Transparent Bundled Pricing For Safer Lower-Cost Surgery

A single procedure can leave you with five bills, a stack of jargon, and the nagging fear that one surprise charge will hit collections. We wanted a better answer, so we sat down with Dr. Kikkeri, an anesthesiologist and pain management physician who helped build a bundled surgery model designed around one clear price, measurable quality, and a calmer patient experience.

His motivation is not theoretical. He shares the moment that changed his career trajectory: seeing a patient with metastatic colon cancer after she stopped getting preventive colonoscopies because her deductible rose and she could not afford screening. That story pushes us into the real stakes behind transparent healthcare pricing and bundled payments. When access to care collapses under financial stress, “choice” becomes meaningless, and preventable disease becomes catastrophic.

We break down what bundled surgery pricing actually means in practice: what is typically included in a bundle (facility, surgeon, anesthesia, routine pathology, and even implants in many cases), what may be excluded (certain imaging or pre-op specialty work), and why knowing the total cost upfront changes the clinical experience. We also talk about surgical navigation, quality metrics for surgeons and ambulatory surgery centers, and pre-op risk stratification that helps lower complications and infection rates. For self-insured employers and TPAs, we connect the dots to predictable surgical spend, reduced stop-loss pressure, and better member satisfaction.

If you care about independent surgical centers, healthcare cost transparency, and building a system that feels human again, press play. Subscribe, share this with a colleague, and leave a review with your biggest question about bundled pricing.

Transcript

Welcome To Power Living

SPEAKER_02 0:00

Power Living with Kimberly Langford, where inspiration meets empowerment. Kimberly is a nurse executive, leadership coach, Reiki Master, and your guide on this journey to whole person wellness.

SPEAKER_00 0:15

Wonderful. Thank you.

SPEAKER_01 0:16

Thank you.

Why Hospital Surgery Costs So Much

SPEAKER_00 0:17

And then you know, uh, we have a show here called Did you ever hear the show Fab Albert? Yes. Yeah. So hey, hey, hey. Dr. Kakiri, I'm so glad to have you um on our podcast today as we talk about uh, you know, it's interesting because um hospital-based services, whether it's inpatient or outpatient, off the charts, and it's eaten a hole into everybody's wallets. And um, you know, surgery, procedures, whatnot, we typically, uh, you know, it's not it's not like buying a washing machine where, you know, where more money gets you a better deal, right? And so, but uh I don't know that everybody knows that about uh healthcare, how you know inverted the industry is. But I, you know, today we're talking a little bit about the glory of bundled pricing and um helping members find the optimal side of care at the optimal price with optimal outcomes through uh a better experience with like an ambulatory and uh an independent surgical center with bundled rates. And so I'm really glad to have you uh here as we talk about um, you know, how this model, how your model uh can have such a profound impact on the financial and the surgical risk for these folks. But but if you wouldn't mind, uh I would love because your story is so inspirational. Would would you mind just sharing with us a little bit about your journey and um you know what was it as a medical doctor, anesthesiologist? What is it that that that started you down this path? What's your why, Dr. K?

SPEAKER_02 2:12

I'm uh the uh the the biggest why I got started was it happened several years ago when I was practicing uh in my clinic. I continue to practice pain management in clinic and uh I'm an anesthesiologist, so I practice both anesthesia and pain management. And uh I got a call from uh one of my surgeon friends to come to OR3. When a surgeon calls, the anesthesiologist usually runs to that R because we don't know what's going on. So when I went there, I said, no, no, no, no medical emergency, just wanted you to look on the monitor, TV monitor. He was doing a diagnostic laparoscopy, and on the TV screen, there was the picture of the liver where he was doing uh laparoscopic examination on the surface of the liver, there were diamond-studded spots, and uh as we you and I both know, that's a very ominous sign, and uh unfortunately it was a metastatic colon cancer. Metastatic colon cancer, it's when it goes to the liver, it is um it's very differ very, very difficult to treat, and uh and that is the part of the story. And he said, Dr. K, look on the other side of the ether screen. On the other side, look at her face. When I looked at her face, that was a shocker. And this is the lady who used to come and get preventive colonoscopy with us on a regular basis, and because of uh increased in her deductible due to Affordable Care Act, she could not afford her care. She stopped coming, so pre-cancerous polyps became cancerous polyps, and then it spread. When it spread without her knowledge, she developed some stomachache, and then um, next thing you know, unfortunately, she passed away. And this story, we knew her because she used to come more frequently, and we get attached to our patients.

