So good evening, I'm Craig Morrow at the University of Pittsburgh, and we're here tonight doing a last webinar for the AOSSM Fellow Series. And this series has been a huge success thanks to Meredith and the entire AOSSM team. Meredith is on here tonight with us helping to moderate, so you'll have some announcements from her at the end, but we thought we'd jump right into our webinar here tonight, which is a topic is building your practice, which we have a great team here tonight, which I'll introduce here shortly. And we thought this was particularly appropriate for right at the end of fellowship to be able to discuss some of the tips and tricks for going out into practice and building your practice. So I'm Craig Morrow, one of the fellowship directors here at the University of Pittsburgh, and our team here tonight, I'm gonna introduce, we have, sorry, let me make sure my PowerPoint. We have Beth Schubenstein from Hospital for Special Surgery. Beth was one of my mentors in my fellowship. She's a great clinician, director of the Patellofemoral Center there, but just has an amazing practice and team, and I thought that would be a great advantage for us to have her on the webinar here to discuss some of her thoughts and tips and tricks. So thanks, Beth, for coming on. And Albert Lin is here in Pittsburgh with me and does a lot of shoulder surgery, helps to run our sports division, and has been a longtime friend, and we've done this type of seminar with our fellows. So he and I have talked about this quite a bit and will be a great addition here tonight. And Jeremy Burnham comes to us from Baton Rouge, was actually a fellow here with us several years ago, and has built a huge sports practice in Baton Rouge with Ochsner, and formerly was in private practice, now in an employment model, so can give us a little bit of the ins and outs of building a practice in private practice versus in the employment model. So Jeremy, thanks for being here tonight as well. So what we're gonna talk about tonight, we have an outline. There's, as you probably have all used this webinar features, there's the opportunity for you on the webinar to ask questions. So if you send in some questions to the chat, they'll come through to Meredith, she'll forward them to us, and we can ask them to the attendees, or if you wanna direct a particular question to one of the panelists, feel free to do so. But this is what we're gonna try to talk about tonight. We're gonna talk about setting up your office, we're going to talk about some tricks and tips for setting up your operating room for efficiency, outreach, how do we go about reaching out to build our practice with physical therapists, primary care physicians, what type of marketing we found to be successful, websites, Twitter, different marketing opportunities, team coverage, how do you go about establishing a network and building your team coverage capacity that we've all trained all these years to do. And then just some thoughts about overall communication and how that plays into your new stage in life as a physician, attending physician. And then the last bit that we'll have some time for that everyone I think wants to shed some light on is their approach to work-life balance and how do you do that in your, especially in your early part of your career and practice. So I think that's kind of the background of where we hope to go with this webinar tonight. And the first topic, as I mentioned, that we're gonna talk about is setting up one's office. And it can be daunting, you've taken all this information, you've taken from your residency and fellowship, post-operative recommendations, what type of injections you wanna use, and you have to synthesize it all together. And so when I was a fellow at special surgery, there were a number of different attendings and they all had different ways of setting up their office, but I think Beth will give us a real insight into how to do this effectively and efficiently. And so I'm gonna turn over to Dr. Schubenstein here to talk about setting up your office and going into practice. Well, thanks Craig and thanks Meredith and the AOSSM and I'm really thrilled to be here. Getting into your practice when you first start, one of the hardest things because you haven't been trained to really do it is actually building a business. And at the end of the day, your practice, even though it is primarily a medical practice and how you treat your patients, it's also a business. And you have to think about what are the key strategies for how do you build a successful business. And on some level, the office is both the front office, which is the clinical staff, and it's the back office, which is your admin staff. And it's important to start to think about the way that people set that up and how you're gonna make your both sides of the office most efficient. So obviously first and foremost, always in our mind is the clinical staff. At the beginning, you're probably it on the clinical staff side, unless you are hiring some type of physician extender, those can be MAs. And actually I think physicians, just people who can assist you in your office, MAs, PAs, MPs, those are all the people that I think scribes are really helpful. And all of those people, you're gonna start to think about how they integrate into your practice to make you more efficient. But at the beginning, it's really about patient care on the clinical side and making sure your patients get the best care, get the best communication from you. But always try to remember that the first thing your patient sees or hears is the voice of your medical secretary, your surgical coordinator, or your front office, your office manager. So those people have to represent you and you have to make sure there's a great book called Good to Great, where they talk about getting the right people on the bus. That's the critical part of this. You have to get the right people on the bus. So what I would say, one of the most critical mistakes I made early on was being thankful that someone was working for me and not being critical and not wanting to rock the boat because I had just gotten started in practice. And so one of the staff wasn't really pulling her weight. She wasn't very nice to patients. She was a little edgy when patients would call with questions or problems. And what I found is that I tolerated more than I should have. And you have to figure out how to get the right people on the bus and the wrong people off the bus early so that you have a practice that represents you. You want to make sure your patients see you and what your expectations are at every point in the process. So I think that's really critical. It's obviously not as critical as taking good care of your patients, but it becomes equally as critical because patients are going to really want to communicate with your office and they're going to spend more time communicating with your office than they do with you. So I think getting a surgical coordinator who works with your patients and doesn't lose patients, a medical secretary or whoever's going to be booking appointments who's patient and who understands that patients are agitated sometimes because they're in pain and they get frustrated and being able to have them understand how to be calm through those situations. And then I think the other part of this is how do you make yourself most efficient in your day-to-day practice? So I actually have now evolved to the point where I have a nurse practitioner who works with me. And when it came time to figure out a nurse practitioner or a PA, I actually ended up with both in different models. So my nurse practitioner is a full-time employee. She works with me every day. She does have a first assist ability. So she took the first assist course. So she can assist me in the OR if needed, but her primary role is being a non-operative specialist in the office. She sees almost everybody unless it's an acute injury and we know their surgery. So she'll see patients every day of the week, which makes access to my office much easier. You can call and get an appointment within a day. She can get you teed up with an MRI. Certainly she can see a swollen knee and aspirate it and decide who's an arthritic swollen knee who doesn't need anything but cortisone versus who's an injury that needs an MRI. And those are things that are extremely helpful because she has ability to see patients all the time, whereas I only have ability when I'm not in the operating room. So she's made me much more efficient. And then I have a PA that's part-time that only works with me when I'm in the OR. And that means that even when I'm in the OR, when I'm traveling, I have somebody who's in the office taking care of patients on an everyday basis. So that's been extremely helpful. We have a scribe who is actually my research assistant. She runs my multi-center study and she scribes