MGMA Podcasts

Daniel Williams: 00:03

Well, hi, everyone. I'm Daniel Williams, senior editor at MGMA and host of the MGMA Podcast Network. Just wanna thank you all so much. We are continuing our coverage of our Leaders Conference. And, also, we have a special guest today.

Daniel Williams: 00:19

We are joined by Mitchell Ramsey. He is one of our future five award winners. We're gonna talk to all of those future five honorees and get an idea of kind of the direction where they're going so we get an understanding of what our future of health care looks like. So I'm so excited about that. Mitchell is a TMS clinical coordinator at Psychiatry Associates of Tallahassee.

Daniel Williams: 00:47

And, Mitchell, first of all, I just wanna welcome you to the show and congratulate you for this honor.

Mitchell Ramsey: 00:55

Well, certainly, thank you for having me. I'm glad this is my, first podcast, participation, so very excited for it.

Daniel Williams: 01:03

We will go easy on you. Now you were telling us offline that you are in Tallahassee, that Tallahassee area, and you are still adjusting after 15 years to the humidity because you grew up initially in the North. I know that because I lived 30+ years in the South before heading out to Colorado and California and places not quite so humid. So what have you adjusted at all to that humidity, or how do you, how do you handle it?

Mitchell Ramsey: 01:31

I have not. So it's, been nice to get the month and a half of the the cold down here. Back in January, we kinda had that second old event of having the snow in the Florida area. So I was trying to bottle that up as much as I can, but it's certainly a a daily battle trying to deal with the, not only the the community, but the heat and the mosquitoes are always a interesting time.

Daniel Williams: 01:55

Oh gosh. You mentioned the mosquitoes. I went to a wedding last year, and it was just outside of Jacksonville.

Mitchell Ramsey: 02:04

Oh yeah.

Daniel Williams: 02:04

This isn't a scientific term, but we were getting eaten alive by what somebody there called no-see-ums. Do you know those things?

Mitchell Ramsey: 02:14

They can certainly pack quite the punch.

Daniel Williams: 02:18

They we were still, dealing with mosquito bites and their after effect, like, several weeks after. They those things are vicious, and we couldn't see them. So that was

Mitchell Ramsey: 02:29

Exactly.

Daniel Williams: 02:30

That was miserable. But so enough on our, insect, you know, categories here, but we are so excited to have you on the show, and we wanna get to know a little bit about you. So first of all, tell us a little bit about what led to your career in health care, in this mental health side of health care, and, just share that with us a bit.

Mitchell Ramsey: 02:58

Absolutely. So I'll kind of go to my, hero origin story. So I am the son of a nurse and a physician. So it's one of those things that growing up, there's always a destined for the health care field. Of course, growing up, always wanted to be an NFL quarterback, and my parents were like, yeah, that's great, but let's stick with academics for a little bit longer.

Mitchell Ramsey: 03:20

But it wasn't until actually graduated high school that I was originally in school to get my undergrad on the pre veterinary school track. But shortly after graduating high school, I was approached with an opportunity to launch a lacrosse program at one of the low income schools in Tallahassee. And I played kind of all through high school, loved the sport, kind of loved the kind of ability to be able to have that mentorship aspect to it. And so kind of jumped on the opportunity. And for the past decade, I've been coaching varying levels of lacrosse, but it wasn't until my second year of coaching where I realized that working on more of the psychological aspect of sports in general, and kind of really toning in on that mental health.

Mitchell Ramsey: 04:07

The more I focused on that, the better my teams had the success, not only on the field, off the field. So I kinda had a little bit of the epiphany moment watching Goodwill Hunting, which has always been my favorite movie ever since the first time. But I kinda was just sitting there with my pup at the time and kinda watched that. Actually, ended up watching it back to back, and it kinda was like, you know what? Certainly, I'd love to stay in the realm of health care, love coaching, but at the same time, I really want to, explore my opportunities in the the mental health sector.

Daniel Williams: 04:42

Yeah. That it what a great story. So what is your superpower then? You were giving us that origin story?

Mitchell Ramsey: 04:49

Oh, I like to kind of follow the, psychological trope and say it's mind reading. So

Daniel Williams: 04:56

I love that. I love that. Let's talk about where you are right now. So I came across a term TMS. It's in the title of y'all's practice.

Daniel Williams: 05:07

First of all, just tell us a little bit about the practice. Give us an idea of what you guys do and the size and scope of that practice. Anything you can share about it.

Mitchell Ramsey: 05:16

Absolutely. So TMS is definitely a, thankfully, a short acronym for the full name of transcranial magnetic stimulation, which is an alternative mental health treatment for those suffering from depression, OCD, where it's rapidly starting to undergo some rigorous research for degenerative brain diseases, like your Alzheimer's, dementia, even PTSD as well. So it's certainly a kind of rapidly emerging field since about the 1980s. But our TMS clinic, we have about four people involved where it's me, two technicians and the front office staff. And then of course we have a couple psychiatrists that we operate out of a wardrobe psychiatric office.