SPEAKER_00 4:39

And that was preventable, yes, largely preventable.

Building Bundled Pricing Beyond Colonoscopy

SPEAKER_02 4:44

Absolutely, and when I spent time with the family, they said, Hey Dr. K, I wish we knew we could have, we as kids, we could have pitched in and gotten her the care that she needed. She never told anyone, and that's the time when I went home, I did not feel good about the whole thing. I decided to be a doctor when I was in sixth grade. Sixth grade. So when I looked at the big picture, in this day and age in the United States of America, this should not happen. But unfortunately, this does happen, even now it happens. So I wanted to come up with some solution. I gathered some of my like-minded people in our team, and then got together and came up with a bundle price procedure. How we can make it affordable so that it's easy to afford, and then make it simple to buy it. So that's how we got started. We started with colonoscopy, subsequently, we spread to other surgeries like hernia repair, gallbladder surgery, orthopaedic surgery, kidney stone surgery, and then joint replacement surgery. So, from one, we have spread to different specialties. Subsequently, we had to help patients coming from different parts of Texas. So we different parts of Dallas were Metroplex. So we started administering this in not just our surgery center, in different surgery centers. And then in a s like in a similar fashion, we had we were asked to help um different parts of Texas. One of my patients was uh uh HR, uh head of the HR in a big self-insured employer. So he introduced us to the concept of working with TPA. So we have been working with self-funded, self-uh insured, and uh we have been helping them throughout Texas. Subsequently, we grew again. Now we are providing this care in 17 different states in the United States. This is about, thank you. This is how we begin. Now, having started with bundle surgery, um, this has been a very fulfilling journey. And when I see people like you who are passionate, passionate about helping people in our industry, when we put our heads together, we can touch a lot of lives.

Navigation With A Human Touch

SPEAKER_00 7:42

Yes, we sure can. And we tend to find each other, don't we? The self-insured industry, it's not such a big industry that uh, you know, good folks can't find each other who share that mission. Um, we just need more of us. And you know, it's interesting because what I have found is that oh, the healthcare system that I grew up in in my young nursing years, it just doesn't exist anymore. I haven't seen it for a long time. It's become very commoditized and um uh fragmented and um uh multiple superfluous uh layers. And so I and and you know, it largely feels like uh we we are using patients and clinicians, we move them around like a like a chess piece on a chessboard to get to the dollar bill. And um, you know, that that really does hurt all of us. And so when you think about a model like this, like your model is is really notorious for you know very transparent, upfront pricing, no nonsense, predictability, um, improved outcomes for members, and uh more satisfactory um uh work life for the clinician as well. And um matter of fact, I was talking with somebody today about, oh I just I remember all the hours I wasted on on the phone doing trying to get an off and then tracking down payments. Really difficult. So, you know, if you you know, a lot of times when we think about transparent pricing, bundled uh options, independent uh surgical centers, um you know, there it this really is not just about cutting corners or cutting costs. Um can you share a little bit about, you know, what are the what are the um what's the value add there in terms of cutting out the waste and um improving outcomes and not just for the health plan and the member, but also for the clinician.

SPEAKER_02 10:11

A couple of things that you uh mentioned in your when you're talking to me. You mentioned about commoditizing uh you know how it has been commoditized. So it is from what we started as a bundle surgery program. Now we out of necessity had to grow into uh you know specialty surgical risk platform. You cannot, there is a big difference between going to a grocery store, buying a gallon of milk. There's a big store. There are a lot of ways you can see uh that yeah, I'm buying a gallbladder for uh X number of dollars, I'm buying a colonoscopy for X number of dollars. Please understand that is commoditizing the healthcare. We are human beings. What is my health history, what is my need is different than yours.

SPEAKER_00 11:14

So when you cut open your insides, they might look a little bit different from the next person's.

