This Week in Surgery Centers: BJ DiMartini – The Intersection of Outpatient Surgery & Medical Tourism

BJ DiMartini – The Intersection of Outpatient Surgery & Medical Tourism

Here’s what to expect on this week’s episode. 🎙️

BJ DiMartini is the CEO of Excel Health, and he has been working hard to open new surgery centers in Hawaii and Washington. But BJ and his team are doing things a little differently – they are building their facilities with a true concierge approach and leaning into the growing trend around medical tourism. We covered the specialties they will offer, how they’re sourcing physicians and attracting patients, the potential challenges they will face, and more.

💡 An Innovative Outpatient Approach: Excel Health’s facility will combine minimally invasive surgical techniques with aesthetic treatments. It’s a unique approach that addresses the patient’s conditions, their overall well-being, and some aesthetic aspects of aging.

🏨 Medical Tourism and Concierge Medicine: BJ shared his insights on medical tourism and the importance of creating a luxurious, concierge-like patient experience. By focusing on exceptional care and leveraging advanced technologies, Excel Health aims to attract patients globally, offering an alternative to traditional healthcare options.

📢 Marketing Strategies: A key aspect discussed was the innovative marketing approach to attract patients. By emphasizing patient experience and advanced treatment options, BJ’s team aims to differentiate its services in a competitive healthcare market.

🫶 Emphasis on Patient Experience: Lastly, BJ stressed the importance of personal interaction in healthcare settings. Simple gestures, making eye contact, and genuinely connecting with patients can significantly enhance the overall patient experience.

Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details.

Episode Transcript

Erica: Hi, BJ. Welcome to the podcast.

BJ: Hi, Erica. It’s nice to see you.

Erica: Yes. Can you share with our listeners a little bit more about yourself and your healthcare experience?

BJ: Yeah, sure. I’ve worked in healthcare for about 31 years now. It began as a combat medic in the army and in 1992 and and then that evolved into surgical coordinator position for an orthopedic [00:02:00] spine and sports medicine group.

Out of Philadelphia region. And from there, I really got to understand more of the musculoskeletal side of things and the surgery business really opened me up to learning, wanting to learn more. I stayed in school and maintained education while I was working as well. And then in 1999, I decided to start working in, in the health insurance industry, worked for Aetna Healthcare and sold insurance and then transitioned over into the implant world where I sold orthopedic and spine implants for Depew Johnson and another. Well known orthopedic device company right? Medical was their name.

And from there, I wanted to actually get more involved from a patient aspect. So I actually changed in 2000. Six and changed course and went back to school [00:03:00] for a master’s in Eastern medicine. And there I was in, I moved to San Diego for about four years and it was full time master’s degree, of course.

And there I learned the techniques in acupuncture and more herbal and supplement. Information and as well as nutrition. And there was a variety of other techniques that are often used in Eastern medicine, like cupping and and so, I moved back to Philadelphia with my wife and we started a couple of clinics there in that region as I also worked for the Philadelphia Flyers.

I was their acupuncturist for three seasons while in Philly. And then transitioned over into back getting back to helping the orthopedic and spine side of things and began working for a company up there that was based out of Tampa called Laser Spine Institute. And they specialized in ambulatory [00:04:00] surgery centers and delivering spine techniques at a minimally invasive endoscopic level.

And I was always into cutting edge technologies and delivering, treatments to patients, that was at the most advanced level. So if you’re thinking of like, a spine surgery, what are some ways that you could. Do a minimally invasive technique to address the same condition where others were maybe using older techniques.

And so that was the inspiration to, to jump over into the ambulatory surgery center world. That was in 2010. And since then I’ve been working with ambulatory surgery centers and developing. And most recently, this is the exciting project we’ve had since is developing Excel health and launching our new surgery center in Honolulu.

Erica: Very cool. You just trying to think through everything you’ve done. You’ve been on the payer side, implants, patient side, direct care. So you’re very well versed in kind of all [00:05:00] angles of what goes into health care. And I’m excited. You had just mentioned Excel Health to really talk about your latest venture because like we just finished up a nine part series on how to open new surgery center.

So our listeners are pretty well versed on the overall process, but your focus and strategy is so different from what we typically see. So what is the concept behind these facilities you’re building now?

BJ: Yeah. So, taking what we’ve learned and we have a great group of partners involved here over the years, we’ve looked at, the way Surgery is treating patients and and how we can advance our technologies. And now we’re looking at it from redefining the aging experience.

Right. So if you look at all these surgeries that are applied, usually it’s because there’s an either an injury or there’s arthritis that’s developed over the years. And there’s a certain age group of individuals that, as we age[00:06:00] we gravitate towards pain and and look, searching for treatments that help that it truly it’s an aging experience, right?

