1 00:00:00,080 --> 00:00:02,000 Hello, everyone. My name is Brian Zimmerman with 2 00:00:02,000 --> 00:00:04,000 Becker's Healthcare. Thank you so much for tuning 3 00:00:04,000 --> 00:00:05,700 into the Becker's Healthcare podcast. 4 00:00:06,319 --> 00:00:09,199 Today, we're on-site at Becker's twenty second annual 5 00:00:09,199 --> 00:00:12,160 spine orthopedic and pain management driven ASC in 6 00:00:12,160 --> 00:00:13,619 the future of spine conference. 7 00:00:13,984 --> 00:00:15,585 And I'm gonna turn things over here to 8 00:00:15,585 --> 00:00:19,105 Jason Ficken, managing partner, Quadriga Partners, and Levi 9 00:00:19,105 --> 00:00:19,605 Shepherds, 10 00:00:19,984 --> 00:00:22,785 CEO, SQL Ortho. Levi and Jason, I'll leave 11 00:00:22,785 --> 00:00:23,524 it to you. 12 00:00:23,984 --> 00:00:26,224 Levi, I wanna begin by thanking you for 13 00:00:26,224 --> 00:00:28,660 carving out some time from the Becker's Healthcare 14 00:00:28,660 --> 00:00:31,380 Orthopedic Conference to memorialize what I know are 15 00:00:31,380 --> 00:00:34,200 really unique insights that emanate from your experience 16 00:00:34,260 --> 00:00:35,159 leading OrthoNebraska, 17 00:00:35,620 --> 00:00:38,600 or now SQL Ortho, for almost a decade. 18 00:00:39,299 --> 00:00:41,005 Given the friendship you and I forged in 19 00:00:41,005 --> 00:00:43,164 the crucible of the deal process that led 20 00:00:43,164 --> 00:00:44,064 to OrthoNebraska's 21 00:00:44,604 --> 00:00:46,225 partnership with Intandem Capital, 22 00:00:46,604 --> 00:00:48,445 I'm eager to just jump into a litany 23 00:00:48,445 --> 00:00:51,244 of questions around the process, motivations for pursuing 24 00:00:51,244 --> 00:00:53,609 a partnership with a private equity group, and 25 00:00:53,850 --> 00:00:56,010 how your experience has been having lived this 26 00:00:56,010 --> 00:00:58,409 for the past two years post close. But 27 00:00:58,409 --> 00:01:00,170 maybe we start with a quick introduction on 28 00:01:00,170 --> 00:01:01,710 yourself as well as what you've 29 00:01:02,170 --> 00:01:04,409 been building with your physician partners and in 30 00:01:04,409 --> 00:01:05,950 tandem at Sequel Ortho. 31 00:01:06,665 --> 00:01:09,645 Yeah. Thanks, Jason. So I've been with OrthoNebraska, 32 00:01:11,224 --> 00:01:12,605 for ten years. 33 00:01:13,064 --> 00:01:13,564 OrthoNebraska 34 00:01:14,185 --> 00:01:16,745 really was an idea when I started ten 35 00:01:16,745 --> 00:01:19,864 years ago. Fortunate enough that gotta join a 36 00:01:19,864 --> 00:01:21,084 physician owned hospital 37 00:01:21,439 --> 00:01:24,079 that was really run by physicians. We had 38 00:01:24,079 --> 00:01:26,640 a health system partner, but those physicians were 39 00:01:26,640 --> 00:01:29,200 incredibly engaged in how we delivered care in 40 00:01:29,200 --> 00:01:30,099 in that hospital. 41 00:01:30,480 --> 00:01:31,459 But we were missing 42 00:01:31,840 --> 00:01:33,379 was the full integration 43 00:01:33,840 --> 00:01:34,900 across the musculoskeletal 44 00:01:35,280 --> 00:01:35,780 continuum. 45 00:01:36,395 --> 00:01:39,034 And so over the past ten years, we 46 00:01:39,034 --> 00:01:42,234 turned Ortho Nebraska into a living, breathing thing 47 00:01:42,234 --> 00:01:44,334 that was once an idea. 48 00:01:45,355 --> 00:01:47,674 And so we integrated across the clinic. We 49 00:01:47,674 --> 00:01:50,489 integrated with physical therapy. We integrated with imaging. 