have to chase a provider. They don't want to have to follow up with five mychart messages to ask clarifying questions of a physician, only to have them answered by an MA who provides an unsatisfactory response. And that's the standard in health care.
00:13:19:15 - 00:13:25:14
Dr. Anthony Giuffrida
I have a question for you, Adam, on that. So do you think that that's continuing to get worse?
00:13:25:16 - 00:13:26:16
Adam Miller
Yes.
00:13:26:18 - 00:13:32:17
Dr. Anthony Giuffrida
How health care is being and what's your what's your thought and why do you think that's getting worse. That interaction.
00:13:32:19 - 00:13:35:16
Adam Miller
The, patient
00:13:35:18 - 00:13:43:06
Dr. Anthony Giuffrida
The fact that a patient didnt’ get an answer they want or they can't get the care they want, or the fact that it takes a long time for them to get that care.
00:13:43:08 - 00:14:03:07
Adam Miller
Access is, I think, the original sin. It takes a long time to see a provider. Moreover, when you see a provider, you only have a certain amount of time with that provider. I'll give you an example. The other day my wife went and saw an endocrinologist. She had to wait. She was she was fatigued. So that was a little odd.
00:14:03:09 - 00:14:19:22
Adam Miller
So, she went and to a, local place, sells hormone therapy and all that stuff. And she just got a full blood panel, and her TSH was on the borderline. And I said, you know, you really need to see a professional. You don't need to see it. You need to see an endocrinologist. You need to see a professional person.
00:14:19:24 - 00:14:29:18
Adam Miller
She goes in, she sees the endocrinologist, the endocrinologist. She has to wait four months for the appointment with the endocrinologist, Fine, I get it. When she finally speaks with the endocrinologist.
00:14:29:24 - 00:14:33:08
Dr. Anthony Giuffrida
Wait, let me stop you there. I don't think we should normalize waiting four months to see a specialist.
00:14:33:10 - 00:14:35:19
Reid Lancaster
I was gonna say....fine?
00:14:35:21 - 00:14:37:04
Reid Lancaster
What do you mean fine?
00:14:37:08 - 00:14:38:07
Dr. Anthony Giuffrida
Not fine.
00:14:38:09 - 00:14:40:14
Reid Lancaster
He’s conditioned, we’re conditioned!
00:14:40:16 - 00:14:45:20
Adam Miller
I'm trying to give. I'm trying to give providers as much grace as I can.
00:14:45:22 - 00:14:54:04
Dr. Anthony Giuffrida
But it's not the providers fault either. It's the system. It's just there aren't enough physicians out there and we can't. I don't think we can do what we need to do. Four months is crazy.
00:14:54:05 - 00:15:14:05
Adam Miller
You you you can't, how about this? If you have I mean, the other day, a spine, physician put up that he had a secondary finding associated with an MRI that he had for, spine pain. Patient had, a cancer, an abdominal, retroperitoneal cancer. He couldn't get that person to consult for three months.
00:15:14:07 - 00:15:14:10
Dr. Anthony Giuffrida
Yeah.
00:15:14:14 - 00:15:32:17
Adam Miller
I mean, forget it. Forget a borderline. TSH. I've got cancer, and I can't see somebody for three months, so pretend you're a pretend you're a patient. How's that going to work the other day? I'm going to. I'm in a little different position than most people. But the other day, I had an my wife, I got an ultrasound on her kidney, and it makes it sound like a real disaster.
00:15:32:19 - 00:15:36:02
Adam Miller
But she had an ultrasound on her kidney because she had a GFI.
00:15:36:04 - 00:15:37:00
Dr. Anthony Giuffrida
I hope she’s okay!
00:15:37:02 - 00:15:52:22
Adam Miller
She's fine, she's fine. But yeah, she's a good exa... You know, she may be catastrophizing who's to say, but, so we got a, I got a read on an ultrasound for my kidney in order to get. And it was just, you know, like an MRI report, right?
00:15:52:22 - 00:16:06:16
Adam Miller
It's just it's a read, and I don't know what to make it if you're not a I'm not trained in it, so I don't know what to make of it. Well, I tracked down a urologist in the hall and just asked him, I mean, if you can't do that, I don't know how you can get responses on these things in a timely manner.
