Welcome And Why Medicine

Dr Andrew Greenland 0:11

I work on medicine. Medical experience of medicine. We're approaching health care from the expectation attitudes towards prevention can be quite different. But many of the clinical operational challenges we face are remarkably similar. So with that, I'd love to welcome you to the show and thank you very much indeed for joining me today.

Dr Sonal Patel 0:52

Thank you for having me here.

Dr Andrew Greenland 0:54

So now could you take us back to the beginning and tell us what drew you into medicine, how your career developed, and how you eventually found yourself leading a medical group in Florida?

Dr Sonal Patel 1:04

Yes, of course. I think from the beginning of time that I can remember I wanted to be a doctor. I'm not really sure why I didn't have any life-changing event that drew me to medicine. It was just something that was fascinating, the human body. And I still find the human body utterly fascinating. It's miraculous. So grew up in South Florida and made my way into college and medical school and completed my residency at Lennox Hill Hospital in New York. My parents, and because I grew up in Florida, I found my way back to Florida in Orlando, got married and moved to the fabulous Tampa Bay. And I will put in a shameless plug to come visit. If no one has been here, it is just the most amazing place. I worked for about seven years while growing my family, and I learned so much about medicine and the business side of medicine that no one ever teaches you in medical school. I know this is becoming more and more apparent to the academia side of medical school. And I believe that the incorporation of business or just insurance is managed here, how to deal with all this, how to deal with people, is um starting to make its way into medical education, but I don't believe it's quite there yet at all. So when you get out of residency, you're really excited to go and perform every single test on every single patient to find every single diagnosis. Because that for the last seven years, four years of medical school and three years of residency is what you have been taught to dive deep and to figure everything out on every patient because that's part of the learning process. It's very different in practice. So I was very fortunate and was able to learn a lot in my first seven or eight years of practicing medicine under my employer. And I took a year off just to rethink medicine and where I wanted to go. And this wonderful opportunity to purchase a practice from a retiring physician came up. I jumped on it, not knowing what I was getting myself into. And here we are, almost 11 years later. I have found my way into learning how to develop, train, retain a staff. And I have found my way up from almost almost being made to feel like I I was too young and I didn't know what I was doing all the way up to being the president of my group. And I think that just took simplicity, um, being open and upfront and observing more than anything. And I'm extremely happy in my practice and where I'm at because now my practice, my patience is very much so word of mouth, because I have expanded and grown my own way that I practice to not just the traditional allopathic medicine that I was trained in medical school and residency, but I've added on to that with the uh little tidbits of functional medicine, longevity medicine, and especially lifestyle medicine. So here we are today.

From Tests To Listening

Dr Andrew Greenland 4:56

Thank you. Love the I'm hearing about the background and the context for all of this. So looking back over the last 21 years in internal medicine, what do you think has changed most significantly in the way you approach patient care?

Dr Sonal Patel 5:08

I believe it's from doing every test possible and having patients come in and out of the room and almost Darren headlights to truly sitting down and understanding the person listening. And that I've learned that medicine is not a blanket, same treatment for every person, same medication for every person for every disease or symptom. You really need to get down to the bottom of it, understand the person, where they're coming from, their circumstances. And if we approach treatment with education of the patient, helping them understand why we are going through this process, I have found so much more success in the quality of life of patients. You can't prevent progression of every disease, you can't prevent um, you know, everything from happening, but you can certainly educate, you can certainly improve the quality of life. And I believe at the end of the day, that's what we're looking for.

A Cancer Diagnosis And Walking

Dr Andrew Greenland 6:12

Thank you. And was there any particular patient experience or experiences that made you rethink what good medicine should look like? And obviously, you've had lots of experiences over your career, but I just wonder if there's anything that jumps out and really kind of shaped what you do now.