with me on new patients so that she can capture the new patients for my research studies. So she serves several different roles. She's not just a scribe. She actually consents patients for studies and things like that, which is really helpful. She can explain the study. She can spend more time. She can make sure that the appropriate imaging is done for the studies. And she's one more point of contact for patients to ask questions to, which is very valuable. So that's, I think, sort of the things that I have found most helpful in setting up my office, but it's taken a long time to get there. And I think the things that you can do right out of the bat are just to make sure that you get the right people at each point along the way. That's a great point. Thanks, Beth. And I think that the systems that we all go into, I'm wondering, Jeremy, if you have thoughts about how this was for you going into private practice or going into employment model, being able to get the right people in the office for you, challenges, benefits of one versus the other, what are we facing there? Yeah, I think that the core principles are the same. One thing that I definitely agree with is if you start off with the wrong person, it's hard to remedy that situation. And so one thing that just over the last few years I've done has started to be more and more selective about interviewing people and how to find the right person and trying to figure out new ways to kind of screen people at the beginning. You can't always predict, but I think that the people that you surround yourself is the number one most important thing. And in private practice, I think in some ways, maybe there's more autonomy, but I think you can still, even in employed model, do the same thing. And a lot of it has to do with buy-in. So if my employees buy into treating patients the same way that I wanna treat them, then I think everybody's working on the same team. And so I agree with everything that was said. It's funny, Beth, when you mentioned your kind of your first experience, when you start and you're just happy to have somebody, that's exactly how I felt when I had my first secretary. And I had to, I tell all my fellows, she was awful. And I didn't know what to say at the time because I was just so happy to have somebody helping me. But I think your secretary, the person who answers the phone for you, the first face of your practice, has to be affable and they have to be efficient. And I think those two qualities, I have that now, but it took me a while to realize that if you don't have that, you are suffering from the very beginning. And then the other thing I would add is, I think you had some great points for what you were saying. Basically, I think the whole context of availability is really important. So you had mentioned that you have an MP now who's always available. And I'm sure, Jeremy, you have a model, and I know Craig does too, where essentially, I mean, every patient wants to know you care about them. Every PCP who refers somebody to you wants to know that they can get them in to see you right away. And I think it's this whole concept that you're always, I mean, to some extent, that you're available. Hey, if you can't reach me, you can reach my nurse practitioner. If you can't reach me, I'll call you back. You know what I mean? You have to have some system where people understand that you are listening to them, you care about them, and you have a way of communicating that. I think that's a really, really important point. And then the third thing I would say is, is everyone has their own tempo in clinic. It's gonna take you probably a while. I think it's gonna take you a few months to realize what your tempo is. Some people can really kind of go in and see people for five minutes, and that person feels like they've, you know, I know Jim Bradley will see 70 people in clinic, and they all feel like, you know, they all feel like, you know, Dr. Bradley spent, you know, all this time with me, but he was literally in there for like 20 seconds, right? But not everyone is like that. And you have to develop sort of, what are you like as a person? Like, are you the kind of person who needs to spend a little bit more time, you know, chatting with somebody? Are you, you know, to make somebody feel comfortable? Or are you the type of person who can make someone feel comfortable in three seconds? And I think those things will kind of, they will kind of also dictate sort of how you run your practice, how many people you can reasonably see in a given day. And that takes a little while to kind of figure out. So, you know, understanding what your tempo is, I think is pretty important too. Yeah, I think those are great points. And I think that we, you know, healthcare is changing, and we all find ourselves in some ways involved with most of us, with these big institutions that, you know, you can lose some of this personal touch. And so if you can surround yourself, even at the small level with people that have that good interpersonal touch and make the patients feel cared about, even if they're coming to a monster behemoth of a university or a health system, I think that really adds a lot to the practice. I think that's what you're hearing from all of us here. How does that play out in the OR, Albert? I mean, it's similar kind of ideas, but what are your thoughts about kind of getting a tempo in the OR and kind of booking your cases and getting comfortable on your feet in the OR? Yeah, so, you know, I know we've given this talk to our fellows like multiple years. And so I think the very first thing, and if you don't remember anything else from me today or, you know, anything at all, just remember when you start your practice, it's really important to keep your indications really tight. And I'll say there's a reason for that. One is if you keep everything tight, your patients will do better after surgery. And there is some pressure when you start to say, okay, I gotta get busy, you know, as soon as I can. But the one thing I will caution you against is do not make your indications sloppy for the sake of being busy. Because that gets me to the second point, you have a very little time when you start a practice to develop a first impression. I think that first impression gets made probably within your first, you know, four to eight to 12 weeks in practice. And so if you are very tight with your indications, you're doing surgery on the right people for the right reasons, your outcomes will be good. And if your outcomes are good, then people understand that you're, you know, you know what you're doing. And I think not only is it, you know, just kind of building your name, but it also gives you confidence, right? Because when you start, it's a different world. You'll see, you know, you want help and the crickets are chirping a little bit, right? It's just you. And so if you, you know, kind of have a stepwise kind of process in your head about why you're doing surgery, what you're gonna do and doing it kind of right, it'll also build your confidence when your patients do well. When your patients do well, then, you know, they'll also refer, you know, other people to you. I think the third point here is making sure you set very realistic expectations for yourself in the OR. You know, when you go to a good fellowship or a busy fellowship, you're used to seeing your attendings, you know, kind of running two rooms, doing, you know, eight to 10 cases or out by three. And you think kind of like, you know, by osmosis, that's just kind of gonna be you when you start, right? But it's not the reality. And the reality is it's gonna take you a lot longer to do things, you know, in your first two years of practice, and it will really the next three to, you know, 10 years to 20, you know, 20, 30, 40 years in practice. I think those first two years are huge kind of growth curve. And it's like, you know, it's a huge learning curve. And so, you know, make sure that you set your OR schedule to accommodate that, you know? I wouldn't book, you know, four large, you know, single room, four large rotator cuff repairs in one day. Because again, your impression is made very quickly, right? So you wanna be the guy that books somebody, a case for two hours and finishes it in an hour and a half. You don't wanna be the guy that books a case for an hour and takes three hours to do. Once you're that guy, it's like really hard to not be that guy. And we all know that guy somewhere in our hospital system. And so, you know, I think really kind of, you know, kind of setting it out and making sure you understand like how to schedule your cases is extremely important. And the third and the fourth thing I would say is in order to get yourself prepared for the OR, nobody knows you in the beginning. And so you have to go like the extra mile in the beginning to communicate what you want and sort