Compromised Quality In A Volume-Driven Healthcare

As we really drove volume, as we increased our volume, the overall quality of care of the individual patient has sort of decreased. We build these massive institutions, we build these massive practices, and then patients are sort of lost in the shuffle. Less and less time is spent overall in patient wellness, and more and more emphasis is spent on trying to channel a patient through to operative intervention. The goal of the hospital system is to get the patient into an operation. I'm not going to say it's nefarious, it's just a volume driven business. Oftentimes, we'll, we'll see practices that are designed around sort of a pyramid where you have non operative specialists who tee up patients and treat them non operatively, do steroid injections, in order physical therapy and that sort of thing, and then those filter up to the surgeons who then see the patient after they failed in their conservative therapies, and then end up in the surgery.