Dr Sonal Patel 6:29

Goodness. Um, I would say that there have been quite a few. I have mostly, I would say maybe 60% of my practice is geriatrics. And of that practice, I have seen these patients go from 60 to 70, from 70 to 80, 80 to 90. And when I see these patients age and they're coming back, now I I knew who they were with their partner, very, very active. And now I see them possibly widowed and less functional. I have one patient in particular who just was diagnosed with this aggressive bladder cancer stage three. And he and his wife just obviously broke down and didn't think they could do it. And I called them into my office and explained what was going on. And the first thing I told them was listen, this is a situation that we're in. I'm gonna refer you over between urology, oncology, radiation oncology. They are all going to treat you and help you. But let me tell you what is more important. You need to both get out there and walk every single day. Go enjoy the fresh air and go for a walk. You need to eat clean. You need to stop eating all the processed foods, everything out of a box and a bag. And so many of these little, little tidbits that I gave them on how to just be cleaner and feel healthier overall while they were going through the process of ultimately the surgery. When they came back to me a year later, and it it was a very treacherous road. But when he came back to me and the wife came back to me a year later, they were just deeply, they felt deeply indebted to me. And and I didn't do anything. I just told them, hey, this is this is how we can get through this, and I'm here with you every single step of the way. They're both still with me. They travel the world, they you know, go on trips, they enjoy time with their grandchildren. And it's it's that one particular patient has always, always stayed with me. My mom initially, when I was in medical school and residency, told me, no matter what, no matter what happens, put the patient first. And when I started this practice, there was an older doctor, he was mature and he just retired last year at the age of 76. And he told me as well, the business will come, everything will come, put your patient first. Between my mom and this mentor, I have always felt like I tried to stay true to that. Sometimes the business gets difficult, and we will talk about that, but I feel like at the end of the day, when you have patients like this, it it makes everything worth it.

Dr Andrew Greenland 9:49

Thank

Turning Philosophy Into Practical Plans

Dr Andrew Greenland 9:50

you, Kitchen. That's such a profound message. Thank you so much. So you talk a lot about um individualizing care around the patient's circumstances and ability to make changes. But how do you translate that philosophy into practical treatment plans that patients can actually follow?

Dr Sonal Patel 10:06

So, as I had mentioned before, a big part of treating a patient and individualizing care is listening to them, is understanding their social circumstances, who they live with, who is their social support, what do they have access to, what does their health literacy look like? And how far can it go? How often do we need these patients to come back? Perhaps not with myself, perhaps with a mid-level or perhaps with a medical assistant or a nurse to help keep checks on them. Some people walk in and you have this long explanation of, okay, let's go back and forth and understand where you're at. And they completely understand a few phone calls later, they're on their way. Whereas other patients, I do need them to come in. I actually have a patient right now, a new patient that I saw last Thursday. She came back on Friday, the very next day. She's coming back today. She's coming back on Friday. It's just because she needs that extra touch to help her stay on track and understand and get back on track with her health care and her medicine. Um, just the lack of understanding. It really, really takes, unfortunately, time. Time and listening to the patient. Sometimes in our world, though, we don't have that time to spend with every single patient. And I believe that's where your staff comes in, training and trusting your staff, maintaining similar values. Staffing issues are always an you know a big problem running your own practice or running in any healthcare system, I believe. And finding the people who truly believe in the same values that you do helps create that team of people that will take care of patients and help propel everything forward.

Movement And Food As Medicine

Dr Andrew Greenland 12:10

Thank you. So, thinking about those patients with complex chronic conditions who may be having conventional treatment, how do you integrate your nutrition and movement and other lifestyle interventions with that other treatment going on? How do you make it all work?

Dr Sonal Patel 12:25

Majority of our insurances in the US, and I'm not sure if that is the same thing in the UK. Majority of the insurances for patients that are over 65 do include a free gym membership. This entails not only using the pool, the indoor heated pool, or using the machines, but there are several classes that are geared towards seniors: sit and be fit, chair yoga, senior strength, just very lightweight classes that help introduce the mobility and the independence of movement back into this patient population that has slowly over decades lost their muscle mass. I preach that every single day because I truly feel that movement along with food is medicine. So the other part is food. And I start by saying anything out of a bag or a box is going to be processed to some degree. So if it's bagged or boxed, and this is how I used to say processed foods, and I believe patients used to understand that as um sausage or bacon, deli meats, perhaps, not any of the rest of it. So now I try to explain to them that if there is food in a bag or a box, it had to be packaged somewhere. Where was that packaged? In a factory. So if it was packaged in a factory, then it's probably processed. So let's try to eat foods that look like how they originally were meant to look. Let's eat whole foods, consider a Mediterranean diet. And once in a while, certainly go treat yourself to a treat. But when you bring it into the home, when we are all, including myself, sold on the buy one, get one free donuts or chips. When you walk right into the store, you know, it's a wonderful marketing gimmick. But all of that is hindering health care and hindering um progression towards reducing inflammation in the body. So I really, really try to start with movement and food and break it down that that is your true first medicine.

Dr Andrew Greenland 14:57

Now

Health Literacy And Written Instructions

Dr Andrew Greenland 14:58

you really champion um personalized care. What are the biggest obstacles for other physicians from delivering the kind of personalized care that you like to deliver?