of what you need in advance. Because nobody really understands, you know, you or sort of your style, what you need. And one thing that I used to do as a practical exercise is, you know, when you're not as busy and you have time to do this when you start, I would have a surgical checklist of, you know, things that I would do commonly. And so that checklist I'd say would say would be as simple as, you know, positioning. It would say beach chair. It would say, you know, spider arm holder. It would say all these things that I could kind of submit to the OR when I was booking cases. So they knew exactly what I needed. Oh, I need Arthrex there. I need Smith and Nephew there. What implants might I need there? I need the four or five shaver. And it made a brainless for the OR honestly. And so when you make a brainless for the OR, you know, you make it a lot more comfortable for everybody when you start so that you're not upset that something's not there. Why isn't this there? Why isn't that there? But that goes into, you know, kind of the advanced communication. So I think if you can kind of, you know, set those guidelines for yourself, you know, tight indications, realistic expectations in the OR, communicate frequently. I think those, I think are probably the, some of the, for me, some of the key things that I found helpful starting. Yeah, that's great, Albert. I mean, it kind of gets to the, you know, the example that's used. If you book the case for an hour, if you book the case for two hours and it takes you an hour and a half, then you're really efficient. If you book the case for one hour and it takes you an hour and a half, they're like, why is this guy so slow? So just- Everyone's pissed at you, right? Everyone's pissed. They're like, who is this guy? He's taking forever. You booked it for three hours and it takes you an hour and a half. They're like, God, this guy's fast. So, any thoughts about that? I mean, I think that's a great summary by Albert. Do you guys have thoughts about kind of the issues there? Yeah, I think those points are fantastic. I would go a step further with the setup that you talked about. I think when you get into practice, you got to get six months or a year under your belt with no complications. Everybody has complications. They come, try to pick your cases so that you can get a comfort level with those cases. And to that end, set up your own cases when you start. Go in the room, set up your own cases. The last thing you want to be doing is sitting there without the exposure you need because someone else set up the case and it makes you look bad, even though technically it's just you're struggling with the exposure. So, set up your own cases. Go speak with your, you know, one of the benefits of being in practice for a long time is I have the same staff each week. I don't have to go talk to them anymore. They know my cases. They know what I want. If there's a different case, if it's critical, if it's a different case than I've done in a while, I'll still go over it with them. But I think communicating with your scrub tech and your circulator at the beginning of the day, especially if you don't have the same ones every week, first of all, it lets them know they're part of a team. And I think that's a huge part of it is making it feel like it's a team effort. And it also tells them what you need for that day, which I think is critical. So, I would say set up your own cases when you get started. And at the beginning of the day, have a huddle with your team at the beginning and just talk about where the critical points in the day lie and how they can make them easier for you. Yeah, I totally agree with that. I, to some form like you, Beth, like if there's a case that, you know, is unique, I still do that now. I'll go in early and say, hey, what do you got on that table there? You know, but, you know, when I started, I got there early, you know, like not 15 minutes early, but like 45 minutes early, like made sure they had everything that I needed and was definitely there for the positionings. I think that is, you know, a critical thing and to a degree, when the staff sees that you care, they care. And so like, oh, you know, you know, Doc came in early to help set up, like, you know, this guy, you know, this guy, this woman that means business. And so I think they will take some ownership of that. Yeah, I think it's always helpful. And for the graduating fellows here who are going out in practice, I mean, just setting up a meeting with the OSU staff or the clinical specialist who's going to be taking care of your service in the given hospitals where you're going to be operating really goes a long way. You know, just reaching out to them, I'm new in town. Here's what I've done. Here are my kind of general preference cards. How do you guys do things? You know, are there templates? And just setting up that dialogue early is really helpful. And I'm sure the fellows are learning that and doing that, but I couldn't agree more about the importance of communication with the OR. The next thing I'll jump to, and I can talk a little bit about this, I guess, is about outreach to primary care physicians' offices, to PTs, and I welcome kind of Albert, Beth, and Jeremy, your experiences with this. I really found it helpful early in practice, the month, two months, three months that I started in practice to make a real commitment. I wanted to make a commitment to the community and to the community to make a commitment to make a real commitment. I went to my partners. I said, who are the important physical therapists in town? Who do you guys have good relationship with? Who's important for me to know? And I reached out to these groups. And I, you know, coming from a big, you know, employed by the health system, a lot of private physical therapists in the area were like, what is this guy from UPMC, you know, reaching out to us? You know, the UPMC is trying to bury us, but it has been really helpful to have these relationships over the years. And I still have some great referrals. So I, you know, I just found this, you know, you can do it in a couple of days. I reached out, I set up meetings. I went out to the physical therapist locations. And I think that really helped me to understand what the location, where the locations were, what kind of patients I could send to these people. I could say to the patients, and, you know, I have a relationship with this physical therapist. You're gonna get, you know, good attention there. It gets buy-in from the patients. And you can do it in an afternoon. You can visit five or six physical therapy offices and leave some cards. And for me, that was really helpful in the early stages of my practice, probably more so than the primary care physician offices. I know people talk about that, but for me, you know, the physical therapists, other orthopedic surgeons, or probably athletic trainers are much better referral sources in general than the primary offices. Jeremy, you've gone through this a couple of times now, building your new practice at auction or employed. What kind of tricks have you found for either the private practice world or the employment world of kind of developing these relationships? Yeah, you know, I think the fundamentals are the same between the two. And what you just mentioned about physical therapy was definitely dead on, you know, where I started my practice. And I did the same thing. I think you had kind of talked to me about that before I finished fellowship. And so, you know, day one, when I got in town, I started trying to meet people and make sure that they had my cell phone number so if they have a patient of mine, they can feel comfortable calling me or texting me if they have a question. And I think that that went a long way. And if you think about the geographic area your patients are coming from, even if you're in a big system, they're gonna go to other places for physical therapy oftentimes. And so those are really good referral sources. And I agree, probably more so than the primary care doctors. And so I really tried to kind of build that relationship and make sure that I could be a resource for the physical therapist as well. And then, you know, I started doing, I think that what you were doing, you probably still do, which is if I sent a script to a physical therapist, I sent that directly and I put the person's name on it and I put my card on there and oftentimes just kind of wrote them a note so that they knew that, you know, my contact info and that they could feel comfortable reaching out with me. And then I agree, I think the other patient source, at least where I am is probably athletic trainers. And so if you think about the whole sports medicine team and who usually ends up dealing with that patient first, it's usually an athletic trainer on the sideline or at least ideally somebody's out there. And so