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Dusty Lynn, SA-C Knew the OR was for her at age 12

“When I was 12, I had a pretty significant surgery, and I knew from that point on that I wanted to work in the operating room,” Dusty says. “I found everything about it fascinating. After high school, I went to school to become a scrub tech and soon after knew I wanted to be a surgical assistant.”

With 28 years in the OR – 20 of them as a certified surgical assistant — Dusty has worked in a variety of surgical specialties. However, she has focused on assisting in neurosurgeries for the past six years since joining AP Health.

“I started out in vascular, but I’ve done basically everything – general surgery, orthopedics, plastics and OB/GYN,” she says. “I think I’ve touched on every specialty in my career.

“I love neurosurgery because it is challenging and it has the potential to make such a huge difference in the life of the patient,” Dusty explains. “When people have spinal surgery, they are almost always in a lot of pain. It’s a great feeling to see someone who has a herniated disc repaired and to know that in helping eliminate their pain, you are helping to improve their quality of life.”

Dusty specializes in neck, back and lateral surgeries, including fusions, cervical surgeries and laminectomies. She also assists in robotics surgeries two or three times per week. On any given day, she’ll do two to six surgeries, each of which can last anywhere from 30 minutes to four hours.

“With neurosurgery, each case is different and you’re always learning,” she says. “Multi-level fusions and tumor removals are the most challenging, which I really enjoy. I certainly don’t get bored.”

Dusty Prefers to be Part of a High Performance Team

Dusty has worked as an in-house surgical assistant for physician groups and hospitals, but she prefers being part of the high-performance team at AP Health.

“I’ve been in situations where I’ve been part of a small team of surgical assistants on staff, where it can be routine” Dusty explains. “I like working with an outsource solution company such as AP Health and building relationships with a variety of surgeons.”

Dusty also appreciates that AP offers the latest in technology, such as the LogistiSx app, which makes scheduling and documentation more efficient.

“It’s a great app. It’s very fast and so easy,” she says. “We put in our time and what procedures or floor work we did that day. Then we send it in through the app. It saves me a lot of time on documentation.

“I really like working at AP Health,” Dusty continues. “I’m part of a team and I’m able to focus on the parts of the job that I enjoy.  When COVID-19 hit and elective surgeries came to a halt, AP Health was able to still make sure we got paid. I feel very fortunate.  We are a fantastic group and we do our jobs well. I like being part of that.”

Fort Lauderdale, FL – January 18^th, 2021 – AP Health, Advanced Practice Surgical Partners, announced that it is Great Place to Work-Certified™. Certification is a significant achievement. Using validated employee feedback gathered with Great Place to Work’s rigorous, data-driven methodology, Certification confirms over 83% of employees have a consistently positive experience at AP Health. Great Place to Work is the global authority on workplace culture, employee experience and the leadership behaviors proven to deliver market-leading revenue and increased innovation.

“We are thrilled to be Great Place to Work-Certified™,” says J. Toby Gray, CEO at AP Health. “We make employee experience a priority every day and it means a lot that our employees have reported a consistently positive experience with their coworkers, their leaders, and with their jobs. This is important to us because we know that when our employees have a high-trust experience every day they are more productive, drive better business results and make a difference to our customers.”

“We congratulate AP Health on their Certification,” said Sarah Lewis-Kulin, Vice President of Best Workplace List Research at Great Place to Work. “Organizations that earn their employees’ trust create great workplace cultures that deliver outstanding business results.”

Great Place to Work® is the global authority on workplace culture. Since 1992, they have surveyed more than 100 million employees around the world and used those deep insights to define what makes a great workplace: trust. Great Place to Work helps organizations quantify their culture and produce better business results by creating a high-trust work experience for all employees. Emprising®, their culture management platform, empowers leaders with the surveys, real-time reporting, and insights they need to make data-driven people decisions. Their unparalleled benchmark data is used to recognize Great Place to Work-Certified™ companies and the Best Workplaces™ in the US and more than 60 countries, including the 100 Best Companies to Work For® and World’s Best list published annually in Fortune. Everything they do is driven by the mission to build a better world by helping every organization become a Great Place to Work For All™.

