Saum Sutaria, M.D.

You're in and out in 45 minutes plus recovery time from whatever anesthesia you have. What did that do to the hospital? Yes, it moved business out of one setting into another setting. But that's not what really happened. What happened is when it got into a more convenient, quick, high service, manageable setting, more people in the U.S. started getting colonoscopies.

You're in and out in 45 minutes plus recovery time from whatever anesthesia you have. What did that do to the hospital? Yes, it moved business out of one setting into another setting. But that's not what really happened. What happened is when it got into a more convenient, quick, high service, manageable setting, more people in the U.S. started getting colonoscopies.

Because it was easy and it had a screening benefit that's enormous. I credit the ambulatory surgery industry with actually preventing more colon cancers than any innovation in gastroenterology over the last... Because it's now normal to get these... Just to make sure I understand the implication of that, it's twofold.

Because it was easy and it had a screening benefit that's enormous. I credit the ambulatory surgery industry with actually preventing more colon cancers than any innovation in gastroenterology over the last... Because it's now normal to get these... Just to make sure I understand the implication of that, it's twofold.

Oh, I think the total cost is probably much higher.

Oh, I think the total cost is probably much higher.

Per unit cost went way down. And everybody got access, so to speak. More people got access. And it prevented more cancers, which have lots of downstream costs. So the idea of moving things into lower cost setting as appropriate is something we generally have to embrace as a way to manage the total cost, especially if the demand on hospitals is going to go up with the aging.

Per unit cost went way down. And everybody got access, so to speak. More people got access. And it prevented more cancers, which have lots of downstream costs. So the idea of moving things into lower cost setting as appropriate is something we generally have to embrace as a way to manage the total cost, especially if the demand on hospitals is going to go up with the aging.

So what's the next version of that? The next version of that that we're in the middle of is, look, a hip and a knee replacement used to be a four-day hospital stay. Now a lot of it is done on a same-day basis in the hospital, but you can also do it in an ambulatory surgery center in an hour.

So what's the next version of that? The next version of that that we're in the middle of is, look, a hip and a knee replacement used to be a four-day hospital stay. Now a lot of it is done on a same-day basis in the hospital, but you can also do it in an ambulatory surgery center in an hour.

And again, you recover and you walk out the same day and you go home and you do your PT at home and other things.

And again, you recover and you walk out the same day and you go home and you do your PT at home and other things.

It costs about half. That's a big difference. You got your 25%. It's significantly different. One of the interesting questions is why does the device not cost less in one setting or another, but the total payment is half, right?

It costs about half. That's a big difference. You got your 25%. It's significantly different. One of the interesting questions is why does the device not cost less in one setting or another, but the total payment is half, right?

Sometimes with choice comes complexity. You're getting into medical billing, which has some complexity. At the simplest level, we break things into professional and technical expenses. Okay, and I'm going to define technical. But professional may be easier to understand. The surgeon who operates on you gets paid a fee to operate on you for their skill and training and other things.

Sometimes with choice comes complexity. You're getting into medical billing, which has some complexity. At the simplest level, we break things into professional and technical expenses. Okay, and I'm going to define technical. But professional may be easier to understand. The surgeon who operates on you gets paid a fee to operate on you for their skill and training and other things.

And that is their professional fee.

And that is their professional fee.

There are others involved in the surgery. The anesthesiologist who is, again, trained to provide incredibly sophisticated anesthesia to go on heart bypass, et cetera, gets paid a professional fee for that service. Their personal fee for their time. The technical fee is the fee for having the surgery in the building and setting called a hospital in an operating room.

There are others involved in the surgery. The anesthesiologist who is, again, trained to provide incredibly sophisticated anesthesia to go on heart bypass, et cetera, gets paid a professional fee for that service. Their personal fee for their time. The technical fee is the fee for having the surgery in the building and setting called a hospital in an operating room.