00:16:06:18 - 00:16:16:22
Adam Miller
By the way, the appointment with a nephrologist would be, I think November was the soonest she can see a nephrologist. So what?
00:16:16:24 - 00:16:17:06
Dr. Anthony Giuffrida
Go ahead.
00:16:17:06 - 00:16:47:21
Adam Miller
And so I guess to put a bow on it, I want to I want to demonstrate how patient access is, how these distortions in patient access are manifesting in the market. So, have you noticed that with increasing volume, there are ever more, nurse practitioner locations that are opening up that are offering a range of services from Botox to IV therapy to coolsculpting to hormone therapy to, whatever.
00:16:47:21 - 00:17:09:18
Adam Miller
Right. You continue to see more and more of these NP locations open, and when you walk in you have a marble floor. They hand you a water, you check in on an iPad, you sit down and there's another well-meaning person that you're sharing the lobby with. Within four minutes, someone calls you back. You have as long of an encounter with that provider as you'd like.
00:17:09:20 - 00:17:32:14
Adam Miller
They order the they order what tests they think are appropriate, and then you get the answers within 48 hours. When I when I schedule an appointment, that was her appointment to go get her blood panel done with the nurse practitioner when she's when she finally waited the four months to see the endocrinologist, the endocrinologist sat with her for about 15 minutes and she said, you know, it was hard for me to understand them.
00:17:32:16 - 00:17:46:02
Adam Miller
I said, did he have a, a tone in his speech where it was difficult to hear? She said, no, it was that he was typing what he was saying on the computer. So I didn't get to actually look, and I couldn't. I wasn't looking at him. I could only look at his profile.
00:17:46:07 - 00:17:47:04
Justin Nabity
Okay.
00:17:47:06 - 00:18:10:09
Adam Miller
So we're waiting for months to have to have a conversation with the side of someone's head. And then the individual, the physician, again, well-meaning doing their job, says, why don't you go downstairs and get, another I want another CBC. So she goes down, so he goes, go to entrance six. She shows up to entrance six at the hospital, and there's nobody there.
00:18:10:11 - 00:18:29:07
Adam Miller
She has to go find somebody to direct her where she needs to go. If a patient continues to have what I would describe as a DMV experience while seeing appropriate providers, you're going to continue to see an increase in the total number of nurse practitioners that are offering a Ritz-Carlton experience.
00:18:29:07 - 00:18:29:13
Justin Nabity
Yeah.
00:18:29:18 - 00:18:31:22
Dr. Anthony Giuffrida
What is the difference through? What is
00:18:31:22 - 00:18:34:10
Dr. Anthony Giuffrida
The main difference in the two experiences?
00:18:34:12 - 00:18:39:03
Adam Miller
Timeliness, cleanliness, or organization.
00:18:39:05 - 00:18:44:20
Dr. Anthony Giuffrida
I'm saying the main difference in what's driving one being good, one being better.
00:18:44:22 - 00:18:46:18
Reid Lancaster
What's the root difference?
00:18:46:20 - 00:18:54:12
Adam Miller
Well, yeah, I guess the the nurse practitioner is in charge of her own shop and the doctor isn't. And the reason for that.
00:18:54:12 - 00:18:57:24
Dr. Anthony Giuffrida
Did she see the nurse practitioner through her insurance?
00:18:58:01 - 00:19:01:01
Adam Miller
Oh no. We just we don't want to mess with that. We just pay cash.
00:19:01:03 - 00:19:01:13
Neil Dougherty
There it is.
00:19:02:17 - 00:19:04:02
Adam Miller
insurance.
00:19:04:04 - 00:19:05:06
Reid Lancaster
Bingo.
00:19:05:08 - 00:19:17:12
Adam Miller
Well, you can't you can't take you know, you can't. You can't take me. You can't take me to an inpatient site of service. I wouldn't let you use a pair of tweezers on me at an inpatient side, a service, that of insurance, being involved. Because I don't know what you'll charge me.
00:19:17:14 - 00:19:48:12
Dr. Anthony Giuffrida
Exactly, but that is the. That is the difference, though. Insurance pays so little to that endocrine doctor for that half hour, 15 minute appointment that he he can't have someone there to help him type, he can't see her for more than 15 minutes. The hospital can't have someone waiting there to direct him to where the CBC is, because it would be a net negative, because the how much in Medicare for a half hour appointment pays less than $100.
