fbpx

Connect with Dr. Sanjay Prasad:

About the Guest:

Sanjay Prasad, MD, FACS
CEO of SurgiPrice Inc., and subsidiaries SurgiQuality and SurgiConnect

Sanjay Prasad, MD, FACS graduated magna cum laude in Biochemistry from the University of Maryland. He then attended Johns Hopkins affiliated hospital to complete a surgical internship. From here, Sanjay completed residency in Otolaryngology Head & Neck Surgery (Ear, Nose & Throat) at Georgetown University Hospital. Sanjay continued with his studies and completed three fellowships at the University of Pittsburgh Medical Center in Neurotology, Cranial Base Surgery and Advanced Head & Neck Oncologic Surgery.

After his training, Sanjay started a solo private practice, Metropolitan NeuroEar Group, in the Washington DC area. He dedicated the first 25 years of his career to otology, neurotology and cranial base surgery. Many patients would come to Sanjay for help with hearing loss, vertigo, acoustic neuroma, cholesteatoma, glomus tumor, mastoiditis, Meniere’s disease, stapedectomy or cochlear implant surgery and skull base meningiomas.

In addition, Sanjay has published several articles, is an in-demand speaker and is a clinical assistant professor at George Washington University Hospital.

Sanjay decided he wanted to help improve healthcare and founded SurgiPrice, Inc. and subsidiaries SurgiQuality and SurgiConnect in 2014. His mission has always been to educate patients about their condition and help patients avoid unnecessary surgery and, when necessary, help patients connect with best-in-class surgeons who operate in a cost-efficient manner.

About the Episode:

In Episode 13 of Entrepreneur Rx, I have the pleasure of speaking with Dr. Sanjay Prasad, a surgeon, and physician with over 30 years specializing in Neurotology and Otology. Sanjay is the CEO of SurgiPrice, SurgiQuality, SurgiConnect, and the author of Resetting Healthcare.

Sanjay shares his background, how his companies allow patients to choose their surgeon based on quality scoring, what his company is focusing on now, his monetization strategy, and advice for others interested in becoming entrepreneurs. His insightful and enlightening discussion is one you won’t want to miss.

Entrepreneur Rx Episode 13:

Rx Podcast_Sanjay Prasad: Audio automatically transcribed by Sonix

Rx Podcast_Sanjay Prasad: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

John Shufeldt: Hello everybody and welcome to another edition of EntrepreneurRX, where we help health care professionals own their future.

John Shufeldt: Hello and welcome to another edition of EntrepreneursRX! I am thrilled to have Sanjay Prasad on. Sanjay is a physician, he's an otolaryngologist, he does skull-based surgery, among other things, he's had an incredibly distinguished career and I'm excited to have him on. Sanjay, how are you?

Sanjay Prasad: It's a pleasure to be on your show, John. Thank you so much for the invitation.

John Shufeldt: I really appreciate it. Ok, you've got a really cool background. Can you like just for people who are listening, because once we get into the story they are going to wonder how you came up with this idea and whereabouts it had come from, so can you kind of go over your background a little bit?

Sanjay Prasad: Sure. You know, I was born in India. I came here in 1962, I was a year old, and my parents came here really looking for a health care solution for someone in the family. And you know, we grew up in the Washington, D.C., area found the solution 30 years, otolaryngology, head neck surgery, I do neurotology and skull-base surgery, and I've been practicing for 30 years and several years ago, you know, I just realized that the system is not working on behalf of the patients, especially the referral system to surgeons, the patients are lost, they're getting surgery they don't need. It's just a mess. So we're trying to disrupt that whole, disrupt is probably a powerful word, we're trying to improve that referral system, if you will, to surgeons. If that makes sense,

John Shufeldt: It makes total sense. And this is, this may be one of those TMI moments. But I recently had a schwannoma removed.

Sanjay Prasad: John!

John Shufeldt: And so I went and I found a gentleman I knew of when he's a neurosurgical resident who did skull base surgery, went to him and the otolaryngologist, got this skull base surgery and had this removed in a 10-hour procedure. And so I'd always remark and I had it pretty easy. I drove over to California. He was in the hospital on Thursday morning, ICU Friday. Drove myself home on Sunday and it was pretty easy. But I always thought, god, what do you do if you're not in medicine? Because even though I was a medicine, I still, it still took a while to get there, to get to see someone like you. How are you improving that?

Sanjay Prasad: Well, we're improving it by using two things. One is a personalized concierge service that handholds patients. You know, patients are told they need surgery and then a whole medical records distribution platform, all HIPAA compliant, which brings your medical record and your imaging, your DICOM files up to the cloud. And then we send it to all the surgeons in your network, in your geographic area for review and they validate necessity, they put in alternatives to surgery if that's indicated, and they also put in their past experience, how many they've done, success rates, complication rates. We corroborate that, we compare them, score them. Patients are now able to choose their surgeon based on quality scoring, very specific to their condition, very specific to the surgery they need.