50 00:01:50,489 --> 00:01:52,590 We had an emergency department. We established 51 00:01:52,890 --> 00:01:55,290 urgent care. We have DME. We have the 52 00:01:55,290 --> 00:01:55,790 continuum 53 00:01:56,250 --> 00:01:56,750 parts, 54 00:01:57,369 --> 00:01:58,670 but what we are seeking 55 00:01:58,969 --> 00:02:02,269 is ensuring that we had the right alignment 56 00:02:02,805 --> 00:02:03,305 model. 57 00:02:03,765 --> 00:02:06,344 And when we had a health system partner, 58 00:02:06,725 --> 00:02:09,784 that alignment just didn't fully cement. And so 59 00:02:10,085 --> 00:02:12,724 what we decided to do ultimately was find 60 00:02:12,724 --> 00:02:15,064 the right partner, find the right capital structure, 61 00:02:15,125 --> 00:02:19,099 find the right compensation model to ensure alignment 62 00:02:19,159 --> 00:02:21,879 over the long run. And so those ten 63 00:02:21,879 --> 00:02:23,740 years have been incredibly fun, 64 00:02:24,599 --> 00:02:25,659 but your help, 65 00:02:26,120 --> 00:02:28,439 I think, is is what we're now trying 66 00:02:28,439 --> 00:02:30,280 to do, which is take those last ten 67 00:02:30,280 --> 00:02:31,500 years of of learnings 68 00:02:32,264 --> 00:02:33,485 and apply that 69 00:02:33,865 --> 00:02:34,685 to a whole 70 00:02:35,064 --> 00:02:37,564 host of additional geographies and markets. 71 00:02:38,344 --> 00:02:40,105 The way we think about it is there's 72 00:02:40,105 --> 00:02:42,525 there's a lot of MSK groups that have 73 00:02:42,585 --> 00:02:43,085 partners 74 00:02:43,385 --> 00:02:45,780 that maybe don't have the alignment model, or 75 00:02:45,780 --> 00:02:48,259 maybe they have the alignment model without the 76 00:02:48,259 --> 00:02:50,739 capital and the strategies to grow and really 77 00:02:50,739 --> 00:02:52,739 take care of patients in their their communities. 78 00:02:52,739 --> 00:02:54,120 And so what we wanna do is 79 00:02:54,419 --> 00:02:56,340 mesh these ten years of learnings to those 80 00:02:56,340 --> 00:02:56,840 opportunities 81 00:02:57,379 --> 00:03:00,340 in other markets under now the the SQL 82 00:03:00,340 --> 00:03:00,840 Ortho 83 00:03:01,224 --> 00:03:02,044 holding company. 84 00:03:02,985 --> 00:03:05,165 Terrific. Well, I can anticipate that 85 00:03:05,625 --> 00:03:08,125 not just the physicians, you know, pre transaction 86 00:03:08,264 --> 00:03:10,344 at at SQL, but, you know, any physician 87 00:03:10,344 --> 00:03:12,745 or maybe even practice leader that's listening to 88 00:03:12,745 --> 00:03:13,485 this discussion 89 00:03:14,230 --> 00:03:16,810 will already have his or her own preconceived 90 00:03:16,870 --> 00:03:19,110 notions of what partnering with private equity is 91 00:03:19,110 --> 00:03:19,770 really like. 92 00:03:20,069 --> 00:03:22,069 Just given you've lived it for the past 93 00:03:22,069 --> 00:03:24,469 twenty four months, can you elaborate on or 94 00:03:24,469 --> 00:03:26,730 or maybe even dispel some of the myths 95 00:03:26,790 --> 00:03:28,569 surrounding these types of partnerships? 96 00:03:30,045 --> 00:03:32,205 Yeah. I I think there are so many 97 00:03:32,205 --> 00:03:32,705 unfortunate 98 00:03:33,885 --> 00:03:37,185 stories, so many unfortunate myths around this concept. 