Chris Porter, M.D. interviews urologist Arnon Krongrad, M.D., Founder of Allevion, about a new kind of surgeon driven surgery logistics service that simplifies patient access to quality care. The service, Surgeo, delivers flat-fee cash surgery packages that are especially helpful to patients with no insurance. Learn more at https://surgeo.com
or connect with Dr. Krongrad at email@example.com Connect with us on Twitter (https://twitter.com/Surgeo
Chris Porter, M.D.: Thanks, Dr. Arnon Krongrad, for talking to the Op Report today about Surgeo. Please tell the audience what this is, what the model is that you've developed for surgical care.
Arnon Krongrad, M.D.: The model is a logistics model. It recognizes that every patient wants three things: quality, convenience, and choice. When it comes to surgery, we believe that quality comes principally from the surgeon, and so as we seek to simplify access to quality care, we put a heavy emphasis on which surgeons to work with. We use a peer credentialing process. I can certainly get into it in great detail. The point is once we find these qualified surgeons, we wrap their services and everything a customer might want. So for example, anesthesia, facility, implants, physical therapy, and so on. We take these uniformly defined choices of flat-fee surgery packages led by peer credentialed surgeons, put them all surgeo.com and invite the user, principally patients at this point, to do their shopping that way. And of course we have offline support, too.
CP: Interesting. So I suspect that the surgeons hearing about this model for the first time would have concerns about accountability and follow up care. Can you talk about the pre and post-op surgeon-patient relationship?
AK: The beauty what's happening with Surgeo is that surgeons are asking exactly the right questions, like the one that you just asked. This is a surgeon driven model, so, for example, when we first designed our first orthopedic program, total knee replacement, we didn't have a urologist design that package. We had orthopedic joint replacement surgeons design them andthey included what they thought was critical to a quality outcome: pre-op evaluation, for sure, the surgery itself, post-operative care including sessions of physical therapy, and so on. Carpal tunnel includes occupational therapy. Penile implant surgery includes postoperative visits and education in regards to how to work the implant. So the model takes into account the opinions of surgeons.
CP: And a lot of patients are traveling to locations for these packages. How are post-op complications and the physical therapy handled in that?
AK: Every patient travels surgery and that's because nobody has surgery in his living room, so there's always some. Now we don't seek to get patients to airports. That isn't the purpose of this thing and we're not a travel agency, and so what we're trying to do is once we identify highly qualified surgeons is to bring in more of them and to distribute them geographically so actually for the convenience of the patient, including in a situation that you described, you're not dealing with any sort of complicated travel. For example, yesterday one of our patients had surgery in Lake Elmo, Minnesota. It's a suburb of the Twin Cities. He lives in St. Paul. I think most of us would consider that to be a very reasonable distance, so it's possible once you check off the quality criterion, which is something we're not prepared to compromise, then we expand the network. Look, fundamentally choice is a critical element of health services delivery. You have to have quality. You have to have choice. And so we're all about expanding choice through the integration of more and more qualified surgeons.
CP: And has getting liability insurance been difficult, or no?
AK: We're not providers, right? We're not delivering designated health services, ok? So we don't need malpractice insurance. Our surgeons do obviously have professional liability much as you and I have professional liability when we touch a patient, but that's something that goes with the provision of services. It's true for the anesthesiologist, it's true for the facilities, and so on. So that liability rests with them. We carry professional professional and general liability insurance for the work that wedo, which is accommodating logistics. We have cyber security insurance, but we're the logistics company.
CP: If this model produces comparable outcomes and patient satisfaction at lower cost, what's going to prevent this from becoming the dominant model?
AK: Nothing. The reality is that I actually think we're going to get better outcomes than average. I mean if you compare us to just the average surgeon, ok, the peer credentialing process really brings in some really unbelievably accomplished and qualified surgeons. It's not just about peer credentialing. It's not just who do you like and who do you like to have dinner with ...