Dr Sonal Patel 15:10

I believe number one is going to be time. And number two is going to be possibly lack of awareness of health literacy of the patient. Patients are going to forget 50 to 65% of what we tell them when they walk out of the door and go home. What did wait, what did they say? I write every single thing down. While I'm talking, while the patient's talking, I am writing every single thing down for that patient. I'm using very simple bullet points. I'm either typing it out for them or handwriting it out for them, but every single patient leaves my exam room with a piece of paper that has instructions on what we discussed. I feel like that is half the battle because they will forget. And so handing out educational material that is personalized by the doctor, not just patient. I used to, you know, you can print patient information from the electronic medical records now. So I used to print patient information all the time. It's just a bunch of papers with a bunch of black ink. And I'm not certain that they ever read any of that or they got past the first paragraph. If they did, do they understand what is being written and how to incorporate that into their lives? So I really have gotten rid of printing out patient information, and instead I write everything out for the patient in real time in terms of what we have discussed. And then I turn around and I roll my chair over and I say, okay, can you read this back to me? Do you understand what is being written down here? And if I need to adjust or make notes, I will. I feel like that is a it takes time, and that is the biggest hindrance, I believe, to many physicians not being able to have the same, you know, interaction with their patients.

Dr Andrew Greenland 17:18

Really interesting. And you said 65% of what you said is forgotten. I think that might be um perhaps another generous. That's a really good point. And I I do the same. I think it's really important to give some kind of follow-up and summary, really good summary of what happened in the consultation. So they really hang on to those key messages.

UK Versus US Prevention Mindset

Dr Andrew Greenland 17:36

Now, you mentioned uh we spoke before that your nephew had a GP in the UK, but I'm observing your practice in Florida. What differences did he notice, particularly around prevention and the way patients approach their healthcare between the two um countries?

Dr Sonal Patel 17:51

He was able to spend some time with me, and he was able to spend some time with some other physicians as well. So he noted differences in the way that I practice with other physicians in the US, and then especially with the healthcare system that is that is what he has known in the UK. And the emphasis on prevention, not just get your screening tests done. Prevention meaning let's reduce inflammation, let's get you moving, let's make sure that physical therapy is a key part of your mobility and getting you back on your feet. Let's make sure that we are involving your family, your friends, your support system to support you in your end goals. So, aside from prescribing medication, aside from referring to a particular specialist, the fact of being able to spend the time to help the patient understand that if we do all of this now, we will prevent your end stage um goal or your end stage issues, such as a cardiovascular event, perhaps, or that fall that is going to perhaps fracture your hip or your wrist or your arm. Um he felt that a lot of that was very different compared to how the practice is in the UK. Um probably because private insurance is present here. Our healthcare system issues are very similar in both countries. There's insurance issues, there's referral and specialty issues, there's obstacles in terms of trying to get and create a good value-based system for both patients, both here and over there. But the difference, and I think the movement that's starting, definitely starting, but needs to gain a lot more momentum in the general population of the healthcare um groups over here, is not just primary prevention with screening, but also with reduction of inflammation movement and food. And I think he found that he found that very interesting and very positive. And hopefully he can take those points back home to you, um, to the UK, and incorporate that back into his own practice and maybe start a movement that's a little bit bigger over there as well.

Dr Andrew Greenland 20:34

Thank you. And with those discussions you had with him, do you think American patients are more accustomed to taking an active role in their healthcare, or is the reality more complicated?

Dr Sonal Patel 20:44

No, it's it's definitely easier than said. I believe for the patients and the people who have health literacy, for the patients who are reading the news every day or are understanding it on top, and especially have a great social structure where the older patients or children are involved in their health care. I believe it's easier. But that's not the majority of America. So I practice actually in a rural area. It's not rural, um, it's suburbia, but it is considered an area of critical need. And it is a place where patients need to be educated. If they understand, then they can move forward. But when coming from a place, and many, many patients come to me, well, I just don't want to be prescribed medication. I don't know what it's for, I'm not going to take it. And I still have patients in my practice to this date, no matter how much I tell them and explain to them, and make sure that they want to take this medication and know why they're taking it before I prescribe it, still come back because, like we said, they forget. What we tell them and what we discussed, and they forget that they understood while they were in the exam room with me. They come back a couple of months later. Oh, well, I wasn't really sure. I I felt like I wasn't, I was feeling fine. I I don't have any chest pain. Well, no, you don't have any chest pain. You have atherosclerotic heart disease, and we're trying to prevent that chest pain. And that is why you are on these medications. So it's still a definite battle.