99 00:03:37,645 --> 00:03:39,585 I wanna go back to this whole concept 100 00:03:39,805 --> 00:03:40,865 of of alignment. 101 00:03:41,405 --> 00:03:43,885 To get very precise, essentially, there's a lot 102 00:03:43,885 --> 00:03:46,680 of, musculoskeletal groups. There's a lot of orthopedic 103 00:03:46,739 --> 00:03:49,000 groups. They already have existing partners. 104 00:03:49,379 --> 00:03:51,300 But I think the the question is is 105 00:03:51,300 --> 00:03:53,939 when, you know, we earn dollars, are those 106 00:03:53,939 --> 00:03:56,280 dollars then retained and reinvested 107 00:03:56,580 --> 00:03:59,295 in order to deliver care, in order to 108 00:03:59,295 --> 00:04:02,415 build access points, in order to recruit physicians 109 00:04:02,415 --> 00:04:02,915 either 110 00:04:03,215 --> 00:04:05,215 in the market or that are coming out 111 00:04:05,215 --> 00:04:05,875 of fellowship? 112 00:04:06,254 --> 00:04:07,795 Are they being used to 113 00:04:08,175 --> 00:04:10,655 build new surgery centers? Whatever the case may 114 00:04:10,655 --> 00:04:13,069 be, are are those dollars retained? And that 115 00:04:13,069 --> 00:04:15,550 to me is the alignment model. And I 116 00:04:15,550 --> 00:04:18,050 think that's the the number one myth 117 00:04:18,430 --> 00:04:21,649 is this is really still a partnership 118 00:04:22,269 --> 00:04:25,185 just like most orthopedic groups have, but it's 119 00:04:25,185 --> 00:04:27,904 a better aligned model where it's really a 120 00:04:27,904 --> 00:04:29,845 retained earnings model to continue 121 00:04:30,305 --> 00:04:31,925 to invest back into 122 00:04:32,384 --> 00:04:35,584 the the continuum or the orthopedic system that 123 00:04:35,584 --> 00:04:37,745 groups are trying to build in their respective 124 00:04:37,745 --> 00:04:38,245 communities. 125 00:04:38,599 --> 00:04:40,199 And so to me, that's that's really important, 126 00:04:40,199 --> 00:04:41,579 and that has then facilitated 127 00:04:42,039 --> 00:04:44,300 a lot of great things then post transaction 128 00:04:44,439 --> 00:04:46,220 with with, OrthoNebraska 129 00:04:47,079 --> 00:04:49,339 under Sequo Ortho as a holding company. 130 00:04:49,720 --> 00:04:52,564 I think we've recruited around six new physicians, 131 00:04:52,564 --> 00:04:54,245 a couple of those that are in market 132 00:04:54,245 --> 00:04:56,564 that see what we're we're building and wanna 133 00:04:56,564 --> 00:04:58,324 be part of what what we have going 134 00:04:58,324 --> 00:04:58,824 on. 135 00:04:59,204 --> 00:05:02,425 We're building an additional clinic. We're actually building 136 00:05:02,805 --> 00:05:05,610 a a surgery center. We are building an 137 00:05:05,610 --> 00:05:09,149 analytics platform. We're hiring incredible talent to run, 138 00:05:10,009 --> 00:05:13,550 different administrative functions that keep us moving faster 139 00:05:13,610 --> 00:05:15,449 than what we think our our competition is 140 00:05:15,449 --> 00:05:15,949 doing. 