1 00:00:00,240 --> 00:00:03,220 Imagine this. You're at the Hyatt Regency Chicago 2 00:00:03,439 --> 00:00:05,859 surrounded by the top minds in the ambulatory 3 00:00:06,160 --> 00:00:07,540 surgery center industry. 4 00:00:07,919 --> 00:00:10,960 Welcome to the Becker's 30th annual meeting, the 5 00:00:10,960 --> 00:00:14,259 business and operations of ASCs from October 30th 6 00:00:14,400 --> 00:00:15,705 to November second, 7 00:00:16,324 --> 00:00:19,285 2024. Picture the excitement as you collect business 8 00:00:19,285 --> 00:00:22,184 cards from over a 1000 executive level attendees 9 00:00:22,404 --> 00:00:23,945 forging priceless connections. 10 00:00:24,404 --> 00:00:25,864 Feel the buzz of conversations 11 00:00:26,164 --> 00:00:28,904 as you participate in more than 60 sessions 12 00:00:29,045 --> 00:00:29,969 led by over 13 00:00:30,849 --> 00:00:33,030 225 elite ASC speakers. 14 00:00:33,649 --> 00:00:37,090 Envision yourself gaining actionable insights on topics like 15 00:00:37,090 --> 00:00:38,390 private equity strategies, 16 00:00:38,929 --> 00:00:43,030 ASC business growth, and innovations in spine, orthopedics, 17 00:00:43,635 --> 00:00:45,734 GI, ophthalmology, and cardiology. 18 00:00:46,354 --> 00:00:49,954 Now imagine yourself listening to inspiring keynotes from 19 00:00:49,954 --> 00:00:53,094 Hall of Fame boxing world champion, Lila Ali, 20 00:00:53,155 --> 00:00:56,879 and professional basketball player, Caitlin Clark. Their stories 21 00:00:56,879 --> 00:00:59,199 will motivate you to take your business to 22 00:00:59,199 --> 00:01:01,600 new heights. You'll leave with a wealth of 23 00:01:01,600 --> 00:01:03,920 knowledge and a network of connections to help 24 00:01:03,920 --> 00:01:06,719 lead your ASC into the next year. Don't 25 00:01:06,719 --> 00:01:09,619 miss out. Get registered today. Visit beckershospitalreviewdot 26 00:01:10,834 --> 00:01:12,754 com and click on the events page to 27 00:01:12,754 --> 00:01:15,094 find the conference website. That's the beckershospitalreview.com 28 00:01:17,075 --> 00:01:19,174 events page. See you in Chicago. 29 00:01:20,515 --> 00:01:23,075 This is Alan Condon back on the Becker's 30 00:01:23,075 --> 00:01:25,954 podcast. I'm delighted to be joined today by 31 00:01:25,954 --> 00:01:27,200 David Fitzgerald, 32 00:01:27,500 --> 00:01:29,840 the CEO at Ortho NY. 33 00:01:30,299 --> 00:01:31,899 David, a a real pleasure to have you 34 00:01:31,899 --> 00:01:33,739 on the podcast with us today. Before we 35 00:01:33,739 --> 00:01:35,500 dive into some questions and pick your brains 36 00:01:35,500 --> 00:01:37,179 on a few items, I'd love to turn 37 00:01:37,179 --> 00:01:38,459 the floor over to you to hear a 38 00:01:38,459 --> 00:01:40,564 little bit more about your role and your 39 00:01:40,564 --> 00:01:42,645 background, not just at Ortho NY, but in 40 00:01:42,645 --> 00:01:44,105 the healthcare space more 41 00:01:45,204 --> 00:01:47,765 broadly. Appreciate that and thanks for having me 42 00:01:47,765 --> 00:01:51,224 on today. But background is been in healthcare 43 00:01:52,165 --> 00:01:54,564 for longer than we'd like to think about, 44 00:01:54,564 --> 00:01:55,064 but 45 00:01:55,540 --> 00:01:56,359 started as 46 00:01:57,379 --> 00:01:59,459 in these kinds of roles in orthopedics and 47 00:01:59,459 --> 00:02:02,420 surgery centers with ProLiant Surgeons in Seattle with 48 00:02:02,420 --> 00:02:04,519 the CEO there for 17 years, 49 00:02:05,700 --> 00:02:07,239 almost 18. And then 50 00:02:07,555 --> 00:02:10,455 did some other stints, stepped into dermatology, 51 00:02:11,235 --> 00:02:13,235 worked with some private equity firms in roll 52 00:02:13,235 --> 00:02:13,735 ups 53 00:02:14,034 --> 00:02:17,094 and helping some of those larger organizations. 