that's been a big part of it too. And I think building those relationships, identifying places where maybe there need to be an athletic trainer and there wasn't already and trying to help fulfill or serve that purpose has been something that we've done and has been successful. What's your relationship been with the primary care physicians? I mean, one thing that was told to me, which I think was helpful by a senior primary care physician in my hospital, he said, you know, when you get a referral from, he said from me, but from primary care physician, send a direct letter back to them. You can't, you know, your senior partners can send this half Xerox thing that says, dear doctor, thank you for this patient. And they can get away with it. But as a new doctor, you're gonna go a long way if that primary care physician gets a letter back. And it's tough to stay in electronic records to do that. But I think there are ways of still making that connection even with the primary care physicians. I know Beth, is that still part of your communication style? Yeah, a hundred percent. I think there are different levels of how we communicate oftentimes. And by the way, just to the point of the physical therapist, it works both ways. First of all, going out to the PTs is great because you let them know what your specialties are. And so they know when to refer patients. It also gives them a little bit, makes more approachable. And I think that helps invaluably when patients are having problems. I've seen patients come back and somehow the therapist never contacted me and I'm seeing them six weeks later. And I'm thinking, how did they never reach out and let me know that this patient was falling off the curve? And it's an approachability issue. So if you make yourself approachable and you get to know the therapist, they're gonna feel very comfortable emailing you and saying, hey, Dr. Shubhansett, Linda's having a real issue. I don't know what to do. Here's what I'm finding. Would you mind if she came back and saw you or do you have any tips? And that lets you know. So I think that's a two-way street. I think it helps you with referrals. I think it also helps the therapist feel that they can communicate with you. Levels with PTs, I have PTs who now send me patients routinely because of my specialty. And so as we were talking about, I always email them back afterwards. Most of them will email me ahead of time to let me know they're sending someone, which is helpful. If I can also catch them in the office and you have a little line that says referred by, I think that's a critical line on your office note. So that you're, and I have my office now have a referral sheet at the end of the day. So on every day we see patients, I have a list of people who were referred by someone, not another patient, but a PT, an athletic trainer, another orthopedic surgeon. And that way I can respond back personally to them. Now, sometimes if it's a physical therapist, my nurse practitioner, I'll shoot them an email and CC me because it'll decrease how much work I have at the end of the day. Sometimes, sometimes if I can just shoot a text to one of them, if I know them well, I'll do that. When it comes to an orthopedic surgeon who's referring me a tough case, I'll call them. I really think that's sort of, there's tiers. And if it's a complex case and they're referring it to you for a reason, I think you reach out personally and you just say, hey, let me first say thank you for trusting me with the care of this patient. And let me tell you what I thought. So I think those are all different ways of how you can communicate, but however you do it, you have to have a level of communication that makes the person who referred you the patient feel comfortable that you're taking good care of them. That's a great point. Yeah, Craig, I would say, we work in a large system where we're really connected. I think early in practice, actually a few, after speaking to a few therapists, they actually came to approach me and said, hey, can I spend some time with you in clinic? The answer to that should always be yes. Have them in clinic, have them come get to know you, understand who you are. But I think, like what Beth was saying, I really think with these type of referrals, it's always nice to, particularly somebody that you know, or PCP refers, or another physician, or another therapist who knows you well, shoot them a quick message. They appreciate it, and just like, and I totally agree with that, when they know that you're approachable, they'll get in touch with you when something is not right. And then you'll know, say, hey, I actually know this therapist. She seems, or he seems like a really decent person. I know to trust him when he calls me, or when she calls me to tell me that something is not right. I need to see this person. I definitely think it goes both ways. I think the overall arching theme here is really communication of some fashion here, right? And I think people appreciate it. PCPs, in particular, wanna know that you're available. And I wanted to make an additional point, is that very early in practice, a mentor of mine told me, hey, treat your non-operative people the same that you would treat operative people. And it's really hard sometimes, right? We all have those clinics where we're like batting, like, you know, badly, right, for operative cases. And then the last thing you really wanna see is like, you know, scapular thoracic pain, or whatever, you know, patella, you know, patella, bilateral patella. I knew that was coming, but okay. And you wanna get out of there as soon as possible. All you wanna do is go in that room and just get the, you know, get the F out of there, right? But the here's the thing, like, patients know right away when you are BSing them. Like, they know, like, when you don't care. And so here's the thing, like, sit down, like, take some time to talk to them about this issue, because they'll say, oh my God, this guy actually listened, and even though you didn't get an operative case out of it, or, you know, maybe it was just, wasn't really much, they'll say, hey, this, you know, this girl, this, you know, this guy, they were, you know, they were great. They'll send somebody to you that they, that, you know, a family member or somebody who is actually operative. And so I think if you don't treat your non-operative people the same way, you're gonna lose a lot of patients that way, and their referral base. Yeah, I think, Albert, it's interesting, the, I always get frustrated when I hear the line, patients say, oh, I saw this other person, he told me he couldn't help me. And I'm wondering if that's communication style, or if that's truly what the physician said. I mean, I think every non-surgical patient, you're doing them a service by directing their care in that direction, and, you know, giving them the best non-surgical care, and in fact, that's probably the better thing you're doing for them, if that's the right thing, is by actually helping them. So if you can get that across to your patient, that you're actually, you're looking after them, and you're giving them good care, even though it's not surgical, and not leave them with the impression, he couldn't do anything for me, I think that really goes a long way to kind of what you're saying. Yeah, so I guess that kind of takes us into some of this kind of true marketing material that we wanted to talk about here tonight, which, you know, I think some of it is what we talked about with reaching out to therapy groups and primary care physicians, but other bit is giving talks, or having your website be up to speed, or being active on Twitter. And I'm just wondering how each of you have kind of navigated that. There's certainly pockets of the country, probably Beth in New York, where this is really important. There may be other parts of the country where it's not as important, or other practices where you're gonna have more of a community-based referral that maybe the big Twitter stuff isn't as important. So I'm just wondering whether, how you guys, how you've approached it, and how much time you put into it, how much effort, and how much return you've gotten from some of that type of marketing work. I don't know, Beth or Jeremy, thoughts on where you wanna start with it? Yeah, I mean, one of the things that I will say is it's an uncomfortable situation to try to market yourself. Being an orthopedic surgeon, on some level, I sort of finished my training and thought patients would just know that if they heard I was good, then they would come see me. And if I treated my patients well, I would get busy. So, you know, we all, at least in the city, we all knew the dermatologist who had a billboard on the subway and we all saw who it was and it just made my skin crawl. So I really, you know, pun intended. So I didn't really want to be someone who marketed