141 00:05:16,330 --> 00:05:18,654 And so to me, it just goes back 142 00:05:18,654 --> 00:05:20,735 to that whole concept of alignment and then 143 00:05:20,735 --> 00:05:21,235 reinvesting 144 00:05:21,854 --> 00:05:24,814 back into the business as opposed to, you 145 00:05:24,814 --> 00:05:27,294 know, your current joint venture partners where those 146 00:05:27,294 --> 00:05:29,935 earnings are escaping the system that you're trying 147 00:05:29,935 --> 00:05:31,956 to build. Yeah. That makes a ton of 148 00:05:31,956 --> 00:05:34,132 sense, and there's so many different ways to 149 00:05:34,132 --> 00:05:36,100 kinda go from that answer, but I'm gonna 150 00:05:36,100 --> 00:05:38,819 I'm gonna focus on physician recruitment. Because as 151 00:05:38,819 --> 00:05:40,740 you and I talked about throughout our process, 152 00:05:40,740 --> 00:05:42,740 and as we've continued to, you know, deepen 153 00:05:42,740 --> 00:05:44,839 our relationship over the last couple of years, 154 00:05:45,444 --> 00:05:47,205 One of the secret sauces that I think 155 00:05:47,205 --> 00:05:49,305 is critical, not just to 156 00:05:49,685 --> 00:05:52,884 SQL Ortho success, but any physician practice management 157 00:05:52,884 --> 00:05:53,384 opportunity 158 00:05:54,084 --> 00:05:55,865 is that physician retention 159 00:05:56,644 --> 00:05:57,464 and recruitment. 160 00:05:57,990 --> 00:05:59,829 And I know you'd lamented at times being 161 00:05:59,829 --> 00:06:01,829 in the Omaha market, although it's a wonderful 162 00:06:01,829 --> 00:06:02,329 community, 163 00:06:02,709 --> 00:06:05,029 sometimes it's harder to recruit people there than 164 00:06:05,029 --> 00:06:07,829 a Denver or a Dallas or whatever it 165 00:06:07,829 --> 00:06:09,910 may be. So can you unpack a little 166 00:06:09,910 --> 00:06:10,889 bit more about 167 00:06:11,349 --> 00:06:13,370 what you guys have been able to do 168 00:06:14,185 --> 00:06:17,225 emerging from the transaction to retain and continue 169 00:06:17,225 --> 00:06:18,605 to motivate through alignment, 170 00:06:18,985 --> 00:06:20,824 your existing physicians, and then how you've been 171 00:06:20,824 --> 00:06:21,725 able to recruit 172 00:06:22,105 --> 00:06:24,904 another six plus docs post close? Because a 173 00:06:24,904 --> 00:06:26,745 lot of people are really scared of those 174 00:06:26,745 --> 00:06:27,245 components. 175 00:06:27,779 --> 00:06:29,639 Yeah. I think first and foremost, 176 00:06:30,420 --> 00:06:32,199 you know, our our recruiting philosophy 177 00:06:32,819 --> 00:06:35,800 hasn't changed Mhmm. Announced. Right. And our recruiting 178 00:06:35,860 --> 00:06:38,740 philosophy really starts with, let's make sure that 179 00:06:38,740 --> 00:06:40,920 we have a good plan to 180 00:06:41,595 --> 00:06:43,595 replace physicians as they move towards the end 181 00:06:43,595 --> 00:06:45,194 of the career. Let's make sure that we're 182 00:06:45,194 --> 00:06:46,735 building the the subspecialties 183 00:06:47,115 --> 00:06:49,194 that really are demanded in our market. Let's 184 00:06:49,194 --> 00:06:51,355 make sure that we're making sure that we're 185 00:06:51,355 --> 00:06:53,995 using, we'll call it, advanced practice providers in 186 00:06:53,995 --> 00:06:56,430 order to fill in service gaps. That that's, 187 00:06:56,430 --> 00:06:58,189 I would say, our strategy, but our our 188 00:06:58,189 --> 00:07:00,829 philosophy is we're only gonna hire people that 189 00:07:00,829 --> 00:07:03,550 really fit our culture, that are motivated by 190 00:07:03,550 --> 00:07:05,470 what we're trying to deliver, which is an 191 00:07:05,470 --> 00:07:07,250 extraordinary experience for patients, 192 00:07:07,709 --> 00:07:10,829 an incredible focus on the outcomes we create 193 00:07:10,829 --> 00:07:13,204 for our patients, and then making sure that 194 00:07:13,204 --> 00:07:15,125 we're taking care of of all of our 195 00:07:15,125 --> 00:07:18,504 people, our nurses, our techs, our MAS, our 196 00:07:18,884 --> 00:07:20,264 billing office individuals. 