54 00:02:17,794 --> 00:02:21,240 And recently, I had the opportunity to work 55 00:02:21,939 --> 00:02:23,819 with and do a little consulting with Ortho 56 00:02:23,819 --> 00:02:27,000 NY and we call Ortho New York. And 57 00:02:27,300 --> 00:02:28,680 then, just really 58 00:02:29,300 --> 00:02:30,199 found the opportunity 59 00:02:30,500 --> 00:02:31,240 to spend 60 00:02:31,620 --> 00:02:34,599 more time here, meet our CEO and really 61 00:02:35,155 --> 00:02:37,155 focus on the growth, focus on the change 62 00:02:37,155 --> 00:02:39,155 and do those things and we're really excited 63 00:02:39,155 --> 00:02:41,575 here about what's kind of happening in orthopedics, 64 00:02:41,794 --> 00:02:43,014 happening in the Northeast. 65 00:02:43,474 --> 00:02:46,514 And so, we're based in the capital regions 66 00:02:46,514 --> 00:02:48,969 they call it of, Upstate New York. So 67 00:02:48,969 --> 00:02:49,870 from Albany, 68 00:02:50,330 --> 00:02:51,069 up north. 69 00:02:52,490 --> 00:02:54,810 Fantastic. So I think no better man to 70 00:02:54,810 --> 00:02:56,569 really take charge as CEO. I know you've 71 00:02:56,569 --> 00:02:59,290 been there at Ortho New York for about 72 00:02:59,290 --> 00:03:01,594 a year now. But just going back to 73 00:03:01,594 --> 00:03:03,354 everything that you've executed in terms of your 74 00:03:03,354 --> 00:03:05,375 time as CEO of Pro Line Surgeons, 75 00:03:05,675 --> 00:03:07,435 where you've taken that group from a small 76 00:03:07,435 --> 00:03:08,335 practice into, 77 00:03:08,635 --> 00:03:11,435 I believe, 400 plus providers, 20 20 plus 78 00:03:11,435 --> 00:03:13,675 ASCs. But I'd love to kinda hear from 79 00:03:13,675 --> 00:03:15,870 you. When you're focusing on Ortho New York 80 00:03:15,870 --> 00:03:16,370 now, 81 00:03:16,750 --> 00:03:19,389 what's the strategic direction, the expansion that you're 82 00:03:19,389 --> 00:03:21,150 looking at? What most makes sense in that 83 00:03:21,150 --> 00:03:21,650 market? 84 00:03:23,069 --> 00:03:25,310 It is both organic growth and it is 85 00:03:25,310 --> 00:03:27,924 consolidation of some of the practices that in 86 00:03:27,924 --> 00:03:28,504 all of 87 00:03:29,044 --> 00:03:30,884 the Upstate New York area. There are some 88 00:03:30,884 --> 00:03:31,864 larger ones that 89 00:03:32,405 --> 00:03:34,564 crazy enough those of us who weren't as 90 00:03:34,564 --> 00:03:36,084 familiar with New York as we were at 91 00:03:36,084 --> 00:03:36,664 the West 92 00:03:37,044 --> 00:03:39,204 where our clients is in Seattle. But it 93 00:03:39,204 --> 00:03:41,305 is there's a lot of good small communities 94 00:03:41,364 --> 00:03:43,849 where they have orthopedic surgeons, but recruitment is 95 00:03:43,849 --> 00:03:44,349 difficult. 96 00:03:45,050 --> 00:03:46,349 Combining is difficult. 