myself, but on some level you have to do that. And I think the way we market has changed. So whereas when Craig got out, when I got out before Craig, you know, I introduced myself to people and I tried to meet some of the primary care docs who are around, some of the primary care sports docs that are around, the athletic trainers. I think that's certainly one very important arm as we've talked about. But the other part that you can't neglect anymore is social media and having a web presence because our patients are young, at least most of our sports patients are young. And the first place they're gonna go is online to try to find you and to see who's gonna do their ACL or who's gonna do their cup or who's gonna do their UCL. So you got to have a presence and the presence has to be probably multifaceted. You have to have a good website so that if they want to find actual information once they decide they're coming to see you, you introduce yourself well, you introduce your staff on your website, you have very specific, again, communication. You communicate to the patient through the information you have on the webpage that's gonna help them understand why they should come see you. But there's also this aspect of now being present on social media. So whether it's Twitter, Instagram, Facebook, my office actually has a presence on all of them now. I was the reluctant social media doc. I really didn't want to do it, but I understood that it was a must. So I actually had my husband's soccer buddy growing up, he runs a company and he started me on it. And actually we spent about two years with them getting us up and running. And now my nurse practitioner and my PA and my research assistant and I kind of usually at the beginning of the week, they propose a couple of different posts that we can do and then we decide and we do it and then they do it. But however you do it, it is a necessity at this point, probably not just in New York City because all of our patient populations are of the age that that's where they're gonna wanna find you. Yeah. Jeremy, what's been your experience in Baton Rouge? Is it your patients coming in because of online material? Do you guys use it heavily with the high schools, colleges? How has that played out? Yeah, we do. And I think when you talk about that patient population, it is a younger patient population in general. And they're on social media and they're on the internet. And when they're thinking about going to see a doctor for their knee, the first thing they're doing is getting on Google or Facebook or Instagram or something like that and looking at things. And so I think that it's almost a must that you have some kind of presence on those. And we track on that. I have a referral line in my clinic note as well. And so if it comes directly from a doctor or a physical therapist or whoever, we put that name on there. But if somebody says, hey, we found you when we searched Google for knee doctors or we found you and saw an Instagram post, we put that on there too, because that helps me have an idea about where people are coming from. And I'll tell you that a lot of the stuff that I really like to do from a sports medicine standpoint, whether it's knee ligaments or cartilage or meniscus, a lot of that comes from the internet, either from the website or from social media or something like that. So I think it's had a dramatic impact on my practice just as far as helping direct some of the things that I really enjoy doing and passionate about to me, that maybe those patients wouldn't have found their way to me otherwise, especially starting out. So I think there's different ways to do it. You can do it all organically yourself. There are different people that you can hire to do it, but I do think that it's necessary. And each social media platform kind of has their own strengths and their own weaknesses. And so I think you look at Twitter and Instagram and Facebook, and I'm the same way. It was not a social media person, but you really, I think you need to have some kind of presence on all of those. And you're just trying to increase the chance that the patient that has a problem that you can help them with can find you. No, that's great points. I haven't been very active with Twitter or like social media platforms. And I am kind of looking inward and saying, how do I best do this at this point in my career? And how do I, you know, is it, and I kind of question sometimes, is it better to just give little snapshots and say, okay, we were, you know, we had a great conference this weekend talking about knee ligaments and kind of putting some information out there that then finds its way. Or have you found kind of putting your own research or other presentations you've given out there? What kind of stuff do you put out there, Jeremy, when you do it? Yeah, I try to stay with objective information and try to just provide content. So for instance, on the website, you know, and when Google tries to figure out whose website they're gonna show a patient, they're really going on the content that you have. And so I may post a little blurb about a research paper that was published and just write a couple of paragraphs that are very easy to read, just with a brief synopsis of what it showed. Or, you know, update if we did, if we had a sports medicine, you know, conference with a bunch of different people in town, I may kind of just post an update. And I think that, you know, the patients aren't the only people that see it. I think physical therapists and other healthcare providers in the area see that too. And so it just kind of alerts them that, hey, this is something that you can see or that, you know, you're available to see. And so I kind of try to do a mix and I stay away from, I think in medicine, you know, you stay away from the really aggressive kind of marketing type tactics. And I just try to provide content and a resource. That's great. So, you know, Craig, you know, you and I probably are similar in this. You know, I don't think I've been as active in these platforms as much as, you know, Beth or Jeremy or many of my colleagues, but I agree with Jeremy. I think that approach seems to work the best when I've seen it. It's just content, not like, you know, not like the billboard dermatologist that you're describing, Beth, but kind of posting things that, you know, that are meaningful to you, that you presented, you know, some, you know, papers maybe that have been published that the patient can tangibly read very quickly. I also think it depends on sort of what geographic location you're at, you know? And so you can be in a location where there are several, you know, competing kind of systems and, you know, you need that to kind of distinguish your practice. I think in Pittsburgh, Craig and I are kind of, you know, benefit from a very large system that has essentially almost a monopoly in the entire city. And so their web presence is pretty significant already. And UPMC will have actually some social media presence that we benefit from. And so I think some of this depends on sort of your health system, your geography, and also in sort of your own personal comfort with advertising yourself on social media. I'm gonna interject for one second because one of the things that I heard repeatedly from Jeremy and from Albert is this, a concept of content, which is really important. And I think then it becomes less what we consider to be marketing or aggressive marketing. And it's really you putting information and content out for your patients. So there's a couple of ways to do that. You can certainly highlight if it's marathon time, you can highlight some interesting things about running injuries and how to avoid running injuries. You can base it on the, if there's a, you know, if it's a US Open, you can talk about golf injuries, things like that. You can also, which I think is really helpful is short videos. And this is where it takes time. And I'm not as good at this, arguably, I would tell you I have to get better at it, but short videos of you explaining something that can go on your website as a blog or that can go out on Twitter, or I guess it can't go on Twitter, but Instagram, however, whatever media you put it through there. It's really helpful for the patients to see you and get to know you. They want a relationship with you as your doctor now. It's not a paternalistic society anymore. They don't want you to be remote. They don't want you to be this, you know, higher up who tells them exactly how it's gonna be. They want you to be approachable and for them to feel like they can communicate with you, just like we were talking about with a physical therapist. And I think that those videos really do help. That media or that platform is very helpful for patients to feel like they get to know you. Even a short video on your website that tells them something about you, why you