SPEAKER_02 11:20

Yes, absolutely. Not only that, but also uh when I, as an anesthesiologist, when I see patients this today, when I saw, and the patient's first response was that they call me Dr. K because uh it's easy to pronounce. I said, Hey Dr. K, I'm so glad that I got a chance to talk to you because I was nervous what's gonna happen. Surgery is not something that people come and have every day. So that is a very good uh concept. So, in our new business uh that we grew into out of necessity, we have incorporated the surgical navigation, which is a part and parcel of our bundle surgery, where we hand hold the patient, walk them through the entire process from the time that they are there that they are ordered the surgery and schedule the surgery. And then they are done with the surgery for the following 30 days. We follow them. And at the end of that, we give the report to the self-insured uh company or TPA that we work with, so that they know exactly this is what happened, these are the things that they did to prevent the risk even before the surgery. So they matched the patient, patient's need to the surgeon, to the facility, to the anesthesia. So, and almost all the time the implant is included for a colonoscopy, pathology is included, so that patient experience becomes individualized strategy where it is done with the human touch.

SPEAKER_00 13:19

Ah, no cookie cutter cutting, so to speak. Yeah.

SPEAKER_02 13:24

You know it doesn't work.

SPEAKER_00 13:26

Yeah, yeah, we like designer care. We are designer, absolutely. So members have a better experience. Um, what about you know, how is it? Maybe you can explain for those that don't don't know, how where does the claim come from that a member is going to have a better outcome than they would in in the hospital with the big shiny billboard and and you know the huge campus?

Measuring Quality Without The Billboards

SPEAKER_02 13:53

Yeah, and uh that's an excellent question. And uh you mentioned early on in your meeting saying that hey, uh you don't higher price doesn't mean higher quality. So, how do you measure a quality of a surgeon? How do you measure the quality of a hospital or a surgery surgical center? How do you measure the quality of a the care of anesthesia that they're getting? How very, very important. How do you measure the quality of the nursing care, which is the central part of all these things? If all these things are taken into account, we came up with an algorithm that has quality metrics, and these quality metrics must be met. Okay, so you can have all the fancy billboard that you want to have, and you can do all those things, but it has to match what we expect out of that, so that the ultimate person who gains from this is the patient.

What A Bundle Includes And Excludes

SPEAKER_00 15:00

Yeah, those quality, key performance, key quality indicators. You know, too, and the thing that comes to my mind, you know, a um a surgery, a procedure, uh a hospital stay becomes more and more expensive when people are sick. You get an infection or um you don't have the proper care, that that that becomes a very expensive stay for sure. Um maybe you can talk a little bit about um, you know, what is it, what makes a bundled surgical price a bundled surgical price, and how does that impact what the customer experiences? You know, oftentimes they'll get several different bills and they're like, what the heck? It feels very fragmented and they have no idea what they're paying for. Maybe you could share a little bit about you know that experience and how that's different.

SPEAKER_02 15:55

Yes, ma'am. I've been a doctor for a since 1988. Okay, I just gave out my age.

SPEAKER_00 16:03

Yes, I do color my hair for those You were six years old then, right?

SPEAKER_02 16:09

So if somebody who has been doing medicine for a long time, if I can be confused with multiple built, deductible out of uh network benefit, you know, allowable, and you can use all those jargons and confuse me. Imagine what a non-medical person would go through, and on top of that, there is a fear of uh you know uh garnering the wages, there is a fear of losing uh sent to collections, sent to collections, and along the same line, I will tell you that uh uh the last year's statistics about thousand families declared medical bankruptcy every single day. This year medical statistics 1464 families declare medical bankruptcy every single day, and it's going up. So this is our way of uh very, very small way of uh helping American families, not declaring bankruptcy. So this is how patients are assured that this is the one bill that you will get. This one bill includes anesthesia, facility fee, surgeon's fee, surgeon's assistant fee. If there is a knee replacement hardware that is involved, it includes that. If it's a colonoscopy, routine pathology is included. What is not included is uh you know the images, like specialized images, uh any images before the surgery. And if they need a cardiac evaluation that needed to that we need for optimization, those are not included. Patients will know ahead of time and they will receive one bill. That's it.

Less Financial Stress Improves Outcomes

SPEAKER_00 18:08

Yeah, that's wonderful. And so that obviously has a financial impact. Um, but the the clinical uh impact sometimes is a little more mysterious. Maybe you can talk about the impact of that bundle price on the clinical experience.

SPEAKER_02 18:27

Number one, uh as I was telling earlier, the surgery itself is stressful, the finance should not add more stress to it, and that increases the blood pressure and their outcome. So when we have the clinical experience, when somebody who is caring holds their hand and brings them through the entire walks them through the entire process, knowing that, hey, I can budget this amount for this. When you budget this amount for that, they know exactly what they're going to pay. And they're especially in a company when we have a self-insured company, some of the companies what they're doing, which is I truly appreciate who care, they have made number one zero uh cost for the patient, zero cost for preventive care, such as preventive colonoscopy. And uh these are awesome. And what they feel is that they feel appreciated by their employer, and the other way they do it is that they waive their copay. So this is how it is um addressed.