97 00:03:46,729 --> 00:03:48,409 But how do we do that and kind 98 00:03:48,409 --> 00:03:50,810 of build a practice that allows them to 99 00:03:50,810 --> 00:03:52,250 stay in their communities, to be able to 100 00:03:52,250 --> 00:03:54,729 recruit new physicians, to service those patients in 101 00:03:54,729 --> 00:03:55,469 those areas 102 00:03:55,930 --> 00:03:57,289 and yet still be able to grow. So, 103 00:03:57,289 --> 00:04:00,375 there there's a tremendous amount of opportunity here 104 00:04:01,074 --> 00:04:03,555 with the people, with the changes that are 105 00:04:03,555 --> 00:04:04,055 happening 106 00:04:05,395 --> 00:04:07,074 and really all have moved outpatients. I mean, 107 00:04:07,074 --> 00:04:08,775 that's really it's a great opportunity. 108 00:04:09,555 --> 00:04:12,115 Yes. I'm curious to see. I mean, one 109 00:04:12,115 --> 00:04:13,895 big trend that we're following in the orthopedic 110 00:04:14,009 --> 00:04:14,750 space particularly 111 00:04:15,129 --> 00:04:17,610 is the the emergence and the the growing 112 00:04:17,610 --> 00:04:21,069 in number of these, orthopedic management services organizations 113 00:04:21,209 --> 00:04:22,029 or MSOs, 114 00:04:22,889 --> 00:04:25,129 you know, growing in number, growing in size, 115 00:04:25,129 --> 00:04:26,509 really across the country. 116 00:04:27,115 --> 00:04:28,555 I'd love to just kinda get your take, 117 00:04:28,555 --> 00:04:29,274 your insights. 118 00:04:29,754 --> 00:04:32,475 Is this something that, Ortho Ortho New York 119 00:04:32,475 --> 00:04:34,634 might potentially consider, or how do you see 120 00:04:34,634 --> 00:04:37,055 this trend really developing in the orthopedic space? 121 00:04:39,060 --> 00:04:40,819 I'll answer it quick short with it. Yes, 122 00:04:40,819 --> 00:04:43,379 I think we would definitely explore that. And 123 00:04:43,379 --> 00:04:46,360 the reason is really more because the trend 124 00:04:47,379 --> 00:04:49,860 in the right way done right is really 125 00:04:49,860 --> 00:04:50,759 private practice 126 00:04:51,345 --> 00:04:52,085 version 2.0. 127 00:04:52,464 --> 00:04:55,025 It is bringing in that partner. It is 128 00:04:55,025 --> 00:04:56,545 one of the things that I'm actually more 129 00:04:56,545 --> 00:04:58,705 excited about right now is the way that 130 00:04:58,705 --> 00:05:01,264 we're kind of moving to business platforms. How 131 00:05:01,264 --> 00:05:03,745 physician groups have decided that we can't be 132 00:05:03,745 --> 00:05:05,459 just mom and pop anymore. We can't compete 133 00:05:05,459 --> 00:05:07,560 against the consolidated hospitals, consolidated 134 00:05:08,019 --> 00:05:10,100 payers is that we need to find ways 135 00:05:10,100 --> 00:05:11,699 to do that yet be able to provide 136 00:05:11,699 --> 00:05:14,980 care really very locally with our own groups, 137 00:05:14,980 --> 00:05:16,920 with our own patients, within our own office, 138 00:05:16,980 --> 00:05:19,060 within that same 7 to 10 people that 139 00:05:19,060 --> 00:05:20,894 they may touch, but you need to have 140 00:05:20,894 --> 00:05:22,654 the bigger organization to be able to kind 141 00:05:22,654 --> 00:05:24,735 of be big and small. And so, with 142 00:05:24,735 --> 00:05:26,435 private equity and the MSOs, 143 00:05:27,214 --> 00:05:29,074 that ability to professionalize 