got into sports medicine and what your mission is. Those are really helpful. Patients talk about that all the time as ways that they felt like when they come in, oh, I felt like I knew you because I saw your website and that video that you did. So those are, I think, are really helpful ways to put things on your website or out there that are true to you. Those are great points. I'm taking notes here and I will learn from this. I think that, you know, part of this feeds into some of the stuff we talked about earlier with the athletic trainers and just building a presence in the community. And it probably helps to establish some of those connections but kind of moving into some of our next topics about team coverage. How does that, you know, team coverage is interesting because some of it's based on some relationships that your health systems have. Some of it can be territorial in your small towns. There may be a, somebody's always taking care of a team. I guess the question is, how does the new orthopedic surgeon in town kind of navigate those politics of teams as well as health systems, our previous relationships in order to tap into the teams and tap into, you know, growing a sports medicine business and tap into, you know, growing a sports medicine practice in a community. Jeremy, thoughts about that? And you've navigated this well. How do you build it up as the new guy in town? Yeah, I think the key is what you mentioned, which is that a lot of places have relationships already. And so I think, you know, coming into town or starting to practice, you really have to spend a little bit of time and just understand who has relationships where, because you don't want to step on any toes or do anything like that. And then I think you have to be willing to just put your time in and just, you know, pound the sideline. And so when I first started, we had, you know, some relationships already, but there were, for instance, like a small school that didn't have an athletic trainer. We started looking for that. We started talking to them. I would just go cover practices sometimes, you know, it wasn't even football season. And I think you just have to be willing to put your time out there. And what I try to do is build a relationship with the coaches and the different school, you know, administrators and things like that so that they understood, just like you're doing when you're talking about, you know, another physical therapist or another physician that you're talking to, what you're all about and that you're trying to provide a resource. And I think when you put that time and you build that relationship, that's how it starts. We identified some schools in our area that did not have athletic trainers. And, you know, I felt strongly that that's something if you're having contact football, that we should be able to find a way to have athletic training coverage out there. And so that's kind of where we started, but it all started after just really building a relationship for the schools and in some cases going and covering practices and things when we didn't have an athletic trainer that was identified yet. And it's really grown from there. And, you know, I try to treat it when we have relationships with schools or contracts or we're providing athletic trainer services to a school, not as a referral source. So I try to look at it as we're trying to provide a valuable service to the coach and the parents and the athletes. And if we do a good job at that, I think that everything else takes care of itself. So we don't pressure, you know, athletic trainers or coaches or anybody like that to send patients to us. In fact, if they're gonna send them to another doctor in town and it's somebody that I know, I'll try to help expedite that and get them in sooner and just play nice with everybody. And I think that if you do the right thing and you take care of people, that eventually that comes back around. Jeremy, you should tell the outgoing fellows sort of how much you grew this. You were kind of telling, you know, telling us a couple of days ago, but you went from something really small to something like really large actually. Yeah, absolutely. So when we started really, we had, when I started practice, we did not have contracts or formal arrangements with any high school. And we built that, I think the first year we were able to put together four or five teams that we helped find athletic trainers for and just provide a team coverage for. And now we're up to, in the system that we moved to, we're up to 20, 25 schools. And that started, you know, from two years ago with really zero or maybe one schools as well. And so it'll kind of catch on and snowball. I think if you do the right thing and, you know, when you, same as when you're looking at hiring office staff, when you're hiring athletic trainers and working with athletic trainers, try to find people that have the same kind of core values and how they're gonna take care of the athletes and then communicate well. And you can't just sign these contracts with these schools and find an athletic trainer to go out there and cover and then never be there. And so I spent a lot of time after hours, after clinic, even on the weekends going by those schools. And I try to show them that I'm available, let the coaches know they can call me. And I think that's really one of the keys because just like your patients, when you operate on a patient, that patient's either gonna be an advocate for you or not an advocate for you. It's the same thing if you're taking care of athletes and working with coaches and athletic trainers in the community. And so you really have to represent yourself well with everybody. And then I think it kind of snowballs from there. That's a great point, Jeremy. I really like how, you know, you framed it that you're not, this relationship isn't set up to be a feeder for you. You know, if you frame it as you're doing a service and building your practice, the rest will come. And I think, you know, if you take care of these players, take care of their families, it may not be that the player you got, you may get grandma with a rotator cuff because you were available and you were standing there by the training room and she said, you know what? My shoulder doesn't bother me. So I think, you know, that was kind of ingrained in me as well from some of my mentors to really just, you know, take care of the team and they'll take care of you. I think that, you know, the next point that we talked about quite a bit was just overall communication styles. And I think that that's a challenge that we all face through our career to be available, but also to how do we, how do we kind of moving into the next step? How do we manage that work-life balance? How are we available? How do we communicate? So, you know, I don't know how to frame this specifically. Albert, you do a nice job of being available, but how do you, how do we balance this when we start into practice? How are we available and doing all the things that we just talked about for the last 45 minutes, but not have it take over our Sunday dinners and, you know, breakfast with the kids or however you want to get that good quality time in? I tell you, and I think everyone here is kind of smiling because, you know, I think the more we do it, the more we are trying to learn, right? I think, you know, when you start, you're not as busy. And I think that's actually where you need to start putting kind of work-life balance in perspective because things get busy and they get busy quick. And, you know, I think all the panel here is, you know, I think we're all very available in some fashion, right? So I think we understand what the importance of communication is. And so, you know, there's a couple of things we do. Like I make sure that my staff answers all phone calls by the end of the day. There's nothing worse than patients calling and never hearing from you. So I think whatever system you have of doing that, I certainly, you know, through our system, I'm able to respond directly back to patients through our EPIC system. And so I take care of that sometimes myself if people are overwhelmed, like my secretary or my PR, my NPR, but we have some method here of always kind of getting back to people who need sort of attention. I think for me, you know, one thing, and of course this is something I still, you know, kind of struggle with, I think, as, you know, as we get, you know, as all of our practices, you know, continue to get busier and busier, it never gets less busy, you know. One of the things that I think we did, my wife and I, before we had kids, tried to set aside a time every week where we could literally just kind of, maybe it was just an hour on a certain day of the week. And for us, it was Thursday. And we'd say, okay, let's not, you know, veg out on the TV when we get home, or, you know, let's actually