For more information on AP Health, check out their Great Place to Work® profile at:

Working at AP Health | Great Place to Work®

Productivity is not just a buzzword for AP Health, it is our value proposition. By consistently delivering a highly skilled and efficient team of surgical assistants and physician assistants, we increase the productivity of surgeons while lowering labor costs and decreasing operating room times.

I manage a team of 15 advanced practitioners who serve surgeons at St. Thomas Health Hospitals and United Surgical Partners facilities. I also work as a surgical assistant, which I’ve done for more than 25 years. I know, both as a practitioner and a manager, the impact a productive operating room has on surgeon efficiency, financial performance, and patient outcomes.

I tell my team of practitioners that we help set the tone in the Operating Room: that means getting in operating room early, hanging x-rays for the surgeon, setting trays of instrumentation, positioning the patient, and getting the patient prepped and draped for the surgeon to come in.

We help create a consistent workflow in the operating room, by having a can-do attitude- to accomplish whatever needs to be done. Having a highly trained, experienced, and dedicated surgical assistant makes the surgeon’s job easier, because they can focus on performing the surgery.  Our team at AP Health specializes in total joint replacements, sports medicine, and spine surgery.  Most of these procedures are done on an outpatient basis.

We optimize productivity in real time, which reduces our customers’ labor costs. We have shown that AP Health practitioners are often twice as productive as that of alternative solutions, especially hospitals with in-house staff. We take a lot of pride in what we do and in strengthening the relationships with our customers’ surgeons

I’ve been working with some of the same surgeons since 2003 and enjoy both the management and practitioner sides of my job. I get to work with a great team that makes a difference in the OR for our customers, the surgeons and the patients in our care. Our productivity and efficiency drive better outcomes for the surgeons and most importantly the patients.

Nurse practitioner Alejandro Rafuls is one of the most experienced surgical assistants in robotic surgery. Alejandro was already well into his career at Memorial Health System when the da Vinci surgical system was introduced there 15 years ago. The da Vinci system is advanced set of instruments to perform robotic-assisted minimally invasive surgery.

Before Alejandro began working with the Memorial Healthcare System, he was a trained general surgeon in his home country of Cuba. He graduated in 1990, and practiced as a general surgeon in Cuba and South Africa for 10 years. In 2000, Alejandro defected from the medical mission in South Africa where he was working and made his way to the United States with the hope of starting a new life with better opportunities.

“I decided to come to the U.S. because I wanted escape communism and the dictatorship in Cuba,” he says. “I knew I would have to reconstruct my professional life, possibly starting from zero. My expectations were correct, but I found that the U.S. has many avenues for professional advancement when you are willing to do your part — learn the language, focus your studies in the field of your choice and spend endless hours working toward your goals.” 

When the da Vinci surgical system was initially introduced at Memorial, Alejandro was fascinated by the benefits of using robots from the outset.

“The idea of being able to do procedures and not putting a hand directly inside the patient or holding a camera or holding an instrument felt like science fiction at the time,” Alejandro says. “Plus, there were the obvious patient benefits of less trauma to the tissues, smaller incisions, less pain and faster recoveries.”

On-the-job Training

“I had the advantage of being right there in 2005 to get on-the-job training,” he says of the then-new technology.

Like all of AP Health’s robotics practitioners, Alejandro received online instruction and attended training at Intuitive, the maker of the da Vinci surgical systems lab, to learn to dock the robot, trade out all instruments and keep the surgical flow going smoothly.

His experience in laparoscopic surgery, a technique that also once revolutionized modern surgical practices, smoothed the way into the new technology. “Robotics is like a variation of laparoscopic surgery, so it was not so difficult to enter the world of robotics,” he explains.

