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This is Alan Condon back on the Becker's
podcast. I'm delighted to be joined today by
David Fitzgerald,
the CEO at Ortho NY.
David, a a real pleasure to have you
on the podcast with us today. Before we
dive into some questions and pick your brains
on a few items, I'd love to turn
the floor over to you to hear a
little bit more about your role and your
background, not just at Ortho NY, but in
the healthcare space more
broadly. Appreciate that and thanks for having me
on today. But background is been in healthcare
for longer than we'd like to think about,
but
started as
in these kinds of roles in orthopedics and
surgery centers with ProLiant Surgeons in Seattle with
the CEO there for 17 years,
almost 18. And then
did some other stints, stepped into dermatology,
worked with some private equity firms in roll
ups
and helping some of those larger organizations.
And recently, I had the opportunity to work
with and do a little consulting with Ortho
NY and we call Ortho New York. And
then, just really
found the opportunity
to spend
more time here, meet our CEO and really
focus on the growth, focus on the change
and do those things and we're really excited
here about what's kind of happening in orthopedics,
happening in the Northeast.
And so, we're based in the capital regions
they call it of, Upstate New York. So
from Albany,
up north.
Fantastic. So I think no better man to
really take charge as CEO. I know you've
been there at Ortho New York for about
a year now. But just going back to
everything that you've executed in terms of your
time as CEO of Pro Line Surgeons,
where you've taken that group from a small
practice into,
I believe, 400 plus providers, 20 20 plus
ASCs. But I'd love to kinda hear from
you. When you're focusing on Ortho New York
now,
what's the strategic direction, the expansion that you're
looking at? What most makes sense in that
market?
It is both organic growth and it is
consolidation of some of the practices that in
all of
the Upstate New York area. There are some
larger ones that
crazy enough those of us who weren't as
familiar with New York as we were at
the West
where our clients is in Seattle. But it
is there's a lot of good small communities
where they have orthopedic surgeons, but recruitment is
difficult.
Combining is difficult.
But how do we do that and kind
of build a practice that allows them to
stay in their communities, to be able to
recruit new physicians, to service those patients in
those areas
and yet still be able to grow. So,
there there's a tremendous amount of opportunity here
with the people, with the changes that are
happening
and really all have moved outpatients. I mean,
that's really it's a great opportunity.
Yes. I'm curious to see. I mean, one
big trend that we're following in the orthopedic
space particularly
is the the emergence and the the growing
in number of these, orthopedic management services organizations
or MSOs,
you know, growing in number, growing in size,
really across the country.
I'd love to just kinda get your take,
your insights.
Is this something that, Ortho Ortho New York
might potentially consider, or how do you see
this trend really developing in the orthopedic space?
I'll answer it quick short with it. Yes,
I think we would definitely explore that. And
the reason is really more because the trend
in the right way done right is really
private practice
version 2.0.
It is bringing in that partner. It is
one of the things that I'm actually more
excited about right now is the way that
we're kind of moving to business platforms. How
physician groups have decided that we can't be
just mom and pop anymore. We can't compete
against the consolidated hospitals, consolidated
payers is that we need to find ways
to do that yet be able to provide
care really very locally with our own groups,
with our own patients, within our own office,
within that same 7 to 10 people that
they may touch, but you need to have
the bigger organization to be able to kind
of be big and small. And so, with
private equity and the MSOs,
that ability to professionalize
for lack of a better word,
the practice of
physician practice management
is really the opportunity to kind of to
move it to that next level, to be
able to compete, to be able to give
them kind of back their voice in all
these healthcare conversations. So, I think it's a
great trend done right with the right partner
with the focus being on
how do we actually make it better.
And costs come out of that and costs
happen, but it really is how do we
do it better. And I think that gives
you the opportunity to be able to do
it because otherwise transformational change is too hard
without a partner.
Yeah. Yeah. Absolutely. So that that's one big
trend. And fascinating to go get your your
insights and your take there in terms of
what's happening in the orthopedic MSO space. But,
David, when you think about trends in the
healthcare or even the ASC space more broadly,
what are 1 or 2 other trends that
you're really paying close attention to and why?