144 00:05:29,454 --> 00:05:30,834 for lack of a better word, 145 00:05:32,095 --> 00:05:33,154 the practice of 146 00:05:33,939 --> 00:05:35,160 physician practice management 147 00:05:35,460 --> 00:05:38,500 is really the opportunity to kind of to 148 00:05:38,500 --> 00:05:40,020 move it to that next level, to be 149 00:05:40,020 --> 00:05:41,379 able to compete, to be able to give 150 00:05:41,379 --> 00:05:43,620 them kind of back their voice in all 151 00:05:43,620 --> 00:05:46,259 these healthcare conversations. So, I think it's a 152 00:05:46,259 --> 00:05:49,254 great trend done right with the right partner 153 00:05:49,555 --> 00:05:51,414 with the focus being on 154 00:05:51,794 --> 00:05:53,495 how do we actually make it better. 155 00:05:55,474 --> 00:05:57,154 And costs come out of that and costs 156 00:05:57,154 --> 00:05:58,754 happen, but it really is how do we 157 00:05:58,754 --> 00:06:00,354 do it better. And I think that gives 158 00:06:00,354 --> 00:06:01,714 you the opportunity to be able to do 159 00:06:01,714 --> 00:06:04,439 it because otherwise transformational change is too hard 160 00:06:04,500 --> 00:06:05,479 without a partner. 161 00:06:06,339 --> 00:06:08,819 Yeah. Yeah. Absolutely. So that that's one big 162 00:06:08,819 --> 00:06:10,500 trend. And fascinating to go get your your 163 00:06:10,500 --> 00:06:12,099 insights and your take there in terms of 164 00:06:12,099 --> 00:06:14,899 what's happening in the orthopedic MSO space. But, 165 00:06:15,139 --> 00:06:17,204 David, when you think about trends in the 166 00:06:17,204 --> 00:06:19,685 healthcare or even the ASC space more broadly, 167 00:06:19,685 --> 00:06:21,044 what are 1 or 2 other trends that 168 00:06:21,044 --> 00:06:23,144 you're really paying close attention to and why? 169 00:06:24,004 --> 00:06:26,584 We already talked about consolidation, but obviously reimbursement 170 00:06:26,964 --> 00:06:29,604 from the physician side and Medicare has continued 171 00:06:29,604 --> 00:06:31,829 down and until we get some kind of 172 00:06:32,069 --> 00:06:34,889 permanent legislative fix, the annual game 173 00:06:35,669 --> 00:06:37,189 of Medicare puts it down and then we 174 00:06:37,189 --> 00:06:38,649 got to bring it back to move 175 00:06:39,029 --> 00:06:39,769 all into 176 00:06:40,389 --> 00:06:41,909 Part B. And then, just really the way 177 00:06:41,909 --> 00:06:44,469 the funding mechanism works for it is broken 178 00:06:44,469 --> 00:06:46,149 and somebody needs to go in and get 179 00:06:46,149 --> 00:06:49,254 that changed. So, obviously reimbursement declined 180 00:06:50,435 --> 00:06:53,735 in couple that with a crazy inflation and 181 00:06:53,794 --> 00:06:55,095 especially wage inflation 182 00:06:55,634 --> 00:06:57,495 and we have got to find ways 183 00:06:58,035 --> 00:06:59,634 to do that. The other big trend that 184 00:06:59,634 --> 00:07:01,095 I'm following a lot is 185 00:07:01,840 --> 00:07:04,900 kind of the legislative pushback on any healthcare 186 00:07:05,120 --> 00:07:05,620 consolidation 187 00:07:06,319 --> 00:07:08,180 and transactions and oversight 188 00:07:08,960 --> 00:07:10,960 and kind of an overreach that seems to 189 00:07:10,960 --> 00:07:11,860 be getting into 190 00:07:12,400 --> 00:07:14,100 things that could be done better 191 00:07:15,145 --> 00:07:16,824 of just really trying to protect 1 or 192 00:07:16,824 --> 00:07:17,485 2 little 193 00:07:17,865 --> 00:07:19,564 small items or constituents 194 00:07:20,105 --> 00:07:22,105 without really looking at what the whole big 195 00:07:22,105 --> 00:07:22,925 picture is 196 00:07:24,425 --> 00:07:26,264 and kind of losing sight of it in 197 00:07:26,264 --> 00:07:27,004 these legislative 198 00:07:27,545 --> 00:07:29,004 efforts on transactions 199 00:07:29,384 --> 00:07:31,540 and eliminating health care growth and 200 00:07:31,920 --> 00:07:34,000 look back for 10 years, things like that. 201 00:07:34,000 --> 00:07:35,779 Lots of states are going down those paths. 202 00:07:36,480 --> 00:07:38,639 Got you. And just to follow-up on the 203 00:07:38,639 --> 00:07:40,580 point that you mentioned previously in terms 204 00:07:41,199 --> 00:07:43,920 of orthopedic practices really having being forced to 205 00:07:43,920 --> 00:07:45,745 try and do more with less now when 206 00:07:45,745 --> 00:07:48,384 you think about inflation, the rising costs, some 207 00:07:48,384 --> 00:07:49,845 of these reimbursement challenges. 208 00:07:50,225 --> 00:07:53,125 Really, the the margins under which independent practices 209 00:07:53,185 --> 00:07:53,845 are operating 210 00:07:54,225 --> 00:07:55,605 are growing a lot tighter. 211 00:07:56,545 --> 00:07:58,579 With this in mind, how how can orthopedic 212 00:07:58,579 --> 00:08:01,699 practices really focus on doing more with less 213 00:08:01,699 --> 00:08:04,579 in such a challenging financial and also workforce 214 00:08:04,579 --> 00:08:05,079 environment? 215 00:08:06,819 --> 00:08:08,979 It really does have to be finding a 216 00:08:08,979 --> 00:08:11,764 way to to do to do to me 217 00:08:11,764 --> 00:08:13,685 it's the same thing, but it's our label 218 00:08:13,685 --> 00:08:15,625 is 2 different things. It's leveraging 219 00:08:16,004 --> 00:08:17,384 both people and technology, 220 00:08:18,084 --> 00:08:19,925 to be able to actually enhance them just 221 00:08:19,925 --> 00:08:21,845 like we talk about a physician practicing at 222 00:08:21,845 --> 00:08:22,904 the top of their license. 223 00:08:23,220 --> 00:08:24,500 I need my employees to be able to 224 00:08:24,500 --> 00:08:25,000 practice 225 00:08:26,020 --> 00:08:27,460 and work at the top of what they 226 00:08:27,460 --> 00:08:29,540 can do and not be doing basically the 227 00:08:29,540 --> 00:08:30,980 chores that they need to be doing their 228 00:08:30,980 --> 00:08:32,980 core work, not their chore work. And if 229 00:08:32,980 --> 00:08:34,899 they can be focused on that, one way 230 00:08:34,899 --> 00:08:37,504 to do that often is to partner or 231 00:08:37,504 --> 00:08:38,164 to find 232 00:08:38,465 --> 00:08:39,365 third parties 233 00:08:39,745 --> 00:08:42,304 who focus on that area or focus really 234 00:08:42,304 --> 00:08:45,184 well on maybe bringing AI or maybe bringing 235 00:08:45,184 --> 00:08:46,865 technology and marry it better than we can 236 00:08:46,865 --> 00:08:47,845 do in a smaller 237 00:08:48,304 --> 00:08:50,065 group or even just in a regional kind 238 00:08:50,065 --> 00:08:51,860 of a group that if they can do 239 00:08:51,860 --> 00:08:53,860 it on a national scale and be able 240 00:08:53,860 --> 00:08:55,299 to