So what we want to do is utilize. These cutting edge surgical and non-surgical tech treatments for musculoskeletal conditions, but also in aesthetics as well. So when you look at aging often you think of I’m looking in the mirror today and I have a blemish or a new aging wrinkle when I smile or something, and it’s a lot of people will go, oh, well that’s just the part of the experience, right?

And we thought, well, why not implement. The merger of both of these specialties in medicine. So we now look at is, from the inside out, we, how can we change the way we think and feel about aging? And , traditionally in America it’s, a process where we don’t really think about it, but once we’re too old, it’s we don’t really fit in with the younger group anymore.

And I think in other cultures aging is a luxury. And so we want to look at it a little bit differently [00:07:00] and how we can feel and stay active and youthful again. It’s the market of anti aging is what some call it. But we’re looking at it as, progressing and moving the way we think about how we’re aging.

And so. In order to do that, if we do need surgery, it’s, applying, again, minimally invasive techniques that don’t actually cause collateral damage secondary to what is being addressed. And so that’s important too, because if you’re getting a surgery on your spine and there’s collateral damage to important muscles of the spine that are used to hold you up or maintain activity then that sets you back, right?

And so we want to. Approach these things in a way that that moves the body forward and stays active and pain free obviously. But if they want to come in and what we’re going to partner with a really cool aesthetics group that’s actually coming out of Canada. And and if somebody wants to address certain things on their skin we’re going to have that [00:08:00] available too.

So it’s going to be a nice little merger.

Erica: Nice. Yeah. So, we had talked about this previously, but we’re focusing on this idea of medical tourism and kind of this concierge medicine as well. What do you think really inspired your focus to go that direction?

BJ: It’s a couple of things.

One is starting with the concierge aspect of medicine delivering and hospitality and delivering an exceptional Patient experience and what that does is it naturally attracts people from a larger areas outside of where you’re delivering your treatment, right? So we can attract from a larger radius and we’re not using the classic, referral systems and large healthcare networks like providers and referral networks that are within their own enclosed system.

Rather we’re using marketing. To branch out and get ourselves and our brand out [00:09:00] there. So from a tourism aspect, it allows us to increase, use our standards to increase our outreach to other areas of the globe that may not have accessible healthcare or affordable.

Or timely. These are the big things that if when I worked at the prior spine organization we often saw a lot of Canadians come and for treatment because they were stuck in a certain health system of their own where they had to wait very long. Amounts of time. So sometimes if they were needed a spine MRI the average wait time was about nine months so we could Allow them quicker access to come in and get health care as needed also you know Asia is a great market and example as well, because we’re located now in Honolulu, Hawaii, and that offers the ability for those in the far east to come over on a shorter flight than it would take to get to the mainland.[00:10:00]

So, countries like Japan, Korea. Now can once we’re launching our branding campaigns and marketing campaigns, they’ll see us and see that there’s another opportunity to come in. anD so we also allow for, again, I’m going to always hit the subject, but advanced technologies.

And so when we are able to deliver. The similar treatments or approach, but with advanced technologies, higher skill set of surgeons, naturally, that will allow other countries patients from those countries to, to see what we’re doing and compare it to what they’re going through. And then the timing of everything and how long the progression takes for them to get clearance or or, their conservative treatments worked up or even scans and images. So we can cut through a lot of that much quicker in a timely way. Increase our or using our advanced technologies to that again, I think compete in the global market. [00:11:00] And it’s also affordable since we’re a surgery center company, we’re comparing ourselves to hospitals and their costs out of pocket costs for patients, that the monthly premiums are going up for insurance, but not just that, but deductibles and co pays and co insurances are also Rising.

Another cool thing that medical tourism does is it allows us to capitalize on our tranquil environment. So, Hawaii Honolulu, there’s really, it’s a beautiful place to go and recover after your procedure. We’re also looking at other locations where we’re expanding to in California Southern California, specifically in LA and San Diego.

And also in Florida in southern Florida, we’re looking at a location right now. And so patients, again they seek destinations sometimes and if you can just apply them the economics to the location from a medical standpoint, then it,[00:12:00] they’ll choose to go to a nice place to go recover and get treatment.

It also really impacts the local economy. So, one thing we looked at in 2015 was we were headquartered out of Tampa Clearwater area. And and we looked at how we impacted the local economy. And we actually. Through the medical tourism brought in about 300 million. In revenue to the local restaurants hotels.

And so, it’s a big impact on that local area with what we’re doing. So, ultimately medical tourism empowers the patient it. Allows them if they don’t feel that they’re in good hands or they just wanted more options and they keep researching and finding and seeking, it empowers the patient to jump and go somewhere because they trust that they’re going to have a better experience and a higher cutting edge technology that’s going to get them to recover quicker.