00:19:48:14 - 00:19:50:13
Justin Nabity
They suck all the money. There's no. cushion.
00:19:50:15 - 00:20:00:24
Dr. Anthony Giuffrida
yOu can’t pay all those people and every single commercial insurance is based off of Medicare. You can't. Would you pay? If you don't mind me asking, what do you pay at the end at the NP place? 150 bucks?
00:20:01:01 - 00:20:05:17
Adam Miller
Oh I, I have no idea, but I would, I would, I would be certain it was less than $200.
00:20:05:19 - 00:20:15:07
Dr. Anthony Giuffrida
Okay. It's, and they’re overhead’s probably much lower as well. But it's out of control. What these people are getting for a half hour appointment where they can't have health.
00:20:15:09 - 00:20:23:08
Adam Miller
Well, they also got cash on the barrel, had the insurance company had to spend 90 days having a rigamarole of a third party. Oh, that's a budget to collect the revenue.
00:20:23:10 - 00:20:43:16
Dr. Anthony Giuffrida
So you bring up an awesome point Adam, where in my mind the health care dollars are being spent astronomically right now. Right. But but you're paying for health insurance. The employer of your wife is paying for health insurance. You pay a deductible. All that money is going somewhere.
00:20:43:18 - 00:20:44:15
Adam Miller
It is.
00:20:44:17 - 00:20:48:11
Dr. Anthony Giuffrida
The health care she received was not equal to that.
00:20:48:13 - 00:20:49:19
Dr. Anthony Giuffrida
That dollar in my opinion.
00:20:49:21 - 00:21:00:09
Adam Miller
Yeah. As a as an independent business owner I pay roughly, $1,900 a month for my family of five for Blue Cross. And I have a $3,000 deductible.
00:21:00:11 - 00:21:01:00
Dr. Anthony Giuffrida
Yeah.
00:21:01:02 - 00:21:04:24
Adam Miller
And it's basically just for catastrophic.
00:21:05:01 - 00:21:25:01
Dr. Anthony Giuffrida
And then and. Yeah, I mean, we we get into this a lot and a lot of our podcasts about how much take home the insurance companies are taking. But you made a great point there. And, it's the problem. It's it's why we aren't healthy in this country and why we don't have great health care. It's just it's a it's a pandemic that's a real pandemic that we have.
00:21:25:03 - 00:21:30:13
Dr. Anthony Giuffrida
And it's sad to see. I mean, your wife deserved better care than no, no knock on this guy. I mean, because it's everywhere.
00:21:30:19 - 00:21:37:16
Adam Miller
It's not his fault. That's exactly right. I don't hold him liable. Do you think he. Don't you think he'd rather talk to her than talk to her computer?
00:21:37:18 - 00:21:38:04
Justin Nabity
Of course.
00:21:38:04 - 00:21:45:02
Adam Miller
Yeah. I mean, don't you think he cares? Don't you think he cares more than he was able to give that day, don't you think? My friend who I was talking to about the.
00:21:45:04 - 00:22:02:08
Adam Miller
Don't you think he's at home upset with himself about how a consult went with a person who he was, was categorically a lunatic. Because pain is driven. I said, you if you were on OxyContin and had a bunch of radicular pain and just got out of the hospital two days ago, you'd be crazy, too. Have some sympathy. Have some empathy.
00:22:02:08 - 00:22:21:19
Adam Miller
This person is a lunatic, I get it, but you would be too were you to be in her shoes. Yeah. And so I so I don't come after doctors on that, but I think the what so the question is what's the answer? I think if you, if you and I are playing a game and I set the rules and, you say, hey, this game is rigged.
00:22:21:21 - 00:22:43:05
Adam Miller
And I'm like, yeah, that's fine. I don't make the rules, buddy. Would you continue to play the game with me? And I think that's what we're doing with insurance companies is, with our traditional medical health care complexes, we're continuing to to just swim upstream against a, in a broken game. And I think as a physician, you say to yourself, well, what can I do about it?
00:22:43:09 - 00:23:10:13
Adam Miller
Well, see the nurse practitioner, she did something about it or she did something about it, cause they had a little bit of an advantage. A doctor is worth more to a hospital than they're worth to themselves. Oh, gee. A nurse practitioner is worth more to themselves than they're worth as an employee, so it's pretty easy. Math for the willing to decide to start a business if they're a nurse practitioner.