197 00:07:20,725 --> 00:07:22,644 If we focus on those three things and 198 00:07:22,644 --> 00:07:25,365 we find the right surgeons that believe in 199 00:07:25,365 --> 00:07:27,629 taking care of those three things, everything will 200 00:07:27,629 --> 00:07:28,930 work out from there. 201 00:07:29,470 --> 00:07:31,389 But going back to then, you know, how 202 00:07:31,389 --> 00:07:32,930 we execute, so if that's, 203 00:07:33,230 --> 00:07:34,830 you know, how we think about our strategy 204 00:07:34,830 --> 00:07:37,069 and then what our philosophy is executing on 205 00:07:37,069 --> 00:07:37,730 on recruitment 206 00:07:38,189 --> 00:07:40,110 in a way, it it has gotten so 207 00:07:40,110 --> 00:07:40,850 much easier. 208 00:07:41,194 --> 00:07:42,794 Because what we can do now is we 209 00:07:42,794 --> 00:07:45,435 can think about a larger pool of dollars 210 00:07:45,435 --> 00:07:47,514 in order to make sure that, you know, 211 00:07:47,514 --> 00:07:49,274 how they step into a new practice, if 212 00:07:49,274 --> 00:07:51,294 they're coming out of fellowship is well supported, 213 00:07:51,995 --> 00:07:54,555 and then it's competitive within the market as 214 00:07:54,555 --> 00:07:56,469 well. And what we can also do is 215 00:07:56,469 --> 00:07:58,949 we can make sure that they have a 216 00:07:58,949 --> 00:08:00,649 long term incentive through 217 00:08:01,029 --> 00:08:03,430 through grants, through equity that that, 218 00:08:03,829 --> 00:08:05,750 is afforded to them the second they start. 219 00:08:05,750 --> 00:08:07,750 They're creating value for the company we're trying 220 00:08:07,750 --> 00:08:09,029 to build. We want to make sure that 221 00:08:09,029 --> 00:08:10,169 they're aligned with 222 00:08:10,615 --> 00:08:12,134 with the the growth of the company. And 223 00:08:12,134 --> 00:08:13,435 so we can give them, 224 00:08:13,974 --> 00:08:15,115 a lot of great tools 225 00:08:15,735 --> 00:08:16,794 right out of fellowship. 226 00:08:17,254 --> 00:08:19,094 And I just wanna hit on one one 227 00:08:19,094 --> 00:08:21,034 of the most important tools is 228 00:08:21,414 --> 00:08:23,574 is if you start thinking about a group 229 00:08:23,574 --> 00:08:25,654 practice as a system across all of those 230 00:08:25,654 --> 00:08:28,220 environments of care from in the in the 231 00:08:28,220 --> 00:08:30,160 ORs, in physical therapy, 232 00:08:31,180 --> 00:08:31,920 in imaging. 233 00:08:32,379 --> 00:08:34,139 When you think about how all of that 234 00:08:34,139 --> 00:08:36,399 works as a system and you manage it 235 00:08:36,620 --> 00:08:38,320 as a a singular system, 236 00:08:39,345 --> 00:08:41,845 the opportunity for them to ramp up 237 00:08:42,304 --> 00:08:44,725 dramatically faster than the alternative 238 00:08:45,105 --> 00:08:47,105 is is really what they're looking for at 239 00:08:47,105 --> 00:08:48,004 the end of the day. 240 00:08:48,304 --> 00:08:50,784 Every physician that we're recruiting wants to have 241 00:08:50,784 --> 00:08:52,544 a busy practice right away. And so if 242 00:08:52,544 --> 00:08:54,710 we have created the system where we're attracting 243 00:08:54,710 --> 00:08:57,610 patients and we're reinvesting back into access points, 244 00:08:57,830 --> 00:09:00,149 it gives them the opportunity to see more 245 00:09:00,149 --> 00:09:02,410 of the patients that they wanna see quicker. 