And then, back to their lifestyle, whether it’s work or Or [00:13:00] just simply, contributing to their family. It’s, many of these goals are applied when they’re making their choices for where to go.

Erica: Yeah, it’s really interesting because we’re trying to focus more on the concept of that, that patients are consumers, right?

They’re not just, okay, your doctor makes a referral. This is where you go. Like there’s not that conveyor belt of mindlessness where they don’t get a say. In the matter. So, shifting the mindset of thinking about patients. They’re buyers. They want to know. They want to have the same experience as booking a hotel room or purchasing something online.

Like, they want that, they’re used to that experience, so why not lean in and make it super easy and comfortable and familiar? You mentioned this briefly and I want to go back to it because it’s the part I’m most in without relying on physician referrals.

Yeah. What does your marketing plan look like? I’m sure we could do a whole episode on that. Give me the high level, but I’m just dying to know how you [00:14:00] plan on attracting patients.

BJ: Yes. Did we sign a non disclosure? No, I’m kidding. Yeah. I’ll hit it from like a, an overarching concept, but the company will work with.

Prior was the best without a doubt in healthcare marketing. They were great at and I’m going back to like 2006, seven, eight when people were still trying to figure out the internet and in 2010, even when I was doing a search locally in the Philadelphia area. Like, I was looking for a spine practice and boom, up pops laser spine Institute.

And it was not even the normal search. It was just a side ad that popped up on the right. And as I’m going, it kept flickering or doing something and I, it caught my attention. So I went and clicked it and sure enough, 20 minutes away was this clinic. And so, that I thought was remarkable.

I thought, wow, how did they know there was a lot of coding and other it [00:15:00] things that I’m not very experienced in, but it’s part of the of the marketing structure and department. So basically. It’s, you’re able to target a certain audience that you’re looking for. If you compare a surgery center to a hospital, you automatically know that it’s a different group of patients.

They’re typically healthier. Right. So, they don’t have as many comorbidities that require overnight stays. And so you’re trying to find those patients and and attract them to with their conditions and treatments that they’re looking for. And then guide them to the practice. But the other part of that actually is the acquisition, who’s speaking with the patient on the other end and why are they going to trust this company, Excel Health with their care.

And so it’s the job and the role of those that are speaking with the [00:16:00] patients to build value in, especially in sharing and the information that we have about our. Surgeons, you know, sometimes we’re finding these patients that aren’t just injured from the last weekend, right?

They’ve actually been in pain for two to five years, maybe longer and have been putting it off. And then more recently, they’ve probably been trying to do other. conservative treatments like injections and physical therapy and, ultimately in the end about 10 percent of these patients will say, all of that fails and they need an option to get their life back, which would include a type of surgical option.

And so we capture those patients who’ve probably already been through this type of system. That I’m talking about. And it’s like, a continuum of care that the patient has gone through from the time of their injury or pain. And so, our job is just to share with them, what our experiences are from a minimally invasive.[00:17:00]

Approach and how our surgeons are very highly skilled. It’s like they build ships in a bottle. They work through tubes when they’re working on the spine. We also have a really nice new robotic system we use for total knees and total hips.

And then next year it’s going to incorporate a total shoulder. System into the same robotic system. And so, we can do this again in a surgery, we can do large joint replacements. In our outpatient surgery center. And it requires a uniquely skilled set of staff. Our staff is exceptional because, the patient needs to be comfortable and out of pain to do these types of procedures.

They have to be really efficient. And work well with the surgeon that’s, conducting the procedure. And so, it, it requires a really efficient, unique team to incorporate all of those technologies into, a little surgery [00:18:00] center. And but yeah it’s definitely exciting.

Erica: yEah, what do you think the primary challenges are that you’ll face with patients traveling all over? Is it insurance, language barriers, accommodations? What are you anticipating?

BJ: It’s, well, it’s definitely all of that. Unique. To Honolulu is a very diverse culture there.

So, what was really fantastic about learning about all of our coworkers there is that everybody has a different background and and so, many speak different languages. So when we have. like that, we’ll have the ability to minimize language barrier. And then as it relates to insurance yeah, we can work with most any insurance.

if it’s a type of like Kaiser HMO style, that has to stay within their network. We can still work with that patient again, because we’re a surgery center. It allows us more flexibility in [00:19:00] containing our costs. So we have a cash fee schedule that can apply for those that don’t have necessarily the insurance that will cover it.