With robotics, however, the camera is no longer hand-held, and the image is much more powerful, he says. “The optics during the procedure are amazing; it’s like seeing inside the body in high definition.”

With his vast experience in traditional and robotic surgeries, Alejandro is one of the most sought-after surgical assistants in the Memorial Health System. About 90 percent of the surgery assists he performs weekly are robotic surgeries and that is increasing over time.

In the OR

Though Alejandro assists surgeons during surgery, his responsibilities begin before they ever enter the operating room by performing pre-surgery exams and generally prepping the patient for the procedure.

Once they enter the OR, robotic surgery makes the role of the surgical assistant more important and puts more responsibility on their shoulders. That’s because the assistant is in the surgical field, next to the patient, monitoring both the patient and the machine for the entire procedure.

“There are a lot of things you have to monitor to make sure things go according to plan,” Alejandro says. “If there is an issue with either the patient or the equipment, you have to let the surgeon know and take steps to address it.”

Commitment to Learning

Alejandro’ career has been based on a pursuit of lifelong learning. While he was a surgeon in Cuba, he first served as a medical assistant when he first came to the United States. He built on that career by getting licensed as a surgical assistant before returning to school and completing both nursing and nurse practitioner degrees from Florida International University.

Prior to joining AP Health, Alejandro was on staff of Memorial West when, about five years ago, hospital leadership outsourced advanced practice providers to AP Health. Alejandro and most of the other surgical assistants accepted AP Health’s invitation to join the company, and he’s been here since.

“My career path has always been in surgery, and AP Health has allowed me to reach new heights and advance my knowledge in the field and become more focused in robotic surgery,” he says.

Alejandro likes the variety of surgeries he’s able to assist with as an employee of AP Health. He has privileges at four Memorial hospitals and primarily assists in gynecology, thoracic and general surgeries.

“One of the things that keeps this job interesting is you don’t work in only one specialty,” he says. “I can learn something new every day — not just from the doctors but the nurses and scrub techs, too. That’s why I enjoy what I do.”

Like many people, Matt Williams had a childhood dream of becoming a firefighter. Unlike many, he did something about it. At age 16, he joined his hometown volunteer fire department in Binghamton, N.Y. But when the department’s understaffed medical first response team asked Matt to join, he soon realized his future was in medicine.   

“From the first call I went on, the feeling of serving the people in our community was amazing,” he says. “I found the impact we had on people rewarding and stuck with the medical team.”  

Matt eventually would get his EMT certification, work on an ambulance, and become a flight paramedic – as his career path led him to clinical medicine.  

“I moved to Florida and got a job as a paramedic at Broward Health North hospital,” he says. “As I learned about the different professions in the hospital, I saw the level of care physician assistants were able to provide and decided that was the career I wanted to pursue.” 

While attending Nova Southeastern University, Matt attended a talk by AP Health CEO and founder Toby Gray, who discussed the company and the variety of specialties available to its PAs. After graduating in 2019, Matt joined the company. 

Diversity of Duties Drives Job Satisfaction 

“I wasn’t exactly sure what type of surgery I wanted to do, and AP Health gives me the opportunity to explore and get trained in multiple types of surgeries,” he says. “I get to continue to learn from a variety of doctors and about different disciplines. 

“I can do a C-section and help deliver a baby and then work in orthopedic surgery to help fix somebody’s shoulder,” he continues. “It’s completely different every day, and every week is always changing.” 

Such variety is perfect for a new PA graduate trying to decide where he wants to specialize. Or if he wants to specialize. 

Matt works primarily at two hospitals – Holy Cross Health and Memorial Regional Hospital – and two surgical centers, assisting with orthopedic, vascular and general surgery. He likes the variety and the ability to learn different doctors’ preferences for how they like to work. 

“It’s a challenge, but it’s also good to see the way everybody does things,” Matt says. “It doesn’t get routine because you are always learning.” 

On-the-job Benefits 

Besides variety, Matt also appreciates the control and efficiencies AP Health provides its PAs. If he prefers particular surgeons or surgeries, schedulers accommodate him.  