246 00:09:02,549 --> 00:09:04,629 And I think that's the attractive part. The 247 00:09:04,629 --> 00:09:07,125 rest are purely just tools to compete with, 248 00:09:07,284 --> 00:09:08,965 you know, call it health systems or other 249 00:09:08,965 --> 00:09:11,524 employed types of models. We want them fully 250 00:09:11,524 --> 00:09:13,605 engaged in the practice in what we consider 251 00:09:13,605 --> 00:09:15,945 this private practice two point o model. 252 00:09:16,485 --> 00:09:18,404 We want them to be very rewarded, but 253 00:09:18,404 --> 00:09:20,245 what they want is is a way to 254 00:09:20,245 --> 00:09:22,904 ramp up quickly, and the system based approach 255 00:09:23,100 --> 00:09:24,379 is the way to do it. I think 256 00:09:24,379 --> 00:09:27,100 it's really powerful because, you know, having been 257 00:09:27,100 --> 00:09:29,339 at the Becker's conference now and just knowing 258 00:09:29,339 --> 00:09:30,079 some of 259 00:09:30,539 --> 00:09:33,019 the perceived headwinds that exist within the industry, 260 00:09:33,019 --> 00:09:34,799 there's a lot of folks that are like, 261 00:09:34,940 --> 00:09:35,839 how do you 262 00:09:36,299 --> 00:09:38,240 appropriately incent someone 263 00:09:39,125 --> 00:09:42,184 who didn't participate in that initial liquidity event 264 00:09:42,565 --> 00:09:45,605 and come on board potentially taking comparable to 265 00:09:45,605 --> 00:09:47,845 less compensation that they might get at another 266 00:09:47,845 --> 00:09:49,065 true private practice, 267 00:09:49,684 --> 00:09:51,125 and they're not thinking about it in the 268 00:09:51,125 --> 00:09:52,485 way that you're talking. So I I loved 269 00:09:52,485 --> 00:09:54,264 some of those levers that you have 270 00:09:54,699 --> 00:09:56,539 to actually pull upon. And and and the 271 00:09:56,539 --> 00:09:58,059 ramp is something that wasn't even on my 272 00:09:58,059 --> 00:09:59,339 radar screen, so I think that makes a 273 00:09:59,339 --> 00:10:01,179 ton of sense. Yeah. I I really think 274 00:10:01,179 --> 00:10:04,399 that's what surgeons, what physicians went to 275 00:10:05,179 --> 00:10:07,334 went down this long path of of medical 276 00:10:07,334 --> 00:10:09,414 school, and then the residency and then fellowship 277 00:10:09,414 --> 00:10:10,774 is what they wanna do is they wanna 278 00:10:10,774 --> 00:10:13,334 have an impact in in their patients' lives, 279 00:10:13,334 --> 00:10:14,534 and then they wanna take care of a 280 00:10:14,534 --> 00:10:16,134 lot of patients. And so what we're trying 281 00:10:16,134 --> 00:10:17,115 to do is afford 282 00:10:17,495 --> 00:10:19,495 them that opportunity and then make sure that 283 00:10:19,495 --> 00:10:22,470 they're rewarded for it. And and, Jason, you 284 00:10:22,470 --> 00:10:24,389 just kinda you you talked about kind of 285 00:10:24,389 --> 00:10:27,029 misnomers or maybe trepidation around some of these 286 00:10:27,029 --> 00:10:27,529 models. 