We already talked about consolidation, but obviously reimbursement
from the physician side and Medicare has continued
down and until we get some kind of
permanent legislative fix, the annual game
of Medicare puts it down and then we
got to bring it back to move
all into
Part B. And then, just really the way
the funding mechanism works for it is broken
and somebody needs to go in and get
that changed. So, obviously reimbursement declined
in couple that with a crazy inflation and
especially wage inflation
and we have got to find ways
to do that. The other big trend that
I'm following a lot is
kind of the legislative pushback on any healthcare
consolidation
and transactions and oversight
and kind of an overreach that seems to
be getting into
things that could be done better
of just really trying to protect 1 or
2 little
small items or constituents
without really looking at what the whole big
picture is
and kind of losing sight of it in
these legislative
efforts on transactions
and eliminating health care growth and
look back for 10 years, things like that.
Lots of states are going down those paths.
Got you. And just to follow-up on the
point that you mentioned previously in terms
of orthopedic practices really having being forced to
try and do more with less now when
you think about inflation, the rising costs, some
of these reimbursement challenges.
Really, the the margins under which independent practices
are operating
are growing a lot tighter.
With this in mind, how how can orthopedic
practices really focus on doing more with less
in such a challenging financial and also workforce
environment?
It really does have to be finding a
way to to do to do to me
it's the same thing, but it's our label
is 2 different things. It's leveraging
both people and technology,
to be able to actually enhance them just
like we talk about a physician practicing at
the top of their license.
I need my employees to be able to
practice
and work at the top of what they
can do and not be doing basically the
chores that they need to be doing their
core work, not their chore work. And if
they can be focused on that, one way
to do that often is to partner or
to find
third parties
who focus on that area or focus really
well on maybe bringing AI or maybe bringing
technology and marry it better than we can
do in a smaller
group or even just in a regional kind
of a group that if they can do
it on a national scale and be able
to find ways to do that to partner
with them to deal with that labor shortage,
to deal with growth, to deal
with ups and downs of the business, that
bench strength that you can get from partnering
with somebody who actually is better at that,
is one way that we're trying to do
more with less.
Yeah. Yeah. Well, you mentioned some of the
things. Obviously, physicians, I'm not their support staff
or administrative staff, all offering at the top
of their license, so to speak. But interesting
to kind of hear the fascination with technology
and AI partnerships also can really lend a
hand in this space.
When you think about the future of the
specialty, what are you most excited about? Does
AI technology like this really on top of
your mind or anything else?
Yes, that is definitely one of them.
And the things that I'm excited about is
that it's transforming back to what we talked
about kind of at the beginning with
the private equity,
MSOs and that is transforming into more of
a business platform.
We've always just focused in healthcare and especially
in physician practice or in surgery centers just
on each and every patient and trying to
give them the right care which you have
to do.
But at times that is not the most
efficient way to do it. So if you
keep that patient in your mind, but then
talk about how do we actually make
we standardize or we build processes around how
to
the patient and the doctor are the unique
pieces and yet everything else is now the
same and to be able to do that
across a greater scale whether that's with AI,
with using the right employees to do that,
instead of kind of everything is bespoke for
every single patient,
then you can start to leverage that. So
whether it's AI that helps you do that,
whether that's a different type of technology,
whether that's just processes, whether that's getting rid
of the old faxes, whatever that may be.
It's finding those ways to
push that extra chore work out of there
to get it done.
Yeah. So one definitely one big opportunity, not
just in the orthopedic space, but health systems,
hospitals, independent practices across the board with some
of the the influx of this AI technology
and tools and what it can potentially do
in terms of efficiency.
David, before I let you go, Ortho New
York, can you give us, just dive one
bit deeper into how are you looking at
the next 12 months of growth? Is it
is it adding physicians, administrative
staff, is it adding other sites, locations?
Curious to hear a little bit more about,
what your plan is for the future?
Yes. It is both of the organic growth
of adding in some new physicians. We're excited.
We have 2 joining us now that fellowships
are done. So, we have 2 joining us
this September.
Truly the call right before this recording was
with a new surgeon that wants to join
us next year. And so, definitely the organic
growth, we are building
a new building and expanding
in the areas
of Saratoga Springs that is continuing to grow.
So we're adding another surgery center there and
continuing to go forward with that. So we
are very excited about where that future is
and maybe finding the right partner or the
right partners
with the other ortho groups in the area
to find ways to move ourselves into the
future.
Yeah. Fantastic. Certainly,
an exciting time in Ortho New York. It
sounds like a lot of coals in the
fire there. So, really, really appreciate having me
back on the podcast with us, David, and
I look forward to connecting with you again
down the line.
Thank you. Appreciate it.