Scott Webb (Host): If you're like me you don't like going to the hospital and you also like a one-stop shopping approach to medical care, and that's why office-based lab care is music to my ears. And joining me today to discuss the many benefits of office-based lab care for patients and their Doctors is Dr. Stratton Danes. He's a board-certified vascular surgeon with the Vascular Care Group.

 Welcome to Answers in Vascular with the Vascular Care Group. I'm Scott Webb. Doctor, it's nice to have you here today. We're going to talk about office-based lab care and what that means exactly, and maybe I'm just speaking for myself, but i feel like some listeners out there are going to nod their heads as well, I kind of hate going to the hospital for procedures. So just wondering, in general in your opinion, why is office-based lab or OBL better?

Dr. Stratton Danes: I guess that's a two-pronged question. It depends if we're going to take it from the patient side or from, let's say, the physician delivering the care.

Host : Sure.

Dr. Stratton Danes: So if we talk about, first, the patients which is ultimately the most important person or individual in this equation, an office-based lab is a facility where patients come to see their doctors, but it's also a place where they come for diagnostics. We have ultrasound lab in our OBL. So, we see patients, we can schedule their ultrasounds, which are vital in our type of care or delivering vascular care.

And then, my ultrasound people that know me, know my protocols, know what I'm looking for then give me reports that then we have another appointment sometimes with the patient, we can go over things. And then, let's say we're doing procedures. The procedures themselves, a great deal of them, are done right here again in the same space. So, it's one space where you're seeing the clinician, getting a study and sometimes getting your care delivered. And it's the same entrance, it's the same front desk people, the same environment, you know where the parking is. It's not on one side of the hospital one day and another side of the hospital another day. It's very easy and it's really good for our older patients because it's very simple. They know once they come here the first time, they know it and never forget it. And I think that's great for a lot of patients.

Host : Yeah. It does feel a bit like one-stop shopping, which I can really appreciate. And you're so right about the entrances. I just was going for physical therapy at the hospital. And then, I showed up one day and that entrance was closed for some reason. And I had to go find another way to get to physical therapy. And I thought, "Well, this is just frustrating." So, we get a sense there that it's kind of one-stop shopping, you can kind of do everything there, same door, same staff, all of that. What can we expect on the day of a procedure?

Dr. Stratton Danes: So, if we're talking on the day of a procedure, you are going to again walk in the same space as you always have. My nurse will take you out of the waiting area. And bring you back to the procedure room. And the nurses that you've actually maybe already seen in the past are familiar, you're seeing them again. They will get you ready. Some of our procedures require an IV in the hand so that we can give you some sedation and make the procedure less uncomfortable from an anxiety and discomfort side.

From there, it's about then five yards into the procedure room where you have the procedure done. And then, five yards back out to the recovery room in the same space with the same person still at your bedside. We don't have any transition of care. One of the nice things we do is the nurse that's kind of in charge of you goes into the room with you, comes back out with you and is sitting with you at the bedside until you leave, and it's one person, it's one name. And I think that creates a more comfortable and inviting environment for the patient.

Host : Yeah. It certainly sounds so. And just wondering, give us a sense of how long are folks generally there? Maybe it depends on the procedure, of course. But in general, how long can we expect to be there?

Dr. Stratton Danes: Usually, we're looking around less than three hours. Sometimes two and a half hours from door to door, meaning your door of your car, leaving to your door going back in if you want to say. Or maybe the better way to say when you walk through our door and then leave our door, it's usually only about two and half hours. The procedure itself usually is about an hour, hour and a half, fifteen minutes to prep up and then about an hour of recovery. Some of our simpler procedures, sometimes our vein procedure patients are in and out in forty-five minutes.

Host : Yeah. That's amazing. So, somewhere between forty five minutes on the easy side and then maybe as long as three hours, which doesn't seem so bad.

Dr. Stratton Danes: No, its not. You know, I had carpal tunnel surgery done at the hospital, which is i think a fifteen-minute procedure in and of itself. But it still is two hours' worth of time in the hospital, and that's the simplest surgery you can have at the hospital. And it still took a long time just with paperwork, checking in, going in, coming out. And so, I think our patients really appreciate the efficiency of the system when we know in this day and age, healthcare efficiency is not something that is used to describe healthcare delivery in the United States anymore, nor is friendly and accommodating, and that's another thing that I think we are. All those words describe what your experience is here at the OBL. And we have one office manager that you can call up. And if you haven't been happy with your care, you talk to my office manager, and then she will directly talk to you and rectify it. It is very-- I don't think the term is tangible, but touchable, meaning like it's so accesible here in our office compared to working through a phone tree, working through "I don't remember who saw me." You know the people that are delivering your care. My staff is consistent. We're not turning people over. And in your follow up, three months out, six months, a year back, you walk in, and it's the same people still here. It makes you feel that at least this place is stable. You're creating a good environment for good execution of healthcare, because your staff knows you, knows the patient, and it makes it less chaotic.

Host : And, Doctor, what i told you on the the first question that I kind hate going to the hospital and asked you why office-based, OBL, is better, and you said, well, maybe from two perspectives. And we kind of talked about the patient's perspective, but I want to hear from your side of things. Why do you prefer OBL versus the hospital?