Risk Stratification And Lower Complications

SPEAKER_00 19:50

Well, you know, and it's interesting that you that you say that because you know, I have had patients in the hospital before you even finish the admin paperwork, they're stressed and they're asking, you know, what what what is this likely gonna cost? Because they have they have no idea. And that is very stressful. The other thing that um that comes to mind is um where um oftentimes in that experience for the member, not only do you have the um the less stress with the you know transparent pricing and whatnot, but when you look at it from the employer's perspective and being able to forecast what their spend is, or in terms of underwriting, um, it's much easier for the plan. And oftentimes what we've seen is that a plan can save so much. That's why, you know, incentivizing members by just what you talked about, zero out of pocket, no deductible kind of thing, um, because the employer saves so much. And not only in the cost of the surgery, but in the risk reduction as well, which we don't often think about, um, the risk reduction, because that can be really expensive to have, you know, a complication or infection or something like that. Um and you know, when you talk about that in terms of you know lowering that kind of risk, um what is it that actually makes uh a surgery at an independent facility? What is it that clinically, what is it that you and you talked a little bit about that earlier. I mean, what is it that you do that actually lower because the infection rates are significantly lower at an independent site? So what's the magic there?

SPEAKER_02 21:43

Yeah, number one, uh you had asked about uh how do we decrease the surgical spend? Okay. And in all sincerity, I'm grateful for people like you because you not only watch, I know because we meet every month. Month, we go through every single case. We not only look at it from the surgery, how much money was spent, what is the member experience underlying member experience, and you also speak about hey, how much money did we save? And uh all these things you address. And I'm I'm telling you, Boon Chapman is lucky to have you because you are you have you watch this, you watch this. So when we look at different aspects of uh reduction in surgical claim, so when there is a decrease in the surgical claim, when the each and every patient's surgical spend is accountable, and uh yeah, and then this decreases their uh stop loss insurance rate because this is when we optimize them ahead of time, because please understand a colonoscopy for somebody who with no risk is different from colonoscopy with somebody who has three vessel heart disease, who was more prone for heart attack. So we can because we have wonderful nurses who go through this chart and stratify ahead of time, and they we run it by our Nesth team, and then we optimize that. It is it is something that has evolved over a period of time, it did not happen overnight. So, all these things we always ask the question what can we do better? What can we do better? What can we do better? So, when we came up with this strategy, it has tremendously decreased the surgical, not just surgical spend, decrease in the uh stop loss insurance, decrease in the lasering of different things, and with a tremendous increase in the member uh experience.

SPEAKER_00 24:14

Yeah, and it's interesting. I was talking with a fellow nurse today, actually, and we were talking about, you know, in her hospital setting that, you know, the churn, because it is the I love making money. It's one of my favorite hobbies. However, if that's your goal, if the revenue is your goal, if that's what you're chasing, well, good luck, because you're always going to chase it. That's a hard way to grow a business and a hard way to live a life. When you're when you're chasing instead a more noble purpose, you're chasing instead higher quality and joy in the work that we do. And how many clinicians do you know do not enjoy their work anymore? Uh, they hate it. Um, the stress for nurses who um carry way too many patients to be safe. Um, and heaven forbid, if they say, you know, I'm not going to take this load because it's too many patients for me to safely handle, well, you know, then they're they're in trouble, not the hospital who's optimized their revenue for, you know, that's what drives the staffing instead of the quality of care. So all those levers, when you think about that, I think about, you know, the incentive that actually drives the different result or the tail that wags the dog, right? Or the head that wags the dog, whatever that expression is. Um, and I think, you know, when when we operate with that, if your goal, my our goal here is always the the member is always in the center of everything we do. And I firmly believe, and I found this to be true throughout my career, when you put the member in the center, everything else will fall into place, including money. Money will start chasing you and not you it. And that's a glorious way to um not only to grow uh a business, but to grow a meaningful impact uh in the lives of the clinician and in the lives of their patients. It's a totally different model could because of the incentives.