try to talk to each other. And in the beginning, it seemed kind of silly when it wasn't like, when we weren't that busy. But actually, as time has gone by, you know, those are things that in little snippets of time where you can feel like a sane human being, you know, and try not to disrupt it with, you know, kind of answering your texts or your emails. I mean, it's still exceedingly hard to do. I mean, everyone's trying to get in touch with you, right? Everyone in the whole world, patients, athletic trainers, you know, other physicians, whatever it is, your research assistant, you know, everybody is always trying to get in touch with you. But I think it's really important to set aside at least some time where you can say to your family, hey, let's not have work be anything, any part of this. And it's hard, it's certainly really hard. Yeah. I'll just say one of the things that I think is interesting is when I first started in practice, just to give you an idea, I gave every one of my surgical patients my cell phone afterwards. I said, you know, if you have any issues, actually, this came from Steve O'Brien, who trained me when I was a fellow at HSS. And I gave everybody my cell phone. And so I think the idea is to be as accessible to people when you start, as Dr. Lin mentioned, you're not that busy at the beginning. So it's a good time to kind of get that concept of being available. And then all of a sudden the floodgates open, you don't know what happened because now you're too accessible. And I think that's where you want to try to figure out when it's time to start titrating that accessibility. Patients need to be communicated with, but they don't always need to communicate with you. So I think that's part of what you have to build in. This goes back to getting the right people on the bus, or in this case, getting the right people in your office. What I did at the beginning is it was access to me, and it was only access to me. And then a couple of patients abused that privilege of using my cell phone and I started to slowly build in gateways. But those gateways are still very good levels of communication with my NP, with my PA, with my research coordinator, if there are questions. But they will always, and because those people are people I have trained and people who I work really closely with, they know when to reach out to me and get me involved. So patients don't feel like they can't get to me, they feel like they get to me if they need to. And I think that's a really important part of that creating that work-life balance. And then the other part of it on the home side is, as Albert said, set aside some time. We actually started now, I think it's eight years ago. So I was about eight years into practice, nine years into practice, and we started taking the entire month of March off and because of team coverage, my husband's team coverage, most people, I know Dr. Warren did it every July because football season and camp started in August. And when I trained at Columbia, Biliani took the whole month of August off and I used to say, wow, a whole month, that's crazy. My husband's team coverage means that March is the best time. So we would pull the kids out of school, we'd go to Wyoming and we'd homeschool them for a month. Then we get to spend a whole month without doing it. And it's because your brain needs to rest. A week, as we all know, doesn't really give you enough rest because you spend the first two days wondering about your surgical patients you just finished operating on. And then you spend the last two days revving up for the next OR day and wondering what's going to happen. So I think there are ways to build it in and different levels of practice to get different amounts of quality time. But I think it is important to think about it ahead of time because if you only think about it once you're too busy, it's hard to build it in. Much easier to kind of set your sights on what you'd like to do at each level and stage of your career. Those are great points. I also, it took me a couple of years, but we don't take a month, but I now really cherish my two week vacations. We try to do two weeks in the summer and two weeks at spring break. And you can say, how am I going to be away from my practice? But if you get the right team there, my PA is seeing patients, they can, you know, everything's accessible. It really works. It really works great. And I agree with you about the time, Albert. We, you know, Camilla and I, we started setting aside a date night and initially it was like, we're going to do this every week, but we really got into the habit. And now it's like, we're kind of addicted to not doing bedtime for our kids on Wednesday nights. Wednesday nights is our night. So we go out to dinner. We sometimes find ourselves getting home before the kids are asleep and driving around the neighborhoods. We don't set aside a night. I mean, I think it's really helpful. That just kind of a refresher in the middle of the week is great. And if you don't, you know, and the first, I didn't do it for probably five years in practice. And then if you don't do it, you just get on, I'm like, how can I fit that in? But once you put it in your calendar and you make your, you have the babysitter set up, you're already paying the babysitter. You just do it. And it's great. It's money well spent and time well spent. It was Harry Rubash, actually, when I was a resident who had recommended to each and every resident to do that. And then at the time, well, at the time I wasn't married for one, so I had no concept of it. And number two, you know, it just, in the beginning of practice, it seemed kind of odd, right? And it was like, oh, well, you know, we see each other a lot anyway, you know? Now, I mean, it's great. It's like something to look forward to on a week-to-week kind of basis. Jeremy, you have a bunch of little ones running around. How do you do it? Yeah. Well, it's a constant work in progress. I haven't figured it out yet. I try to, something I picked up during fellowship from watching all of y'alls, I try to be intentional about it. And if I'm done at, you know, 5.30, I try to come home and have that, whether it's a two-hour block or whatever I can have with my kids and then pick it back up with work after that. And so definitely when I started practice, I just would work straight through and I wasn't intentional enough about it. And I think I spent too much time working with no break. And so we've kind of circled back around. And, you know, what you said about the date night, Dr. Moore, I mean, just scheduling something. So if I can put it on my calendar and it's scheduled, and then we all know we're not gonna schedule anything else during that time period. And, you know, we need to have a babysitter lined up then we do that. But it's still a work in progress for me. And I'm trying to get, you know, I think when you start practice, you have so many kind of demands and you're just trying to get everything to go just right. And I'm learning a little more patience and that sometimes, you know, that two-hour block, it's gonna be okay. You can get to that stuff afterwards, so. One thing I forgot to mention, which, you know, and everyone has their own system. I try to get all of my computer work, like whatever is pending on Epic, my email, I try to get it all done before I go home. So I don't have to do it when I'm home. That's, I mean, not everyone does that. Some people just kind of bring their dictations home and so on and so forth. But for me, that's worked out the best. So I can kind of, you know, kind of separate my work and sort of my family. So I'm not kind of mixing the two. So I try to do that. It takes a little bit longer for me to get out of work, but at least I know when I'm home, I'm not looking at, you know, looking at work things or, you know, ignoring my daughter or whatever it is, you know. Yeah, I think the challenge we all face is how do we, at six o'clock when you get home, how do you put the cell phone down? How do you put it on the front hall table and still be available to the athletic trainer or whoever needs to, but also to be present and in the moment with your kids and your family? And it's not unique to medicine. I think that's a challenge we all face today with technology, but that's been something my family, we've been working on is just, you know, putting the phone down when you come in and trying to have, even if it's a half hour dinner altogether where you're not being interrupted, most things can wait. It's tough though. And one of the last things I'll tell you, just I had a mentor when I was in residency and his wife bought him a bonsai tree when he was a resident and she bought it for him so that he could always make sure he had a hobby, that he would cultivate a hobby. And one of the things that I learned from him because he actually retired at the age of, I