Dr. Stratton Danes: I've worked for hospitals before. And so, the problem with working at the hospital is time management. So, if you are working at a hospital, even your office isn't going to be where you're actually doing your procedures. It's not where your ultrasound lab is. It's all spread out. So on a day that I'm doing, let's say, office, I'm sitting at my desk but i can also go into the procedure room, do a procedure in between patients. I'm more efficient here. I can read out my diagnostic reports I can do. I can correspond with primary care providers, referral doctors. I can return phone calls to patients. My nurses are just a couple doors down, they come in and they say, "Patients need this," "Pharmacy is unclear on this." And what it allows me to do is to multitask and get things done again efficiently and effectively from one spot. And so, my days are much more productive, which prevents burnout, creates a better work environment for me, which then translates all the way down. If the doctor is in stress, then he's not making people around him stressed, which then means the patients don't feel stressed, and it just kind of filters down in a good way

Host : Yeah, it kind of trickles down, right?

Dr. Stratton Danes: It trickles down.

Host : Yeah. So if you're not stressed, your staff isn't stressed, the patient feels, you know, safer, more comfortable, more confident in the care. I mean, it all just makes sense to me. And just kind of wondering about resources there at the office. Do you feel like you have everything you need compared to the hospital?

Dr. Stratton Danes: I mean, from what we're trying to do, so in the OBL, the office-based lab, we do, we'll call it two categories of procedures. We do venous work, which tends to be more of your varicose veins, painful, swollen legs. And those are procedures that we do here in the OBL very easily. And we also do very advanced artery and venous reconstruction work in our angio suite, which with the amount of equipment we have, with my staff that are so experienced since we're doing multiple procedures a week, we are executing extremely complicated cases here in our office-based lab more than I've ever done in a hospital. Because we do such a volume here our office, we're able to be on the cutting edge of equipment, imaging that allows us to take care of our patients better.

Host : Yeah. I'm picturing sort of at the hospital and folks sharing robots like the da Vinci robot or things like that. I'm guess it gets nice to-- if you'll pardon expression-- like no one else plays with your toys, so to speak. You know, your resources, the things that you use and the suites and things, you know who's been using them, how they've been cared for, cleaned, all of that good stuff, right? Is that a comfort for you?

Dr. Stratton Danes: I think it is. I mean, I share my office with one other partner. We kind of split our days using the big equipment. And even better than what you're saying, meaning we know the equipment, it's the same equipment, it's the same operators all the time, they know my preferences. It's not that on this Tuesday depending on the staffing, there could be Bob, Jane and Joe, but the next day it's Mary, Scott and Tim. And they know me, which means I don't have to sometimes even say certain things. I can stay focused on the fine details of the patient that sometimes you get distracted when you don't have staff that are well-trained. Again, we keep coming back to effective and efficient and excellent quality care because of that. We're also very adept. If we see new technology that we like or that we're interested in and we want to bring it in, we just have to agree among ourselves. I don't have to ask an administrator whether I can have approval for something. If it's been deemed to be safe and effective, and we can bring it in, we bring it in because we're driving the delivery of care here. We're trying to deliver extremely high quality care in our OBL, and we're in charge.

Host : Yeah, right.

Dr. Stratton Danes: The doctors are in charge in the OBL. And I think that's a good thing, and I think that's something that's been lost in the hospitals. Doctor used to run the hospitals, and we don't anymore.

Host : I see what you mean, yeah. So, you have a sort of a short hand with the folks you work with there, right? They just know how you like things and you don't even have to say things, it's just understood. "Well, this is how doctor likes things." And then, as you say, not nearly as much or any red tape. If you just know you need something. It's been proven to be safe, you know, and effective, well, then you can get it and you can use it and deliver that high quality care. It's awesome.

Dr. Stratton Danes: I think that's one of the things. So again, as we said, the first question you asked, and i said it's two-pronged. If you're fighting less to do things, then everybody is doing better, the patients are doing better, and then your staff is doing better, which then creates a happy environment for your staff, which means then they're here and they're executing well. And so, you bring everybody with you

Host : Yeah. What's the expression? A rising Tide lifts all boats. Is that right?

Dr. Stratton Danes: That was actually the expression I was trying think of. As I get older, I think I lose more knowledge and get more focused in my world. I kind of become more less of that well-read person that I was in college.

Host : You know, Doc, I get paid to say words and you get paid to perform these, you know, really important procedures, really helping people, perhaps saving lives along the way, so it's all good stuff. We're all carrying our weight here. i really appreciate your time today. Nice to learn. As i said, I'm not someone who really likes to go to the hospital so nice to know what OBL is and how it works and what i can expect. And I'm sure all the listeners agree. So. Thank you so much.

Dr. Stratton Danes: Oh, you're welcome. Thanks for inviting me. .

Host : And for more information, please visit our website at thevascularcaregroup.com. Thank you so much for listening to Answers in Vascular with the Vascular Care Group. I'm Scott Webb. Thanks for joining us.