He works two days a week with Dr. Erol Yoldas, one of the top orthopedic sports medicine doctors in Florida, who has become a mentor.  

Matt’s clinical skills are beneficial to his patients, Dr. Yoldas says. “Having Matt on the surgical staff enables me to efficiently and effectively help our patients get back to the level of function that they expect,” he says. “He is a valuable member of our team.” 

AP Health’s proprietary mobile application, LogistiSx 2.0, streamlines Matt’s job by capturing and reporting all case information and keeping his schedule – all without mountains of paperwork. “It’s one easy resource to get all the information you need,” he says. “It saves me time reporting and allows me to spend more time with patients.” 

But the best part of being a PA is what drew him to the medical profession as a teenager: helping people through a difficult time. 

“It might be a patient’s first surgery, and, even if it’s not, it’s a scary time,” he says. “To be someone who is calm and reassuring and see the positive impact you have is extremely rewarding. Once you experience what it’s like to help someone like that, it’s all you want to do.” 

It’s no secret the COVID-19 crisis has an effect on nearly every facet of life, with one of the hardest-hit areas being the hospital industry. The AHA estimates “a total four-month financial impact of $202.6 billion in losses for America’s hospitals and health systems, or an average of $50.7 billion per month”. Even prior to COVID-19, hospitals were having difficulties meeting growing financial demands. 

COVID-19 cases are on the rise in several states where the emergency ban had been slightly lifted, including in Florida and Tennessee. Last week, Tennessee reported the largest one-day jump, with 1400 newly positive tested patients.

What can help hospitals alleviate devastating financial losses? 

One practice many hospitals are increasingly implementing is the use of outsourced high-quality Advanced Practice Providers (APP’s), provided through privately held healthcare service companies such as AP Health. 

Throughout the pandemic, hospitals outsourcing clinical staffing experienced a level of financial flexibility not felt by hospitals employing full-time surgical staff. 

Major Hospital Savings

The financial losses hospitals are experiencing as a result of the pandemic are palpable, with the full effects remaining to be seen. One concern remains absolute — hospitals are in need of money-saving solutions through practices like outsourced surgical staffing programs. 

According to J. Toby Gray, AP Health’s Chief Executive Officer, the “model for outsourced, team-based surgical care reduces our hospital partners’ costs and increases their flexibility. They can quickly scale their surgical and on-floor teams with the Advanced Practice Providers that AP Health recruits and manages.”

Without the need for recruiting and full-time salaries of credentialed staff, hospitals can save exponentially. The ripple effects of those savings allow hospitals to respond timely to the spikes in COVID-19 cases that have occurred in recent weeks, as well as the safe re-implementation of elective surgeries. 

Flexibility

Hospitals who outsource surgical staff for perioperative care have much more flexibility in terms of financial resources, staffing possibilities, appropriately staffed surgical teams, and more.

Since the ban on non-urgent surgeries implemented in April, hospitals have lost about $161.4 billion. As state governors and hospitals work to re-instate elective surgeries and non-COVID-19 care, adaptability in resources is highly favorable. 

With outsourced perioperative care, hospitals can increase their capacity for elective surgeries and COVID-19 patient care by allocating staff appropriately, without the pressure to furlough any full-time staff.

Streamlined scheduling and documentation

A key component of the patient care continuum is having a secure, streamlined way to report pertinent patient information on-site at hospitals. The communication between outsourced perioperative care professionals, surgeons, and hospital staff is crucial to a successful outsourced surgical assistant staffing program.

One such way AP Health enhances perioperative care is through the recently launched web and mobile application Logistix2.0. The app integrates with hospital scheduling systems where an AP Health practitioner is working surgical cases, allowing for a number of benefits. 

