Kansas Pain Management co-founder discusses AI, patient experience and physician burnout

Mahoua Ray, MD, is the co-founder and managing director of Kansas Pain Management and Kansas Anesthesiology Professionals, as well as chief of pain management at Menorah Medical Center and treasurer for the Kansas Society of Interventional Pain Management.

Dr. Ray will serve on the panel “Budget Planning for 2023 and Beyond: Capital Investments, Staffing and More” at Becker’s ASC Annual Meeting. As part of an ongoing series, Becker’s is talking to healthcare leaders who plan to speak at the conference on Oct. 27-29 in Chicago.

To learn more and register, click here.

Editors note: This article experienced a delay in publishing. Mentions of the Becker's ASC Annual Meeting are in reference to the October 2022 event.

Question: What is the smartest thing you've done in the last year to set your organization up for success?    

Mahoua Ray: I think the smartest thing was that I started doing a weekly round with the ASC administrator and nurse manager. Prior to that we were only meeting maybe once a month, and then we had quarterly meetings. With the staff turnover, things were changing rather quickly. In the beginning of last year it was kind of the end of COVID, and then in December 2021 there was a lot of shortage with Omicron. So I had to get involved with those rounds, and that has really helped out — just to walk through the ASC, talking to them, looking at policies and patient satisfaction surveys, talking about where staff is going to leave and how we are going to foresee any kind of staff shortage. 

Q: What are you most excited about right now and what makes you nervous?  

MR: I’m really excited about, after a long time, to have better staff now; the staff shortage seems to be getting better for us here in Kansas. After two years of COVID I think we are finally getting back up to pace. 

The thing I’m really nervous about is the reimbursement cuts from Medicare. I’m also nervous about less young people going into healthcare; I feel like all the way from the front office to prior authorization, from nurses to LPN, that population is getting closer to retirement. I don’t have as many younger people come in, so that makes me a little bit nervous about the future.

Q: How are you thinking about growth over the next 12 months?  

MR: We want to open more outpatient locations. That’s pretty much for everybody, but I think we have really tried to optimize our prior authorization department to quickly get the patient scheduled. If we are going to schedule the patients out because of prior authorization, or if the prior authorization is going to get denied, we have been losing patient spots. So potentially there is wasted space in the ASC — and that’s not a good thing. We’re really working on that, we are trying to start the prior authorization process as early as possible, so as soon as the physician puts the order in any of the locations we start working on it. 

We have hired more nurse practitioners, where they can get patients in for office visits in case the prior authorization gets denied. It’s very hard to do peer-to-peer for us; it’s hard to schedule, it’s hard for the physician to be free, so usually our strategy is to get them for one more office visit to look at the denial letter and then document everything that they need line-by-line.

Obviously just like everybody else we want to open more locations. But the thing that is different then the last few years about growth is that I feel like if we can get our prior authorizations expedited as well as optimized, that will help a lot.

Q: What will healthcare executives and leaders need to be effective leaders for the next five years?   

MR: One thing I think medicine is far behind in: we are not incorporating artificial intelligence. I think this one thing that healthcare leaders will need to use is being used everywhere. For example, there are patients that were in the practice prior to COVID, and then COVID happened and they stopped coming to the practice. Now, they want to come back, but things have changed around telemedicine and they cannot just get back on track. If we have artificial intelligence, for example, it should be able to look at the patients and contact them to say that these positions are available in these locations because so many offices have closed down during COVID. For example, we had to close down a couple of offices in the Lansing area, and those patients did not know where to go. If we had artificial intelligence, we could have done things differently.

I think we as healthcare leaders need to optimize artificial intelligence algorithms. It’s obviously complicated, but as physicians or as healthcare people, we are very far removed from technology in those kinds of ways, and I think in the future we will have to incorporate a lot of artificial intelligence.

The other thing is that we are always working on patient experience. What I have realized looking at patient satisfaction surveys and following our Google reviews, more often than not it’s not the physician experience, it’s the front office experience, it’s the nursing experience. All patients want to feel respected just as a physician does. I think that healthcare leaders really have to enforce that because in the end, we are here for the patients. Just one or two staff members who maybe don’t smile, or say something inappropriate can spoil the whole experience for the patient.

Q: What is your strategy for recruiting and retaining great teams?   

MR: As a healthcare leader, you have to prevent physician burnout. One of the solutions is EMR. You can train a scribe or hire a scribe, or have the patients fill out their portal forms online. The best part about the patient portal is that the patient fills it out in his or her own language. The patient is going to write in the portal in their own spare time; they are way more detailed than what a physician can gather in a short visit. The second thing is that physicians have gone through long years of residency and fellowship, so they work hard. But they also need a good amount of time off. We should be generous with physician vacations. Sometimes the only way for them to take time off is to go to a conference, and that should not be the way it is. It’s really the physician’s choice what they want to do in that time off. In the end we all know there are very few of them compared to the number of people they care for. Locum and intermittent physician care is never the same; our patients need continuity of care. 

Physicians have waited very long to get where they are, that is something we should never forget. They have skipped many birthday parties, haven’t attended many weddings. Talk to the physician, listen to the physician, and connect the problems that are arising in his or her career right when they start.

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