find ways to do that to partner 241 00:08:55,299 --> 00:08:57,700 with them to deal with that labor shortage, 242 00:08:57,700 --> 00:08:59,639 to deal with growth, to deal 243 00:09:00,179 --> 00:09:02,759 with ups and downs of the business, that 244 00:09:03,940 --> 00:09:05,620 bench strength that you can get from partnering 245 00:09:05,620 --> 00:09:07,804 with somebody who actually is better at that, 246 00:09:08,044 --> 00:09:09,245 is one way that we're trying to do 247 00:09:09,245 --> 00:09:10,225 more with less. 248 00:09:10,924 --> 00:09:12,605 Yeah. Yeah. Well, you mentioned some of the 249 00:09:12,605 --> 00:09:15,644 things. Obviously, physicians, I'm not their support staff 250 00:09:15,644 --> 00:09:18,044 or administrative staff, all offering at the top 251 00:09:18,044 --> 00:09:20,100 of their license, so to speak. But interesting 252 00:09:20,100 --> 00:09:23,399 to kind of hear the fascination with technology 253 00:09:23,539 --> 00:09:25,860 and AI partnerships also can really lend a 254 00:09:25,860 --> 00:09:26,839 hand in this space. 255 00:09:27,539 --> 00:09:29,059 When you think about the future of the 256 00:09:29,059 --> 00:09:31,460 specialty, what are you most excited about? Does 257 00:09:31,460 --> 00:09:33,299 AI technology like this really on top of 258 00:09:33,299 --> 00:09:34,600 your mind or anything else? 259 00:09:35,245 --> 00:09:37,105 Yes, that is definitely one of them. 260 00:09:39,245 --> 00:09:41,485 And the things that I'm excited about is 261 00:09:41,485 --> 00:09:43,644 that it's transforming back to what we talked 262 00:09:43,644 --> 00:09:45,345 about kind of at the beginning with 263 00:09:45,725 --> 00:09:46,944 the private equity, 264 00:09:47,564 --> 00:09:50,420 MSOs and that is transforming into more of 265 00:09:50,420 --> 00:09:51,559 a business platform. 266 00:09:52,100 --> 00:09:55,220 We've always just focused in healthcare and especially 267 00:09:55,220 --> 00:09:57,779 in physician practice or in surgery centers just 268 00:09:57,779 --> 00:09:59,460 on each and every patient and trying to 269 00:09:59,460 --> 00:10:01,139 give them the right care which you have 270 00:10:01,139 --> 00:10:01,799 to do. 271 00:10:02,285 --> 00:10:04,445 But at times that is not the most 272 00:10:04,445 --> 00:10:06,285 efficient way to do it. So if you 273 00:10:06,285 --> 00:10:08,684 keep that patient in your mind, but then 274 00:10:08,684 --> 00:10:10,305 talk about how do we actually make 275 00:10:10,684 --> 00:10:13,805 we standardize or we build processes around how 276 00:10:13,805 --> 00:10:14,305 to 277 00:10:14,720 --> 00:10:16,720 the patient and the doctor are the unique 278 00:10:16,720 --> 00:10:18,559 pieces and yet everything else is now the 279 00:10:18,559 --> 00:10:20,080 same and to be able to do that 280 00:10:20,080 --> 00:10:22,639 across a greater scale whether that's with AI, 281 00:10:22,639 --> 00:10:24,820 with using the right employees to do that, 282 00:10:24,960 --> 00:10:27,440 instead of kind of everything is bespoke for 283 00:10:27,440 --> 00:10:28,580 every single patient, 284 00:10:29,084 --> 00:10:30,524 then you can start to leverage that. So 285 00:10:30,524 --> 00:10:32,125 whether it's AI that helps you do that, 286 00:10:32,125 --> 00:10:34,304 whether that's a different type of