The launch of Logistix2.0 eliminates the tediousness and errors caused by paper-based records. It provides all parties with a centralized document-of-record which can be updated in real-time. The document-of-record is used for practitioner scheduling, hospital and insurance billing, case coding, and more. Additionally, AP Health practitioners can easily record everything from time-in/out to surgery notes and insurance information, allowing them more time to focus on what matters: quality patient care. 

Patient Care Satisfaction 

From pre, intra, to postoperative, patient care satisfaction is of the utmost concern when it comes to perioperative services. The patient care continuum functions best with a surgical team who understands the in’s and out’s of their respective tasks and how each of their roles play into patient satisfaction.

Outsourcing perioperative services through providers like AP Health ensures the patient will be receiving care from board-certified and credentialed, skilled professionals dedicated to their clinical practice.

Because AP Health professionals are assigned to a particular surgeon’s team, they get to know the surgeon and the patient’s needs on a personal level. Everything from H&P’s to transitional care is treated with the same level of attention, increasing the likelihood of positive outcomes for both the team and the patient.

Efficiency for the Present and the Future

As COVID-19 cases continue to surge in the U.S., so does the uncertainty of what the future holds for the healthcare and hospital system.

The need for hospitals to increase their efficiency in budget-friendly ways remains, and the outsourcing of perioperative care through skilled surgical staffing programs is a viable solution. 

Perioperative healthcare companies like AP Health assist hospitals by reducing recruiting and in-house staffing costs as well as administrative responsibilities, provide surgeons with much-needed resources and skilled team members, and assure satisfactory patient outcomes.

In response to  the changing needs of hospitals, surgeons and Advanced Practice Providers, J. Toby Gray, CEO, announces the rebranding of Advancing Practitioners, the company he founded in 2014. He unveils the new name, AP Health, as the company makes significant investments in technology to improve internal efficiencies. As more hospitals look to outsource Advanced Practice Providers (APPs), AP Health realized the need to increase the scalability of its service offerings.

“Whether a hospital’s surgical program is mature or brand new, they generally have limited resources to manage it.” There is a lot that goes into managing a team of SFA’s: recruiting, training, scheduling, retaining and billing,” says Gray,“ and they’re not  equipped for it–that’s where we come in.” 

More hospitals throughout the country are coming to that realization, which has driven the company’s significant growth over the past six years. “AP Health understands the market for Nurse Practitioners, Physician Assistants, Certified Surgical Assistants, and Registered Nurse First Assistants; it’s all we do-we’re meeting an acute need,” Gray says. 

In fact, AP Health has seen a 12-fold increase in the number of patient-encounters for the company in just the past four years. Gray sees that trend continuing and even accelerating. Keeping pace requires technology-driven modernization. “AP Health is in the business of making hospitals and surgeons more productive, profitable and efficient. In order to meet the growing demand, we had to improve our internal productivity and efficiency-which we did!”  

AP Health developed a new proprietary mobile application, LogistiSx 2.0, an efficiency tool for AP Health practitioners in the field and its administrative staff. LogistiSx 2.0 enables each AP Health practitioner to securely capture and report all pertinent surgical case information on-site at the hospital, creating a centralized document-of-record that drives everything from practitioner scheduling to case-coding and hospital and insurance billing. 

“It provides all stakeholders – our practitioners, hospital clients, surgeons and our administrators with a single source of real-time truth on each case,” says AP Health COO Greg Flanagan. He points out that LogistiSx integrates with hospital scheduling systems, automatically uploading each hospital’s 5-day surgical care schedules each afternoon. Every AP Health practitioner receives his/her next-day schedule through the mobile app and receives text alerts regarding any change to that schedule. “This ultimately improves the quality of service we deliver to hospital clients, surgeons and patients and allows us to scale staffing quickly based on surgical needs on any given day.” 

Flanagan believes such real-time data integration and front-line/back-office efficiency gains are crucial to improving AP Health practitioners’ productivity and satisfaction. “We’ve built AP Health by attracting and retaining the most qualified Advanced Practitioners in surgical care and by providing our hospital clients with a consistently high level of service. This is central to our continued success as a company.” 