Staffing Systems And Follow Up Actions

Dr Andrew Greenland 22:32

Which brings us to something I'm particularly interested in. The challenges of delivering the medicine we want to practice while we're um running a sustainable model. So, first of all, could tell us a little bit about your practice itself. What is the setup that you have where you're working? Um, what's your sort of staffing and what's your sort of throughput? And how do you run the practice?

Dr Sonal Patel 22:53

So I have a mid-level that works with me, a nurse practitioner, and I have two medical assistants. I utilize them greatly for education, for follow-up, for callbacks. I have finally been able to figure out in my electronic medical record how to create actions. And where I felt like maybe it was tedious before, I now utilize those actions on a daily basis almost with every patient, where I'll go in and I'll set a one-week reminder to my medical assistant saying, hey, call this patient back and follow up and see how her how is she doing on her search ralene that was prescribed? Is she having any side effects? Is she tolerating it? Is she taking it? Um, you know, two-month action. Did this patient get her mammogram and her bone density test done? It was due last month. Let's just follow up and make sure we have those results. But also, you know, is she understanding why she needs to have it done? I think compliance is a really, really big issue, um, especially in majority of the populations that are not in big cities. I mean, even for ourselves as healthcare providers, you know, we're not necessarily the best patients. So having that follow-up, my mid-level understands and has been trained, and we've discussed that education, education, education is really, really important to me. So she is wonderful at educating patients on my on follow-up visits after I see them. I'll have her, I'll have them come back right away, maybe a week or two, three, depending on the patient's ability and availability to come back and say, hey, sit down with her and have more education on what's going on. Why do we need these diabetic medications? Okay, let's break down your diet. So I feel like my staff is integral and and has the same values that I do, and is that I'm not able to see every single patient, every single follow-up visit, and have the success that I have and improving quality of care of every patient. So I feel that when you work with your staff and help them understand why it's important, just like we help the patients understand why it's important, it becomes something that slowly grows into success. And that's where your practice goes, grows into word of mouth. Um, sustainability of the practice is really important. So I cannot spend an hour with every patient out of the eight hours of the day and still have time to review the documents, the labs, to write out the charts, to do everything. Um, of course, much work is done later, but I truly believe that that's where integrating some technology and AI systems comes into play. Um just over the last year, I believe that there's been significant momentum in how AI systems are being and scribes, AI scribes are being incorporated into our practices, which helps create a greater hands-off approach in terms of typing while the patient is talking and instead looking the patient in the eye, having the ability to just have that deeper conversation while there's a scribe that is writing everything down and that we're able to go back and just review and make sure that it's accurate.

Dr Andrew Greenland 26:32

Thank you. So you've already had a lot of success, and the model of care that you want to deliver is something which is very meaningful to you. But what are the kind of the biggest challenges and bottlenecks in running your practice day-to-day at the moment, or things you've had to overcome recently to make all of this work?

When New Check In Tech Breaks Flow

Dr Sonal Patel 26:50

Speaking of technology, incorporating a system where we can have patients check in ahead of time and then confirm their appointments and virtually check in on their phone when they arrive at the office has been a great just setback, I believe, for us this year. It's taken a lot of manpower from our side and a lot of time to help patients understand how to navigate, complete these forms. Um and I believe that would be for any system that's new. It's it's taken the staff time to incorporate it, check-in, check-out, referrals, all of that stuff, as well as then teaching the patients hey, you know, many patients are very resistant to technology, especially older patients, very resistant to checking in. And so we've had some serious bottlenecks where patients have not been able to be seen half an hour later, 45 minutes, an hour later after their time, and it backs everything up. So we have been navigating through that. We implemented it at the beginning of the summer, which I highly recommend for everyone. If possible, if you're going to make big system changes, try to do them towards the beginning of the summer when many people are wanting to go on vacation, a little bit lighter months. But when you start getting into the fall, kids go back to school or the winter months when there's a lot of sick visits and people are coming in because they're just not feeling well, it becomes very hard to implement new systems. Um, so I'm glad that we have the foresight to implement this towards the middle of May. But we have been navigating it and it's it's been a very, very big bottleneck for me this year. But thankfully to say, we are getting through it now, and everything has has calmed down. The wave is kind of you know reaching a balance.

Dr Andrew Greenland 28:47

Really interesting. So, from what I'm hearing is that the technology is there, the process is there, but it's more a case of the uptake from the patients and the staff to actually make this work. Is that right for the one here?