Mitchell Ramsey: 06:01

So it's certainly very unique to kind of get the both realms of the psychiatry side, and certainly very fulfilling to be in the what we call the neuromodulation field.

Daniel Williams: 06:12

Wow. That is so cool. I'd heard a little bit about that, but then I ran across it in looking at your nomination, and I wanted you to just share with us about that. So that is that is so interesting. Let's talk about when you found out about you receiving this honor of being a future five award winner.

Daniel Williams: 06:32

I'm fantasizing right now that you're out on the lacrosse field. You got a text. You saw it. You announced it to your team. And, like, in a Good Will Hunting moment, they all picked you up on their lacrosse

Daniel Williams: 06:42

sticks and bounced you around there. Probably didn't happen like that. So what was it actually like when you found out about receiving this honor?

Mitchell Ramsey: 06:50

So it was a certainly a very unique kind of situation. I was actually on a flight from Dallas back to Tallahassee, And we were about to start our descent into Tallahassee before the pilot came over the intercom and said, oh, sorry, folks. We have to divert all the way back to Dallas. So it was a three and a half hour flight back and I land and I'm starting to look through all of my emails and that's where I saw the voicemail message from MGMA saying, Hey, congrats, awarding this award. And so it was one of those, I was half awake after a a day of flying and kind of I had to try to get a little bit of coffee going to get excited for it.

Mitchell Ramsey: 07:32

But once I was able to settle back in Tallahassee, get back to the office, it was certainly a lot easier to kind of, realize what's an extreme honor.

Daniel Williams: 07:43

Yeah. That what a great story. Well, thank you for sharing that. Now in your nomination, I saw that a key highlight was how you transformed your patient intake and onboarding process. Talk a little bit about that.

Daniel Williams: 07:57

What'd you do? And what does that look like in the process?

Mitchell Ramsey: 08:00

Yeah. So certainly, when I first kind of started my current role, I'm certainly one of those that likes to look at everything from that 30,000 foot view. So we kind of noticed that we had a lot of patients who would come in for these initial consultation appointments, to learn a little bit about TMS, but for whatever rhyme or reason, they're like, Oh no, that's an avenue we want to take or we're going explore other options and come back to you. And so it was one of those, I really put myself in the shoes of one of our patients coming in. And so we certainly overhauled how our lobby looked, kind of how our consultation room looked.

Mitchell Ramsey: 08:39

And more importantly, we kind of threw the official script that we were trying to standardize with that, threw that out the window, certainly had more of that storytelling approach to it, Really got on that personal level. It's actually something that I received the TMS treatments myself through my own mental health journey. So being able to have that connection on more of that personal level, So saying, oh, here's the statistics. Here's how successful it is. Give us the time and the co payments for that.

Mitchell Ramsey: 09:13

It's really able to go kind of to more of that granular level of, Hey, I understand what you're experiencing. I know what you're feeling. Here's how we can kind of take that first step forward into kind of that progress.

Daniel Williams: 09:25

Wow. That is so cool. Now you had earlier talked about that sports psychology aspect of things, so it really does appear that you're bringing some empathy and some other aspects of that to really connect with the patients and building that trust. Talk about anything else. It looks like one of the other things you have worked with in, the organization, it's going in a bit of a different, aspect of it, but it's in that billing and insurance side of things.

Daniel Williams: 09:56

But you've also integrated some techniques, some tools, some new processes to improve that there. Tell us about that, what you identified, and then how you built that out.

Mitchell Ramsey: 10:07

Yeah. So it's always never a dull moment dealing with the insurances nowadays. So in Tallahassee, we're very fortunate to have a regional HMO organization that does do a lot of the insurance health coverage side. So kind of early stages in the role, it was really an emphasis on what was taking about two to three business weeks for prior authorizations. We reached out to the company and said, Hey, what is taking so long?

Mitchell Ramsey: 10:37

Like, what can we do on our end to help with that? So a lot of it was kind of undertaking a lot of more paperwork on our side to kind of make it a little bit easier on theirs. But again, really came down to building that rapport, building those relationships and kind of having that open communication line between provider and payer of, Hey, here's situation a, what can we do to remedy that, aspect with that? And again, really just went through those nitty gritty details to uncover any of those issues going on.

Daniel Williams: 11:07

That is remarkable. So in looking again at your nomination and some of the information you shared in there, you've also been active in collecting data on TMS outcomes, even contributing to broader FDA approval. I think that's pretty significant. So talk about that process. What is being worked through as far as, the outcomes that you're seeing, by the use of TMS?