John Shufeldt: And how did you come up with this idea?

Sanjay Prasad: Well, you know what's happening today, John, you and I both know this. There's a referral to a surgeon made either from a primary care doctor or from an emergency room visit or urgent care. But there's just not enough time to spend thinking about the cost of the care, not enough time spent thinking about the outcomes of surgical outcomes. So we're trying to empower primary care physicians and our emergency room physicians to make that referral based on cost and quality. It just makes a ton of sense to us.

John Shufeldt: Yeah, it makes total sense, but it happens retrospectively, right? So for example, me and the emergency department I say go to, is it a website that I'll refer patients to and they upload their information?

Sanjay Prasad: So it can happen pretty easily from the emergency room. It's a simple call or referral to our concierge service. We take it from there. All patients need to do is to sign a HIPAA release that allows us to aggregate their records and send it to multiple surgeons. And we do all the magic on the back end. We source their medical record, we source their DICOM images, send it up to the cloud, and then off we go. And then the patients essentially get a list of surgeons who have opined on their case, you know, they've got a swollen knee, they can't get in and out of the car, they can't get their clothes on, it's so hard to do. And then by the comfort of your home, you get all these opinions. So it just makes so much sense.

John Shufeldt: I have to tell you that this idea is genius, and I don't say that about a lot of ideas, but this one I absolutely love. There's a company I started a number of years ago called Healthy Bet, which was not as sophisticated as yours, but it was based on price. It would allow surgery centers and surgeons to bid on folks, in outpatient elective procedures. Hey, we've got an opening on Tuesday morning, or always flow. We'll do your total knee for X.

Sanjay Prasad: Yeah.

John Shufeldt: And didn't go anywhere, and it was a little early. But the thing that was missing is exactly what you're doing, which is embracing and tying these quality outcome measures, how has this been received?

Sanjay Prasad: You know, it's been very well received in the surgeon community, I can tell you, my colleagues absolutely love this. And every surgeon, John, is very proud of their outcomes, so this gives them a chance to kind of brag about their outcomes. This is great for them, and the surgery centers love it because they're getting their operating rooms filled with cases they wouldn't have otherwise seen. And we're also, John, it's really interesting what's happening. These cases are peer-reviewed before they get to the surgeons, you know, a technology, whether it's an app or iPad or website. So they're peer-reviewed, necessity has already determined, it's actually lowering their malpractice risk. And in fact, I think when time, it's going to lower their malpractice insurance premiums, it's a win-win for everybody, not only for them, but also for the surgery center and for the hospital to lower their malpractice risk.

John Shufeldt: That's really interesting. Now there's a male medical student I worked with, and he came up with this prospective analysis based upon a database query of patients who are walking in, and he did it for the emergency department. I said it doesn't help us because there's some .... We're seeing them, no matter if they suit every physician they've seen. However, though, if you were a surgeon and you see this patient, I mean, who sued other physicians four times, you're going to think maybe not a patient I want to deal with, and it'd be an interesting tie-in to vet patients much like Uber. You know, you call up Uber and they say, oh, this guy's a jerk, he's always rude to us, we're not going to pick him up. It'll be interesting to add that component to what you're doing.

Sanjay Prasad: Absolutely. I mean, there's always a room for more innovation, no question. But, John, you know, one thing we've been studying for the last six months is this issue of racial disparities in surgical outcomes. And you know, your audience may not be aware, but you know, black patients when you compare to white patients uniformly seem to do worse with surgical outcomes, and with ovarian cancer, you can talk about kidney transplant, you can talk about, you know, gastric fundoplication, you can talk about hepatocellular carcinoma. They have higher mortality rates. They're not getting referred to high-volume, high-quality surgeons. You know, this disparity is happening. And you know, the group had Brigham wrote a beautiful meta-analysis of 88 articles in 2013, but there's no solution. So our system is a solution for this because when we send the records to surgeons, surgery centers, and hospitals, we are anonymizing, we're sanitizing the records for name, race, and ethnicity. And so we are, in fact, are applying for an SBIR grant through the NIH to study this. And so we're really excited because this is a very powerful solution to level the playing field for black patients.

John Shufeldt: So that's incredibly near and dear to my heart. You know, I work in an inner-city emergency department. We have a business that does all of our care in indigenous areas. So I've become incredibly sensitive to the racial and socio-economic disparities about the way patients are treated in the U.S., and I don't think I realize that until going out on the reservation, and you are absolutely right and I read that study and it frankly, it's embarrassing that there's two levels of care and two levels of quality or more in the U.S. right now, and it's shameful. And so I think what you're doing, I didn't think of this until you said it, of course, that it's the dougie's out there, right? It's making patients anonymous. Now, they're just, hey, this is a patient with a schwannoma.