SPEAKER_02 26:22

I wholeheartedly agree with you. And this day and age, when procedures are getting denied right and left, and the care that is provided to the patients are getting denied right and left. Physicians are getting frustrated so much that uh they have to spend hours on ends in appealing the denial. And uh what used to be a very enjoyable uh journey was uh it's now physicians, majority of them are stressed out. And uh unfortunately, it is a system that is bound to have a very rough time ahead. Very rough time.

SPEAKER_00 27:09

Absolutely. I mean, people don't perform at their peak when they're miserable. I do not want a doctor taking or a nurse taking care of me when they're miserable because that makes me nervous.

Best Procedures For Bundled Surgery

SPEAKER_02 27:19

You want a happy, competent doctor. 100%. 100% a happy, competent nurse. You want a and uh the nursing care is something that is really, really important. That is one of our quality metrics.

SPEAKER_00 27:34

Yeah, yeah, 100%. Let me ask you this question. Um for an employer or an insurer, a plan, um, what kind of surgeries, what kind of procedures benefit most from this kind of model?

SPEAKER_02 27:54

Usually when uh you when any new employer or new client joins our thing, they usually we try the high dollar surgeries, like uh yes, yeah, like uh spine surgery, including laminectomies, spinal fusion, in the neck, neck fusions, and what have you. And for joint replacement surgeries and other like uh knee scope or shoulder scope, shoulder replacement surgery.

unknown 28:31

Oh, yeah.

SPEAKER_02 28:32

These are all the high high dollar surgeries that is commonly used, and then comes the middle part, which is more frequently used, that is, gallbladder uh surgery, hernia repair, and then comes the one that is used the most, that has the highest impact on their uh number one patients' lives, and also the surgical spend later on down the line, that is preventive colonoscopies in the surgical field. And uh I took care of uh a patient yesterday doing anesthesia, a healthy young man, healthy young man with no medical history, and and the uh gastroenterologist was so smart in finding out the pre-cancerous condition and took it out with the scope before it became any. This is like such a fulfilling uh experience. Yeah, absolutely.

Second Opinions That Save Tens Of Thousands

SPEAKER_00 29:38

And you know, it's interesting that you brought that up, and especially with your story that you shared as we started our conversation, because you know, we were making some headway before COVID hit and everybody went in their shells and nobody was getting their screenings. And now, you know, might as well have that all over again because to your point, I mean, I know families who are paying more in their in their premiums just for the privilege of carrying around an insurance card than they are their mortgage. And they can't even access it until they blow through, you know, sometimes a$10,000 to$15,000 deductible. And I don't know what kind of access somebody has in that kind of a situation. And, you know, when you talk about how in this model where, you know, we can really go after the low-hanging fruit, where are you gonna have the biggest impact on the plan and the member is in those catastrophic, those high dollar cases and the high frequency cases, right? Where you're gonna have the biggest immediate impact. And in so doing, not only do you have a better experience for the member, and obviously there's more joy in the work for the clinician as well, but you're also preserving those plan assets, which members who will never intersect, never need healthcare, they're also benefit from that model as well, right? Because you know, they're not paying the higher shared uh premium pool for the higher risk that's in that population.

SPEAKER_02 31:02

So yeah, along the same line for the high dollar surgeries, we have because of the demand, we are we offer um second opinions so that before they go into bigger surgery. We had a patient uh that came uh from uh Oregon and was charged uh was gonna was going to charge the company sixty thousand dollars for what's called a sacroiliac joint fusion. Sacroiliac joint fusion.

SPEAKER_00 31:41

Not terribly uncommon.

SPEAKER_02 31:43

No, it's not terribly uncommon, and about um literally two hours ago, I did a SR joint fusion myself today at our surgery center. And I promise you, it's not even uh one tenth of uh what we spent on that. So when they sent the patient from Oregon to ask for the second opinion, when I had it reviewed and when we said what we said, the patient uh company offered the patient to do this surgery with no out-of-pocket expense to the patient and flew the patient from there to our facility and had it done. And uh we were able to take care of this. Now we have we can find those places in Oregon to help this. They don't need to fly here. So these are the stories, real life stories, that take a big impact.

The Future For Self-Insured Employers

SPEAKER_00 32:46

Well, you're you know, it's interesting because in that model, not only you're driving down costs and improving outcomes, but you're improving access to care. I mean, if you can't afford it, you have no access. So um that's really incredible. I personally, I know you and I have talked about this before, but I would love to see this model take over healthcare. And, you know, at Boon Chapman, it's one of our big drivers is how can we how can we uh foster more utilization of these independent centers? Because we see, we see from the spend side the spend is less, members are happier. They have a VIP kind of red carpet experience. They're not treated like cattle, shoveled, you know, shuffled along through the through the um stalls kind of experience. And um that's really profound uh in terms of impact for you know for an entire health plan as well. What do you think? What what do you think the future is in terms of surgery?