Daniel Williams: 11:35

And then also, maybe what additional red tape or approval is needed so this can be more broadly applied in practices?

Mitchell Ramsey: 11:45

Yeah. So it's certainly something that, we have a great relationship with the manufacturer of the TMS device that we use. They go by the name of Brainsway. They're kind of one of the less conventional methods of TMS, but it's certainly something that we've worked with them over the years to really have kind of our outcome data that we collect at the end of each treatment course, kind of see how a patient progressed with their depression or anxiety symptoms or PTSD, kind of getting that overview of what they were kind of experiencing over the whole treatment course. We collect that and we send that out to the manufacturer.

Mitchell Ramsey: 12:27

Of course, everything's HIPAA compliant, but it's really something that working with them to really get the FDA extensions where within the last couple of years, we were able to work with them to kind of expand the FDA approval ages to where it's more accessible for kind of the older populations, the more seasoned populations as we like to call them. But certainly, again, really just all around that relationship building to have an extended access to the treatments.

Daniel Williams: 12:58

Yeah. I got a couple more questions for you before we sign off. So, in addition to the work that you're doing in the practice, one of the things that we look at, at MGMA when we look at the nominations for future five is we're looking at the kind of things you do outside of the practice. I see that you've done work with groups in in mental health organizations and other places related to that. Have you been able to incorporate that information, bring that back to the practice, help you do your job better?

Daniel Williams: 13:30

Tell us anything about that you might wanna share.

Mitchell Ramsey: 13:33

So it's very much all about kind of having that, whole umbrella of the coordination of care. So a lot of what I do outside of the main practice is work with a grassroots organization that kind of really works with a peer to peer support group. It's called the National Alliance on Mental Illness or NAMI for short. So we've been working with the Tallahassee chapter very significantly to kind of spread awareness of the resources that NAMI supplies, but also what we supply. So again, kind of having that option for patients while if we have someone come in and say, Oh, well, I can't afford the co payments or the time for TMS.

Mitchell Ramsey: 14:15

It was always something where we worked with NAMI to kind of say, Oh, well, here's this peer to peer support group for you. And really try to capture anyone that, might quote unquote slip through the cracks and really ensure that our community is really, having those mental health needs met by any means necessary.

Daniel Williams: 14:33

Yeah. Well, I wanted to ask you, when did you start at this clinic? How long have you been there?

Mitchell Ramsey: 14:38

So I've been there since, 2021.

Daniel Williams: 14:41

Okay. So you've really seen a lot of things that have been happening, since the pandemic, and there's been a real seismic shift in a lot of ways, people became very much more open, more transparent, much more vulnerable about mental health and maybe how it's affected their life or other people, that are in their life. When we think about now, you've seen that taking place as we move forward now, you being a future five honoree, and you've got your career ahead of you. What do you wanna see moving forward in mental health in the way that it's addressed and that we treat people who may be coming in for mental health? And, because I'll be quite frankly, you were sharing something in your own life.

Daniel Williams: 15:33

But for me, back going back about twenty five, thirty years, initially, what I was feeling was physically. I was feeling physical ailments, whether it was stomach issues, whether it was headaches, other things like that. They test me for everything, and they'd go, you know, it's not it is manifesting in that way in your body, but it's actually starting with stress, anxiety, and other things. So as you look at the totality of all of that, what do you wanna see happening in mental health? I know I gave you a lot to think about there, but you you can paint this on your own canvas here.

Mitchell Ramsey: 16:11

It's certainly something that every little day, I certainly am optimistic in the fact that that stigma around mental health is slowly but surely breaking away. Of course, it's still kind of turning in the right direction. Of course, there's always gonna be those speed bumps where so that we see our office on a daily basis where patient kind of comes in, shows that they're, they kind of manifest like they're doing a lot better than what they say they are. They're like, Oh, well, I'm doing better. Like everything's starting to improve.

Mitchell Ramsey: 16:41

And then we do our depression based testing and they're scoring off the charts on that. So I think there is still some work to be done in terms of kind of making it more socially acceptable to kind of have that vulnerability and say, Hey, I'm actually not doing okay. And I know everyone's got the age old, oh, how are you doing? Doing okay kind of conversation, but I certainly see a lot in healthcare in general, outside of our practice. It is kind of trading in the right direction where other specialties are becoming a little bit more cognizant of that mental health implication and really honing me in on that to where it's not just a, Oh, it's anxiety, it's depression, good luck to you kind of deal.

Mitchell Ramsey: 17:22

So kind of still really hoping to see kind of the extensions of the, care coordination across the different specialties, but it's really, every day seems to be getting a little bit better.