Gray also adds that, “Recruiting qualified surgical practitioners and creating a culture that increases job satisfaction by honoring the work/life balance limits the turnover of staff. LogistiSx removes much of the administrative burden from our practitioners, allowing them to focus on their clinical mission, which, in the end, is all that matters to them and our clients.”  

AP Health’s surgeon-centric approach is another factor that contributes to the success of our hospital partners’ surgical programs. We provide our surgeons with a team that can anticipate their needs and work seamlessly alongside them. This betters revenue, time/patient management, and outcomes in the OR. AP Health’s outsourcing model helps the surgeon be more productive by giving them the ultimate support and control in and out of the operating room. 

“We are being selective with our growth; we’re looking for opportunities to provide value to surgeons, and hospitals,” Gray says. “Ultimately, this rebranding effort is the front-facing piece of a much deeper organizational commitment to delivering an ever-higher level of service and efficiency to all stakeholders as we grow.” 

Cardiothoracic programs place more demands on hospitals than any other surgical specialty. This is due to the highly specialized procedures that are performed and the elevated risk of morbidity and mortality of Cardiothoracic patients . This program’s critical nature calls for quick-to-act surgical teams that anticipate rapid changes and are able to perform minute-by-minute assessments-the stakes couldn’t be higher.

When Jupiter Medical Center and its Cardiothoracic surgeon, Dr. Arthur Katz, started a new Cardiothoracic program in April 2020, they partnered with AP Health to meet their surgical staffing needs. AP Health provides Jupiter Medical Center with highly-skilled Advanced Practice Providers (APPs) that can meet the demands of this new program. The team began with a three-person group of practitioners to ensure the hospital of proper coverage and  help maintain the work/life balance that is important to practitioner- job satisfaction. 

Directing AP Health’s Jupiter Medical Center team of Cardiothoracic APPs is Daniel Teller, a Certified Physician Assistant with over three decades of experience. Teller oversees the patients’ care under Dr. Katz’s supervision and operates as an extension of him. Teller has a wealth of knowledge in establishing, managing and expanding Cardiovascular and Thoracic surgery programs.  

“As the surgeon, he (Dr. Katz) exercises ultimate control over the team’s hiring and composition, as well as the day-to-day operations of the program” says Teller. “I’m responsible for rounding on pre- and postoperative patients in the ICU, the step-down floor, consults, daily notes and discharge summaries. I also lead ongoing education for the Cardiothoracic team and train other nurses to make sure everybody’s on the same page about what heart surgery demands.” 

Teller estimates his time is equally divided between non-surgical duties and the operating room, where his skill set includes endovascular vein harvesting and endovascular radial harvesting. “Dan’s a unique individual who’s started Cardiothoracic programs in the past – Jupiter is his third. He has decades of experience caring for these patients, enjoys teaching and has a wide range of clinical skills, including the manual dexterity needed for vein harvesting,” says J. Toby Gray, CEO of AP Health. “Hospitals generally have a difficult time recruiting people like Dan. Not only because of their unique skill set, but because they are in such high demand. AP Health specializes in finding and retaining highly trained and skilled practitioners like him- I know he’s extremely valuable to Dr. Katz.” 

The placement of the APPs on the new Cardiothoracic surgical team reflects the surgeon-centric approach fundamental to AP Health’s outsourcing business model.  With Teller as program director and Dr. Katz as the ultimate decision-maker, AP Health made sure their skills aligned directly with Dr. Katz’s methods and preferences. “AP Health put together an exceptional team to help launch our Cardiothoracic program,” says Dr. Katz. “They understood the importance of achieving quality results in year-one, so they recruited Dan Teller – a senior-level, highly skilled cardiac PA – to help build our program.”  

For his part, Teller is excited about starting and directing a new Cardiothoracic program. “I’ve started two other programs, and I’ve always enjoyed the challenge. I know from experience what we need to continue to train and focus on to be successful and expand the program at Jupiter Medical Center.”