00:23:10:15 - 00:23:26:23
Adam Miller
Conversely, it's pretty hard math to figure out. I'm going to say I'm going to go to private practice. I'm going to function outside the hospital. I'm going to do something different now. Then to take it a step further to deal. How am I going to manage the insurance issue on private practice? That's only part of the step. What about insurance?
00:23:27:00 - 00:23:50:03
Adam Miller
Well, now you need to create a concierge practice. I asked a physician the other day. I met with in Wisconsin. I said, he's a spine surgeon who's going out to a private practice leaving academics. I said, how do you think about positioning yourself, to the market? How do you want to represent yourself, in your practice? And he said, I really want to offer a second opinion program.
00:23:50:05 - 00:24:12:05
Adam Miller
I did really well with second opinions, and I think that'll be that'll be a great way for me to, you know, get my way into a new market by saying, hey, I'm here and I'd like to I said, you know, second opinions did really well with you because for you, because you were an academic institution, people who went to an academic institution had basically passed under a sign that said, abandon hope.
00:24:12:05 - 00:24:32:07
Adam Miller
All ye who enter here, they come into an academic institution with the expectation that they have given up whatever this person says, that's the gospel. And so you did well because that was where you were now you're in private practice. You're just another guy. They don't know you're that guy. You're just another guy. You're going to need to come up with something different.
00:24:32:07 - 00:24:51:01
Adam Miller
Are you going to be talking about serving patients with endoscopy? Are you going to talk with certain patients with motion preservation? How are you going to do it? He goes, “Gosh, I never thought about it that way. I'm going to have to figure out what I'm going to do.” I think it's unfair to me that a physician, in order to be a successful private practice physician, needs to be an attorney.
00:24:51:03 - 00:25:20:22
Adam Miller
They need to be an MBA. They need to be a doctor. They need to be a human resources manager with, you know, Simon Sinek, levels of empathy, an EQ, it's absurd. You have to be super man or woman to have all the skills into one person, let alone the 24 hours you have in a day. And so that's why organizations like you guys help so much by allowing experts to step into each of those domains of expertise and fill those gaps for physicians.
00:25:20:22 - 00:25:34:10
Adam Miller
And so I think from a physician listening to this, I'm saying to myself, what do I need to do to help get myself right? It's a first. It's I need to think about how I'm going to function outside the bounds of traditional health care. How can I leg into this concierge business? How can I provide an offering to patients?
00:25:34:16 - 00:25:47:05
Adam Miller
Who do I need to contact? What content do I need to make? You know, I don't have to do it all, but I have to do something and I need to be confident about just saying, you know what? I know when I don't know enough to know enough. And I need to pick up the phone and get some help.
00:25:47:07 - 00:25:48:24
Justin Nabity
That’s courage .
00:25:49:01 - 00:25:51:02
Neil Dougherty
That’s very well said.
00:25:51:02 - 00:26:03:07
Reid Lancaster
Adam, your’re five stars. As always, I think that's a great place to lay in this podcast. That was impressive my friend. That was impressive. We typically ask the three questions, but you just answered
00:26:03:09 - 00:26:03:14
Justin Nabity
Yep.
00:26:03:15 - 00:26:09:21
Reid Lancaster
them one step at a time. That was very powerful. I think that was very on point and this is one of my favorite podcasts, man.
00:26:09:21 - 00:26:24:15
Reid Lancaster
So thank you for taking the time on your your family trip there, to give us some of your time to, to help, manage. And then at some point, cure this problem of a of a health care that's in shambles. So thank you so much.
00:26:24:17 - 00:26:30:13
Adam Miller
I appreciate the platform and appreciate sharing the time with you.
00:26:30:15 - 00:26:32:00
Dr. Anthony Giuffrida
Thanks, Adam.
00:26:32:02 - 00:26:33:01
Adam Miller
Thank you guys. Have a great day.
00:26:33:01 - 00:26:36:19
Reid Lancaster
See ya buddy.
00:26:36:21 - 00:26:53:16
Justin Nabity
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00:26:53:22 - 00:27:01:06
Justin Nabity
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