Daniel Williams: 17:34

That is wonderful. So couple of fun questions before we sign off. Our leaders conference where, the main announcements for these different, MGMA awards are gonna be made. We're gonna be there in Orlando. We're gonna be there September 28 through October 1.

Daniel Williams: 17:53

First of all, you're just down the road. Are you are you coming over? Are you

Mitchell Ramsey: 17:57

Very much. Sorry. It's, first time for the MGMA conference, and, I have heard a lot of hype about how wonderful they are. So very much looking forward to fighting the Disney traffic to, make it down there.

Daniel Williams: 18:10

So I've been asking other people who are coming from across the country. In fact, somebody from Oregon who has already bought Disney tickets. You're just right down the road. You may not be a Disney kind of person anyway, but

Mitchell Ramsey: 18:22

Of course.

Daniel Williams: 18:22

Do you do that sort of thing, or what do you do when you go to Orlando? Do you have any kind of a bucket list or any expectations while you're in Orlando?

Mitchell Ramsey: 18:30

Yeah. It's certainly kind of every couple years. You always have to make the, annual pro pilgrimage to, Disney or Universal down there. I'm always gonna make one of those theme park stops, but I'm a a big furry, so I always gotta find a a local spot to kind of explore. And with coaching, I've had to travel to Orlando multiple times.

Mitchell Ramsey: 18:50

So I have a little, bucket list or scratch off list for all the local restaurants I went ahead. And every time I go down there, it seems to be a growing list each time.

Daniel Williams: 19:01

Do you have a favorite kind of food that you like to eat?

Mitchell Ramsey: 19:04

Not so I'm definitely big on doing, like, the the Tex Mex kind of food. So, it's certainly hard to pick kind of the best restaurant down there, but I'm hoping to find a new one come September.

Daniel Williams: 19:18

Well, we do a lot of coordination and, engagement once we get there through the MGMA app. So maybe if you find some places, you can, share that information. You can find some good food places for everybody.

Mitchell Ramsey: 19:31

Absolutely.

Daniel Williams: 19:32

Okay. Most important question here. I saved this one for last on purpose. You're a lacrosse coach. So using a couple of different sports here, are you more Nick Saban or Ted Lasso?

Daniel Williams: 19:44

What is your approach when you coach people?

Mitchell Ramsey: 19:47

Yeah. So it's, certainly something that, growing up, my father is a huge Green Bay Packers fan. So I kind of, was growing up on kind of the bits and lorry kind of teachings, but, it's really when I actually got into the coaching seat, I definitely became more of a a John Wooden kind of disciple. So it was a kind of finding that mix and match of, really when can I, kind of get a little too heated, and when is it a little bit of a control of the Ted Lasso? It was more, say, more like a John Wooden, Vince Lombardi on the field, but more Ted Lasso off the field.

Daniel Williams: 20:21

Oh, that's wonderful. Yeah. I've got a book by John Wooden. Be quick. Don't work don't hurry.

Daniel Williams: 20:27

And be quick. Don't hurry. So, you know, be quick and decisive about things, but don't be in a hurry when you get there. So

Mitchell Ramsey: 20:33

Exactly. Love

Daniel Williams: 20:34

some of those John Wooden teams. They were a little bit before my time, possibly yours as well, I think.

Mitchell Ramsey: 20:40

Quite a bit. But

Daniel Williams: 20:42

But he lived on through many of his books and his teachings, so a lot of great information there. So Very interesting. Thank you for sharing that. I think we've covered everything. Anything else you wanna share with people who are also early careerist that, you know, maybe some advice you might wanna share with them?

Mitchell Ramsey: 21:02

Absolutely. So best advice, being kind of a a small practice administrator, certainly in a world where it seems to be a lot of these small practices are getting snatched up by these larger organizations. Certainly, best advice is whether you're in that David position or that Goliath position, every little bit that you add to the healthcare sphere is always going to be positive way down the road. So it's certainly little bit of that butterfly effect, but certainly don't get down the dumps thinking that you're in a small position because certainly, every little bit adds to that snowball effect and it'll certainly lead to a very positive outcome.

Daniel Williams: 21:41

Alright. Well, Mitchell Ramsey, I wanna congratulate you again for being an MGMA Future five award honoree.

Mitchell Ramsey: 21:48

Thank you. It's definitely an extreme honor.

Daniel Williams: 21:51

Alright. Well, thanks to Mitchell for joining us today, and thanks to all of you for listening. So I'm gonna put up, some information in our in our episode show notes. You can go right to, our awards information. Maybe you read about Mitchell and the other honorees.

Daniel Williams: 22:08

Also, you can see how to nominate people next year or maybe pass it on to a peer and get them to nominate you. So, also wanna say go to mgma.com/leaders to go ahead and learn more about our leaders conference, and you can register there if you haven't already. So until then, thank you all for being MGMA podcast listeners. Listeners.