Sanjay Prasad: Right!

John Shufeldt: Nothing else matters and nothing else should matter.

Sanjay Prasad: You're right. And you know, and we're blinding also insurance. So why does the surgeon need to know the insurance? Just make the best decision you possibly can based on the records and based on the pathology, it just makes so much sense.

John Shufeldt: Now, how do you say some of your system is sophisticated enough that it stays in-network? So, for example, health care, you get the information from the ED. They say, hey, Shufeldt has a bio... fracture. It's elective. He needs an orthopedic surgeon. When you send it out, you send it out to only United Healthcare orthopedic surgeons in my area, in-network, obviously?

Sanjay Prasad: Yeah. So we're we've gained a tremendous interest with Blue Cross Blue Shield, and they're very interested in connecting their members to the best in class surgeons within their network. And not only that, you know, the employers love this because now this solves some of the discrimination issues with surgical outcomes there as well. And they want the best of care. But patients sometimes end up seeing an out-of-network physician, and they just don't realize that there may be surgeons within the network that have better outcomes, more volume, more higher quality than who they've seen. So this is a great way to get patients from out-of-network situations into in-network situations, drop their deductibles, drop the cost for the employer. It just makes so much sense.

John Shufeldt: It does, it's a little, it's like the triple aim, and now literally everybody wins.

Sanjay Prasad: Yeah.

John Shufeldt: How is this monetized?

Sanjay Prasad: So we charge the health plan. We charge them a subscription fee per member, per employee, per month, and then we can also charge a concierge fee. We're very flexible on our revenue stream with whatever works, you know, look, we've gained so much interest from Blue Cross. We've got two Blue Cross plans that are very excited about this. They've referred us to the Association of thirty-six other Blue Cross plans, and we've got a Fortune 50 company that wants to start using this. We're just so excited where we are.

John Shufeldt: And that is totally amazing. How long have you been? How long has it been up and running?

Sanjay Prasad: You know, the idea was in 2014, started it, built the technology. You know, COVID hit, right, in last year. All surgeries went on pause. And now, even now, patients are somewhat reluctant to get back in the surgery center. They're very reluctant to get on to the hospital setting. It's a great time to reset health care as we know it today. And in fact, I wrote a book, John, I know you're a multi-book author. I wrote a book on resetting health care post-COVID 19 pandemic, and it's all about resetting and reorganizing health care, so it works for the patients. It just makes so much sense.

John Shufeldt: It does, and you're right, it's a perfect inflection point in this time. Yeah. I was in the ED till early this morning, and as I know, you know, and our listeners know, it's back and it's back with a vengeance. And although it might be less lethal, it's certainly more contagious. But I had a number of patients last night and all of them who are sick did not get the vaccine.

Sanjay Prasad: Oh, god.

John Shufeldt: I just.

Sanjay Prasad: Oh no.

John Shufeldt: Turned to his ignorance, to his value or just, you know, when you are unavailable. But it was, you know, people are still dying of COVID and it's probably unnecessary. So you're right, it's a good time to reset. Sanjay, what was your biggest aha moment doing this?

Sanjay Prasad: The biggest aha moment was I wasn't sure, you know, I wasn't sure if I would get surgeon engagement. And I've just been shocked because the surgeons love this because when they sign up on our platform, they do have to be board certified. They do indicate their areas of interest. So we only send cases to them based on their area of interest. But I'll tell you something else that happened. You know, we have connected patients now based on area of interest, not necessarily on specialty. So what do I mean by that? If somebody gets a colorectal cancer, right, or they get a cancerous polyp, for example, they go see a colorectal surgeon, you know, they're ready to have a colectomy, the ready to have this, you know, a lot of morbidity, a lot of cost, ICU stay, perhaps, etc. But that same case is connected to an interventional gastroenterologist who can perhaps remove that through a colonoscope. He just makes so much sense. A tenth of the cost, patient's back to work, less time away from work, you know, fast recovery, zero mortality. These are some of the benefits of the multispecialty opinioning that we're doing. It just has to be done, John.

John Shufeldt: And it is amazing, are there, you have, how many competitors are or as Peter Thiel would say, is this a zero to one concept? In other words, were you the, really the first one in the market, that aggregate the data this way and you have the perfect background to do it. You're a surgeon, so you get it. Is this, is this your zero to one concept?

Sanjay Prasad: Well, we'd like to think so. Of course, as your startup, right? You'd like, you'd like to think that way. But we've gained a lot of interest with Fortune 50 companies, and the major insurers are finally aboard on this concept. You know, they, I don't know. I don't know where it's going to go, but I can tell you, I just feel like it's the moment for health care in America. There's no question.