We also have the access to loans , like a care credit. Type of loan for a patient to help with their costs and we can also bill out of network. So patient will typically be Used to or understand their own out of network costs associated with that but you know for the most part in Honolulu, we’re in network with most all insurers and So we can work Mostly with a lot of that, we don’t have a tremendous gap other than it being an isolated island out in the middle of the Pacific.

So, so yes, so travel is going to be required for mainland and for Eastern Asians that want to travel over. We actually just recently captured a patient from Trinidad in the Caribbean. So he traveled all the way across from Caribbean to Hawaii [00:20:00] and sought out our Dr.

Jeff Rowe spine surgeon for his care. Yeah, he’s, he comes from the Seattle market is well known was the minimally invasive director over at Swedish and his skillset is. Exceptional when it comes to minimally invasive endoscopic techniques of the spine. And so, he decided that he would go ahead and launch our Hawaii facility by partnering with , Dr.

Thomas, no, who’s a neurosurgeon. So we have a a crossbred neuro with orthopedic spine trained surgeons there. And then we also have orthopedic pain management. And we’re surgical options as well as non surgery options. And we’re opening up the doors for other specialists like ENT and cardiovascular or interventional radiologists that want to also do like an office based lab in one of our procedure rooms.

For those conditions.

Erica: Gotcha. Awesome. So, do [00:21:00] you believe that facilities like this are the future of the outpatient industry or more just a luxury and niche category?

BJ: Well, both. Good question. We certainly are looking at it from a luxury standpoint because We’re attracting an aesthetics and cosmetics group that would also like to come in.

And traditionally, that’s a very nice appearance and facility. You usually get wowed, right? If you were to walk into a clinic like that, and we want to merge that with ours. So even if it’s a spine orthopedic condition then would love to have it really nice.

So people feel, wow, I feel like I’m in a luxury setting, but yet it’s not. Out of the pocket type of cash and they’re going to be treated like they’re in a luxury setting, right? The patient experience is going to feel luxury and also the appearance and the setting of it will feel that way too.

So you can have [00:22:00] both. You just have to put some TLC into the aesthetics of the building, right? And when you walk in, all of those patient facing areas should be nice. One of the first things I looked at when I walked in was the floor and I just thought, why don’t we get this thing shining really bright, and just, little things that we can do to to increase the experience, make it look nice.

, and, patients absolutely will feel that. So until we’re going to actually spend more money on to those areas and build out some of the nicer versions of what we would consider an interior design. Right now there’s many things you can do just to. To upgrade it.

BJ: And and then, of course, the number one thing is how you treat the patient, in a concierge setting. So it’s definitely something that you can, as managers and directors can spend more time with their staff and any. Opportunity when you’re crossing paths with a patient throughout the day and that opportunity in that moment is, is a special time to [00:23:00] connect with the patient.

So , we don’t want to let those moments slip by, we want to make sure we address anything, even if it’s a caretaker waiting for their loved one, offering them a refreshment, is there anything we can get you just taking that extra time to stop and connect in that. right then. They might feel anxious and be waiting and that’s expected, right?

And so these are all the things that, you can just do to make it feel like it’s a luxury setting and a caring setting.

Erica: Sure. Great answer. So last question for you. We do this every week with our guests. What is one thing our listeners can do this week to improve their surgery centers? I

BJ: think that’s it.

Right. What I just kind of finished in that last sentence. Spend the time with your staff making sure that they’re not just. Walking by a patient, make eye contact, , introduce yourself. Those connections last eternity and the patient end up leaving and may not remember if they’ve had [00:24:00] anesthesia necessarily, but their loved one will.

And and then the patient will remember all the prior experience up until the anesthesia kicks in that, how they were treated is. Is different from the way that they’ve been treated in other health care settings. And so that is, to me, is probably the most important thing you can do because it not only reflects how your brand or how your image will be outgoing, but usually there’s, four or five other people that are waiting to hear.

back from that patient of how well we did on our end. They’re going to want to know how they feel, and there’s five, people waiting just because they probably need some help. They might need another a type of treatment option and they want to hear a good experience before they make up their mind on where they go.

So, that’s the kind of the organic. Referral or holistic referral way of going about it , by delivering good care in that moment. So it starts with the staff and little touch points on every department of [00:25:00] where that patient flows through and how they’re treating each person.

So I think that if you spend time with that’s where you get your good marks on your patient experience surveys. And ultimately a good patient experience survey can lead to a great. Quality outcomes survey.

. So, , it kind of extends on down the line and just, you know, improve your experience for the patients and, , connect with your employees.

And I think everyone will ultimately feel that.

Erica: Perfect. Thanks so much for coming on BJ. We really appreciate it.

BJ: Thanks for having me, Erica. Really appreciate it. We’ll talk to you soon.