think 76 to become a botanist. And he had actually developed dwarf trees and hybridized seedlings and things. So he was very, very good at it. But his point was this becomes your life when you first start out. It really does. And it can be all consuming. And if you just do this and your family, honestly, that's just, as we all just said, you have to try to carve out time for both. Where do you put something else in? I have not been as good at this as I wish I had been, but I will try to get better as my kids get older and develop a hobby. Think about something that you would like to do that's kind of your own thing, because that will be something that you can always do. And through all the points in your life, that will be kind of a respite from your work. That's a great point. Well, I think that, wow, we covered some great discussion here. I mean, I think that we hit on some great themes with communication and the teams that you surround yourself with in the office and the OR. And then some of the marketing issues that we're all facing and kind of going through in this modern age of social media. So I think some great discussion tonight. So I thank you all, Beth, Albert, Jeremy, for your contributions to this webinar. And hopefully it was valuable. I think it really was valuable for me to hear your perspective. So I'm sure that the fellows found this valuable. So thank you all for your contributions. And Meredith, I think we stayed on time. If you're still listening and you have some closing comments that you wanted to come across with. Do you want me to share my screen? Sure. There were just a few questions that came through. Okay. In the question box, but also in the- Oh, sorry. I got to expand. And I believe Dr. Schubenstein answered the first one. It was Dr. Schubenstein, what is your opinion on using ascribe in clinic versus dictating clinic? Yeah, I'll go through that quickly. I think ascribe is invaluable and it prevents exactly what Albert was talking about where you, at the end of the day, you have a stack of charts that you have to dictate. So I think that's really helpful. The one thing I would say about ascribe, really important point that I have figured out is I always dictate my surgical discussion. So my plan, my surgical plan is never ascribed. I always dictate that personally. The ascribe does everything else and I dictate my plan because that's the only part of the note I read when it comes time to do the surgery and review my surgery. So I would say, make sure that your word's not theirs. Yeah, Meredith, I can see this question. Do you want me to ask the second one here to the... Sure, yeah. If any of the other ones are applicable. The fellow asked, going to a newer hospital-employed group covered by other independent docs. I don't have any team coverage contracts set up yet. Reach out to athletic trainers. How do I... Yeah, so Jeremy, you kind of alluded to this. How do you reach out to local athletic trainers without stepping on toes of other docs or other people in the area? Yeah, I think there's some places that don't have an athletic trainer. And so I think those are great places. You find those places. And sometimes it may be a small school or maybe in more of an outline area, but they have athletes that need to be taken care of as well and that's a good place to start. And then other times, like if the school is funding the athletic trainer or there's some non-medical group that's doing that, there may be an opportunity to help partially fund that and provide those services. And most people are happy to have a more involved and accessible healthcare team. And so if there's an athlete trainer that's kind of on an island out there working at a school with no relationship and the school's having to fund it, I think that oftentimes is an opportunity to just kind of build those relationships and then start talking and say, hey, is there a way that we can share these costs or a way that we can help you guys provide equipment or something for the athletic training room? And so I think every school is different and I can't emphasize enough how much it's based on relationships and kind of building that. But I kind of thought the same thing when I first started, maybe there's not gonna be opportunity or there's already a competitor that is taking care of all these schools, but I really found there is a lot of opportunity if you just kind of look and keep your ear to the ground and kind of do things the right way, don't step on anybody's toes or go somewhere where people already are kind of taking care of that team. Last question. And we've talked about this with our fellows before and the question reads, as you build relationships, do you develop a relationship on a first name basis? I think it's a good question. We didn't really talk about this. And as you're going from training into practice, particularly, Beth, like you did and I did, when you go back to a place where you've done some training, you'd have a different relationship or compared to when you go to a totally new place and you're now Dr. Burnham coming into town, how do you introduce yourself? What do you want your office staff to call you? What do you want your patients, or maybe patients call you by first name, maybe they don't, or these athletic trainers relationships? I have an approach where I think it's really very much based on what the person calling you is comfortable with. So I have people in my office that call me Dr. Morrow, I have people in my office that call me Craig, and I'm comfortable with both. I found it early on in practice, a little bit of a challenge, what to introduce myself and what to expect out of other people. And do you all have thoughts about how do we navigate that going into new practice and managing relationships on a first name basis or not? Well, so I'll start. I always introduce myself as Beth Schupenstein, and then it gives the patient the option to call me Dr. Schupenstein or Beth or whatever they're comfortable with. The one caveat is when I started in practice, I remember it was my first or second week and I was seeing a 70 something year old woman who had clearly end stage arthritis in her shoulder. And I had all the time in the world because I was only a week or two into practice. And so I talked to her about the surgery and I went through everything after introducing myself. And she said, that's really lovely dear. Beth, who would be doing my surgery? I looked and I said, I don't think I did that one right. I think I totally missed the mark. So I do think each case may deserve a different answer. And I think that at the beginning when you're new in practice and you're a little green, it probably is helpful with some patients to introduce yourself as doctor. I think it just kind of sets the tone. But at some point, as you get more confident and the confidence kind of speaks for itself, I think introducing yourself with your full name and just giving patients and everyone else the option of what they feel comfortable, as you said, Greg, is probably the right way to do it. Beth, I still introduce, I introduced myself just Albert Lin. I kind of give them the option a little bit. And I didn't do my residency there, but I did my fellowship there. There's some scrubs that I worked with at that time, some reps, they call me Albert, and it's totally fine. That's sort of what they're comfortable. That's how they knew me. I guess the only thing that I've told some staff is that, hey, listen, when we're like in the hallway and you see one of my patients coming in, I just tell them, hey, I would just keep it more sort of Dr. Lin so that there is sort of kind of a little bit like we're not all just like chummy with everybody. But to be honest, I don't really care otherwise sort of what, it's usually what they're comfortable calling me. That's a great question though. I think it's a challenge as you go into practice. How do you navigate that? All right, well, I think that is the last question and Meredith, I'll turn it back over to, yeah, I'm gonna turn it back over to you, Meredith. I think we covered some of that on the last question that came up there. All right. Thank you. Thank you, Drs. Burnham, Lin, Morrow and Schubenstein for your time and preparation for tonight's webinar. The AOSSM virtual annual meeting is taking place next week on July 8th and 9th. The entire meeting, including on-demand content is complimentary. All you need to do is register and you can register at the website shown here, which is virtual.sportsmed.org. Thank you again for your participation in this webinar series. Good night, everyone. Thanks guys. Thanks for having me. Thank you. Thanks for having us. Thanks guys. See you guys, thanks.

sports medicine

digital age

social media

online presence

marketing

athletic trainers

work-life balance

time management

patient accessibility

communication