John Shufeldt: I totally agree. What I mean by zero to one is, do you have any competitors, or right now, are you the field?

Sanjay Prasad: Well, there are a lot of solutions out there, a lot of cost containment providers, reference-based pricing solutions, as you know. There's a lot of companies connecting employees to bundled providers, right, as you know, they're sending hip replacements to a certain place or cardiac valve surgeries to another place for bundled price. I think that's all great. They're all using kind of generalized Medicare quality data. We are uber focused on procedure-specific quality data across the array of surgeons. So we're looking at last years, how many gallbladders did you do? What was your bile duct injury rate? What was your conversion rate? How many times did you have to open the abdomen to gain control of bleeding? You know, we're looking at metrics that really matter to patients, and we're here to educate the patients about the quality measures. That's what our concierge does. It's just so beautiful.

John Shufeldt: So, OK, patient, here's what you look for when you're trying that we're going to send you a list of five surgeons in your area, in-network who ranked the best in quality. Here are the things we looked at and the things you should ask about. And that's awesome.

Sanjay Prasad: Absolutely.

John Shufeldt: Wow. I can see why this is in the end such a wrap and uptick as far as usability goes, and there really isn't, I mean, there's really isn't a downside to doing this. I mean, it's the everybody wins.

Sanjay Prasad: Yeah, and John, if you're interested in this, please join our team. We'd love to have your input. You know, anyone who, you know, has some input or channels or distribution channels to insurance brokers or the big insurance brokers like Mercer or Marsh or Gallagher or ..., you know, please contact us, but info@surgiquality.com, it's so easy to reach me. Happy to talk to anybody who can help us.

John Shufeldt: I appreciate that, and I'm going to reach out to you about a couple of questions and some ideas, things that, things that may actually help, but you're clearly leading the pack. Sanjay, what would you, what would you leave the listeners with who listen to this podcast and say, well, I want to be him, because you literally, I think this is this zero to one concept, you're doing something totally unique. You're making the market. What's your advice to people who want to be you?

Sanjay Prasad: Are you talking about surgeons or are you talking about MDs, in particular?

John Shufeldt: Entrepreneurs.

Sanjay Prasad: Entrepreneurs! Well, you got to find your passion. You've got to find something that you're super passionate about. You think about, you know, you can't sleep at night. You wake up in the morning. You have, you have someone you think about, if what you're working on is not that kind of thing, in your mind, if you're not so passionate about it, you've got the wrong. You're barking up the wrong tree. You've got to be so passionate about what you're doing and about fixing the world. The world needs a lot of fixing in a lot of different industries, not just health care and technology is there, but all these tools are there, AI, machine learning, there's so many tools out there, so the opportunities are endless, John.

John Shufeldt: I could not agree more. Well, Sanjay, thank you. This has been an incredibly, really insightful and enlightening. Where can our listeners find you?

Sanjay Prasad: Well, you can find me. You know, you can go to ResettingHealthcare.com if you want to learn about the book. But if you want to learn about the platform, you know SurgiQuality.com, just email me at info@SurgiQuality.com. I'm happy to answer questions, and anybody who has any guidance or advice, our ears are wide open, you know?

John Shufeldt: Thank you very much. I think you're getting a lot of people reaching out to you because I do think this is a phenomenal concept. Thank you so much for being on the podcast. I really appreciate it.

John Shufeldt: Thanks for listening to another great edition of EntrepreneurRX. To find out how to start a business and help secure your future, go to JohnShufeldtMD.com. Thanks for listening.

Sonix is the world’s most advanced automated transcription, translation, and subtitling platform. Fast, accurate, and affordable.

Automatically convert your mp3 files to text (txt file), Microsoft Word (docx file), and SubRip Subtitle (srt file) in minutes.

Sonix has many features that you'd love including collaboration tools, share transcripts, transcribe multiple languages, automated translation, and easily transcribe your Zoom meetings. Try Sonix for free today.

Key Take-Aways:

  • The system is not working on behalf of the patients, some patients are even getting surgery they don’t need.
  • Quality measures can help reduce malpractice lawsuits.
  • Racial inequalities must be addressed in healthcare.
  • Covid-19 has changed the way people see and use healthcare, businesses must learn how to adjust.
  • Don’t be afraid to make your own market, follow you passion.
  • The world needs fixing, the opportunities are endless, no matter what the field.

Resources:

  • Connect and follow Sanjay on LinkedIn.
  • Learn how SurgiQuality helps its consumers maximize their benefits when they need surgery.
  • Understand how SurgiConnect contracts with self-insured employers to help manage surgical care.
  • See how SurgiPrice helps both employers and employees.
  • Purchase Sanjay’s book Resetting Healthcare.