technology, 287 00:10:34,684 --> 00:10:37,564 whether that's just processes, whether that's getting rid 288 00:10:37,564 --> 00:10:40,125 of the old faxes, whatever that may be. 289 00:10:40,125 --> 00:10:42,144 It's finding those ways to 290 00:10:44,129 --> 00:10:45,889 push that extra chore work out of there 291 00:10:45,889 --> 00:10:46,870 to get it done. 292 00:10:47,649 --> 00:10:50,129 Yeah. So one definitely one big opportunity, not 293 00:10:50,129 --> 00:10:52,389 just in the orthopedic space, but health systems, 294 00:10:52,450 --> 00:10:55,009 hospitals, independent practices across the board with some 295 00:10:55,009 --> 00:10:57,090 of the the influx of this AI technology 296 00:10:57,090 --> 00:10:58,769 and tools and what it can potentially do 297 00:10:58,769 --> 00:11:00,004 in terms of efficiency. 298 00:11:01,024 --> 00:11:03,585 David, before I let you go, Ortho New 299 00:11:03,585 --> 00:11:05,425 York, can you give us, just dive one 300 00:11:05,425 --> 00:11:07,504 bit deeper into how are you looking at 301 00:11:07,504 --> 00:11:09,264 the next 12 months of growth? Is it 302 00:11:09,264 --> 00:11:11,205 is it adding physicians, administrative 303 00:11:11,665 --> 00:11:13,845 staff, is it adding other sites, locations? 304 00:11:14,289 --> 00:11:15,649 Curious to hear a little bit more about, 305 00:11:15,970 --> 00:11:17,509 what your plan is for the future? 306 00:11:18,289 --> 00:11:20,769 Yes. It is both of the organic growth 307 00:11:20,769 --> 00:11:22,929 of adding in some new physicians. We're excited. 308 00:11:22,929 --> 00:11:25,190 We have 2 joining us now that fellowships 309 00:11:25,250 --> 00:11:26,929 are done. So, we have 2 joining us 310 00:11:26,929 --> 00:11:27,669 this September. 311 00:11:28,445 --> 00:11:31,085 Truly the call right before this recording was 312 00:11:31,085 --> 00:11:33,565 with a new surgeon that wants to join 313 00:11:33,565 --> 00:11:35,985 us next year. And so, definitely the organic 314 00:11:36,125 --> 00:11:37,665 growth, we are building 315 00:11:38,125 --> 00:11:39,665 a new building and expanding 316 00:11:41,804 --> 00:11:42,544 in the areas 317 00:11:43,509 --> 00:11:46,169 of Saratoga Springs that is continuing to grow. 318 00:11:46,230 --> 00:11:49,750 So we're adding another surgery center there and 319 00:11:49,750 --> 00:11:51,350 continuing to go forward with that. So we 320 00:11:51,350 --> 00:11:53,669 are very excited about where that future is 321 00:11:53,669 --> 00:11:55,750 and maybe finding the right partner or the 322 00:11:55,750 --> 00:11:56,409 right partners 323 00:11:56,789 --> 00:11:58,970 with the other ortho groups in the area 324 00:11:59,024 --> 00:12:01,105 to find ways to move ourselves into the 325 00:12:01,105 --> 00:12:01,605 future. 326 00:12:02,384 --> 00:12:03,825 Yeah. Fantastic. Certainly, 327 00:12:04,225 --> 00:12:05,985 an exciting time in Ortho New York. It 328 00:12:05,985 --> 00:12:07,264 sounds like a lot of coals in the 329 00:12:07,264 --> 00:12:09,745 fire there. So, really, really appreciate having me 330 00:12:09,745 --> 00:12:11,665 back on the podcast with us, David, and 331 00:12:11,665 --> 00:12:13,184 I look forward to connecting with you again 332 00:12:13,184 --> 00:12:14,004 down the line. 333 00:12:14,421 --> 00:12:15,571 Thank you. Appreciate it.