Dr Sonal Patel 28:57

Absolutely. And with an app, with the technology there, we have weekly, I have weekly meetings with the company that provides our technology in little nuances. This is how we can improve. And I'm very thankful that they have been amenable to making these tiny little changes. It's it's code, you know, at the end of the day, everything is is coding. And um, so thankfully, I'm able to understand that okay, please go back to your software engineers and and coders and say, okay, this is how we need to navigate this, and this is where we need to reroute this. Having leadership understand what the problem is and where we need to go and what solution might work best, and then relaying that is definitely something that is really important instead of having somebody else in the office relaying that, somebody else in the office and a third party communicating to someone else, much is lost in translation. So my practice is my own. However, my model of my business and what we have is eight different positions that all have their own practices, and we all share our common staff, such as check-in, checkout, referrals, billing. And so the entire partnership is what we have. The entire partnership has incorporated this new technology. So that is what I am the president of. And so being able to navigate and understand nuances from my staff, from my patients, from other doctors, and then going back to these weekly meetings and saying, okay, this is what we need to change. This is how we need to make it easier. Let's take this off. It's it's really created something now, finally in October, that we're able to get through with these.

The Real Cost Of Time With Patients

Dr Andrew Greenland 31:02

So it sounds like you've cracked that sort of IT aspect of your process. But what's what's perhaps the biggest current drain on your time, energy, or money in the business as an owner founder?

Dr Sonal Patel 31:14

Truly, I think it's still sitting down with patience and spending the time and therefore seeing less patience in a day. Um at the end of the day, you know, it is a livelihood, it is a business, and we have to keep that in mind. But if the patients are healthy and the patients are happy, the practice will organically grow. So if it's growing, where do you put all these new patients? You want growth, you want to have a good business model, you want to be the person that your patients trust. You are their medical home, not just you, but also everyone that's involved in the practice. All of you come together as a medical home. And so I believe patients having access to speaking with somebody when they have an issue or a concern, training and having the right staff to be able to help support me has been a challenge. With every level up, nurse, mid-level, uh, nurse practitioner or um a PA, physician's assistant, everybody also gets paid at their level of education and expertise. So understanding how to balance all of this, the finances and all of that, but providing excellent medical care that helps me feel good and helps me sleep at night and helps me know that I'm making a difference in the world. One patient at a time is really important, but it's it's definitely something that I'm still working through. And as I mentioned before, I do utilize my nurse practitioner and my medical assistant greatly in helping follow up and educate. And I believe that's what helps my system work the best.

What Keeps An Owner Up At Night

Dr Andrew Greenland 33:14

Thank you. So, in a sense, the practice is like having a baby, I guess we call these things our babies. So what keeps you up at night when you think about the business as an owner-founder? Because it's more than just the business, it's your personal, it is your baby, I guess.

Dr Sonal Patel 33:30

It sure is. Um, sometimes it's patients, you know, in the moment, and I I do research, I will tell patients, you know what, this is what we're gonna do for now. However, I'm going to reach out to colleagues about this, I'm going to do a little more research, and then I'm going to give you a call back. Being up front with patients, I feel like they really appreciate that. Um you go in expecting your doctor to know everything. But in this day and age, in the vastness of medicine and how fast we are finding things in science, how fast everything is being discovered, we can't know everything. We have to know when we need to stop and research and reach out. So sometimes in the middle of the night, you know, you wake up and you think, oh, you know what? I have this brilliant idea. I could look into A, B, and C and reach out to this person. Um, I always keep a pad and paper next to my bed and I'll write it down because I don't want to stay awake thinking about it all night. But um, I find that with patient care, that's one of the things that keeps me up. But I'm always coming up with new ideas for the business in terms of what are other things that we could do, like keep little, we have a pretty good lobby. So, and we do have a few doctors that love to educate and speak, and sometimes are nurse practitioners, sometimes calling in a yoga instructor to teach some sit and be fit to all of the patients, whoever wants to show up. Um, tiny little nuances of how we can make this a more holistic and wholesome approach for the patients, those ideas seem to come to me sometimes in the middle of the night. Um, and business-wise, is always how do we become more efficient and cut overhead without compromising patient care? I believe that's going to be the bottom line for everybody.

The Dream Of Seamless Care

Dr Andrew Greenland 35:39

Thank you. So if you had a magic wand and you could fix one thing in the business by tomorrow, what would that be, if anything?