SPEAKER_02 33:48

Where where are we gonna go when you pull out your scene? The businesses struggle these days, really struggles to keep the door open, keep the lights on in their building, because it is very difficult. One of the biggest spend that they have is that employee health care. That's why they're turning to people like Boon Chapman to help manage that. And when we combine that with what we offer is a surgical navigation, hand holding, risk reduction of the risk, and offering them low-cost surgery. This you are you uh in uh Boon Chapman are helping to keep the businesses open, you're helping to keep put the food on the table for so many employers.

SPEAKER_00 34:39

So the future, the way I see is that we have to this is but you were saying something magnanimous, it was important.

SPEAKER_02 34:51

So uh so what I was saying is that people, the businesses, when they have difficult time in keeping the uh doors open, they have to find ways to take care of their employees, take and cut the healthcare expenses down. One of the biggest healthcare spend comes from surgical spend. So, and when the surgical spend is done with uh surgical navigation, risk reduction, and in a bundle manner, cost becomes predictable. That's where Boon Chapman is doing a phenomenal job. And I have been working with Boon Chapman for a number of years, and it has been, and uh especially since uh we got to know you and your team, it's been a delight to work with you because it's at the end of the day we are aligned in our goals, we are aligned in our drive and passion to help people.

SPEAKER_00 36:00

100%. That's a it's a great mission to be involved in. So I guess you know, my takeaway from our conversation today is that you know, uh better surgery isn't just cheaper surgery, it's actually more intentional. It's designed with the member in the center uh in that episode of care and the outcome. Um, it's not just cutting corners, it's really about adding value and and experience and and making and increasing that access. It's a beautiful model. Absolutely.

SPEAKER_02 36:36

And uh I wholeheartedly agree. And uh we can change one life at a time to the for the better.

How To Find Hinkapin Health

SPEAKER_00 36:46

A hundred percent. Yeah, and even more as you continue to expand. I know you're growing. Uh Boon Chapman is growing as well. So it, you know, whether it's maybe a broker, an employer-sponsored health plan, or maybe a doctor who's like, how do I work with, how do I work with this guy and and uh you know, join his model? How do people find you? How do they get in touch with you?

SPEAKER_02 37:11

Uh bam, it's easy to reach me. And uh I'm on uh LinkedIn and our website is hinkapinhealth.com and uh H-I-N-K-A-P-I-N-Health.com.

SPEAKER_00 37:26

And um so tell me, what how how did you devise where did the name Hinkapin come from?

SPEAKER_02 37:36

I honestly it came up with because my son invented that name. There is a tree that gives shade to a lot of people, it is a comforting tree, and the name is not directly related to that tree, but it is akin to that tree. It is something that gives the shade.

Why The Name Hinkapin

SPEAKER_00 37:59

Oh, I love that. We need shade in this day and age from the scorching rays of a healthcare industry that has become you know largely anything but caring. Yes, and so you know, being able to work with you and your team really truly um it's a great honor. And you know, we are bringing help, we are bringing care back into healthcare. And that's why, you know, folks like you and and others, that's why we come. And that's why we, you know, come into healthcare, you know, in the first place. And if you're in the industry for a while, it kind of beats it out of you. So to find a way back in with a vehicle where you can really do something of significant good in the lives of others is such a blessing. So thank you for thank you for that.

SPEAKER_02 38:50

The feeling is mutual towards you and your staff and Boone Chapman.

SPEAKER_00 38:54

I'll pick you later, Doc.

SPEAKER_02 38:59

Thank you.

SPEAKER_00 39:00

Well, thank you so much for your time and your expertise. I can't wait for part two. Part two, we get a talk with your sidekick, Adam, who's a fantastic Cracker Jack nurse. Not only that, but he's head of the Texas, is it Texas Surgical Association?

SPEAKER_02 39:17

Texas Ambulatory Surgical Association.

SPEAKER_00 39:20

Yeah. So he's a boss in the industry as well. You don't work with small players, you work with real experts. I think that makes a big difference too. So anyway, thank you so much for your time, Dr. Kikiri. Great pleasure. Thank you.