Dr Sonal Patel 35:48

Ooh. I still believe it would be the whole process, it would be technology, and it would be the process of having the patients seamlessly be able to check in, come in, and we still do whatever we do in terms of providers. So the vitals will be taken, wait, etc. We speak to the patient. They then check out and are on their way, and all of this is done without necessarily constantly typing on the computer. It's done with eye contact, with empathy towards the patient, with the patient knowing that at every step of the way, from the moment they walk in the building, my medical assistant is going to get someone's checking them in with a smile. My medical assistant is coming to get them. Um, I'm discussing everything with them. They're getting what they need on the way out. And all of this is seamless. That would require still improved technology integration and AI that I believe is being worked on. It's definitely not there, um, but is being worked on. So that I believe if we could have that portion taken care of with accuracy and efficiency, then we all could provide much better care.

Leading A Group While Clinicing

Dr Andrew Greenland 37:21

Thank you. Now, as a medical group president, how do you balance the responsibilities of being a clinician with the demands of leading the organization, particularly when you know business pressures threaten to compete with patient care? How do you kind of approach this?

Dr Sonal Patel 37:37

I get asked that question all the time from my staff as well. Um I love it. I love the drive of thinking of new solutions and figuring things out. I love learning. I feel that in our field and every field, we should continually learn. Um, that is what helps us grow. And it keeps obviously it keeps our mind active, you know. But I'm not complacent. I'm I think it's great to be content and happy, and I'm I'm very happy in my practice. But now being president, understanding the nuances and helping others, and especially younger doctors that come into the practice, helping them grow and situate their practices and be at a level where I am now is something that makes me really happy. So I love speaking to insurance provider leadership or to like our technology, um, even the coders, you know, like get me in on that conversation. So I will try to put in 15-minute pockets or 30-minute pockets where I can to have these meetings with people so I can understand from the bottom up what's going down, what's going on in order to improve, you know, the practice as a whole between everybody, and then just to be a good leader.

Dr Andrew Greenland 39:10

Wonderful.

What We Still Need From AI

Dr Andrew Greenland 39:12

You've talked about AI and you obviously got some AI processes um starting to forge their way in your practice. Is there anything you'd like it um to do that it's not currently doing? Or is it just more about um the processes are there, but it's about you know the uptake from the patients and your staff that actually make these things work?

Dr Sonal Patel 39:32

I believe, even though it's evolving, I believe that it's there. It's just integration with accuracy and efficiency into my medical record system, or into and what I've heard from so many colleagues is into their different medical systems as well. Going back, reviewing all the charting, ensuring that there's not something that is written down that either wasn't stated or then was made as an assumption. Um, so we still have a long way to go in terms of me speaking and my whole conversation with the patient being accurately represented in terms of what I would like to do and having those orders processed. If I'm discussing, okay, let's go ahead and start an ACE inhibitor, um, you know, 10 milligrams, and you know, take it every day, whatever I'm discussing, low salt diet, try to go for daily walks. How do we look on that? Making sure that all of that is done, the medication is sent, all of that is still not something that is in place. And I but again, I believe that we are getting there. Um, it's just gonna take a lot of work in order to create that seamless incorporation.

Preparing For The Medicare Surge

Dr Andrew Greenland 40:59

And finally, where would you like things to be in the next 12 months? What are your kind of plans for the future with the practice?

Dr Sonal Patel 41:06

Our practice is currently definitely growing. Um, we have these periods here in the US, which is actively going on right now from October to December, middle of December. Patients who have Medicare over 65 or have disability are able to choose new insurance plans, are able to choose new doctors. And in that, there's a lot of growth, and all of that starts January 1st. So January 1st to about end of March becomes extremely busy for most practitioners getting in the new patients, um, getting them situated and on their way before they either go back up north for the summer, um, just navigating that whole process. That's a big bottleneck that can happen because you have an influx of a few hundred new patients amongst all of the doctors in the practice. How do we make that seamless and make them feel like they are a priority while also keeping up with our patients that are already existing? So that navigating that whole process where technology and AI can really help out. And so that's what I'm working on for the next 12 months is trying to see where we can incorporate technology and AI in order to help us navigate this, because it happens every single year, you know. So, how do we make this burden easier on the patients, the staff, and then of course the practitioners?

Closing Thoughts And Thanks

Dr Andrew Greenland 42:48

Thank you so much for joining me. Fascinating, interesting conversation. Thank you for sharing your insights and your expertise. Think about your model of medicine that you'd like to deliver. Um talk about AI and how that's your practice. Thank you. We appreciate it.

Dr Sonal Patel 43:21

Thank you for having me.