287 00:10:28,070 --> 00:10:28,570 And, 288 00:10:29,429 --> 00:10:31,690 you know, I wanna add two elements here. 289 00:10:31,990 --> 00:10:32,970 The first is 290 00:10:33,429 --> 00:10:35,830 the the physicians determine who they wanna work 291 00:10:35,830 --> 00:10:38,554 with. Our existing physicians determine if a new 292 00:10:38,554 --> 00:10:40,955 recruit is going to fit in that culture 293 00:10:40,955 --> 00:10:43,035 in is gonna fit in what we're trying 294 00:10:43,035 --> 00:10:43,695 to accomplish 295 00:10:44,235 --> 00:10:46,254 in in our mission and in our purpose. 296 00:10:46,475 --> 00:10:49,355 So they have the absolute say in in 297 00:10:49,355 --> 00:10:50,495 their partner physicians. 298 00:10:51,129 --> 00:10:52,509 And the other thing is 299 00:10:53,129 --> 00:10:56,009 they also these physicians, they're the newly recruited 300 00:10:56,009 --> 00:10:59,230 physicians, they're the ones that decide which patients 301 00:10:59,289 --> 00:11:01,529 they want to take care of, what they 302 00:11:01,529 --> 00:11:03,709 want to focus on if that's a certain 303 00:11:03,769 --> 00:11:06,269 subspecialty, if that's a couple different subspecialties. 304 00:11:07,024 --> 00:11:09,424 They are the ones that dictate the types 305 00:11:09,424 --> 00:11:11,184 of patients that they take care of, the 306 00:11:11,184 --> 00:11:12,965 the pace at which they want to, 307 00:11:13,424 --> 00:11:15,585 take care of those patients. What we're trying 308 00:11:15,585 --> 00:11:17,105 to do is just create a system where 309 00:11:17,105 --> 00:11:18,965 they can be incredibly successful. 310 00:11:19,519 --> 00:11:21,600 And building that system takes a lot of 311 00:11:21,600 --> 00:11:24,240 smarts, and it takes frankly, in today's world, 312 00:11:24,240 --> 00:11:26,320 it takes a lot of dollars. And so 313 00:11:26,320 --> 00:11:28,000 what we're trying to do under SQL or 314 00:11:28,159 --> 00:11:28,659 Ortho 315 00:11:29,039 --> 00:11:31,279 is make it very systematic so then a 316 00:11:31,279 --> 00:11:31,779 physician, 317 00:11:32,240 --> 00:11:33,139 a new surgeon 318 00:11:33,534 --> 00:11:36,034 that elects their practice would be successful 319 00:11:36,654 --> 00:11:38,735 in that endeavor. Well, it's it's a powerful 320 00:11:38,735 --> 00:11:39,955 statement. And I think 321 00:11:40,335 --> 00:11:42,495 for anyone that's listening to this, they probably 322 00:11:42,495 --> 00:11:45,794 have not just that trepidation, but this fundamental 323 00:11:45,934 --> 00:11:47,394 flawed belief that 324 00:11:47,829 --> 00:11:50,149 if they were to partner with private equity 325 00:11:50,149 --> 00:11:52,230 or a group like Sequel, that they lose 326 00:11:52,230 --> 00:11:53,829 all kinds of autonomy. Now we can talk 327 00:11:53,829 --> 00:11:56,230 about you're not gonna lose clinical autonomy because 328 00:11:56,230 --> 00:11:57,929 it's illegal in many situations. 329 00:11:58,470 --> 00:11:59,850 But this thought that 330 00:12:00,245 --> 00:12:02,404 everything is going to be outside of their 331 00:12:02,404 --> 00:12:04,825 control, and what I've heard you say just 332 00:12:05,365 --> 00:12:07,225 in the last four or five minutes is 333 00:12:07,365 --> 00:12:08,904 repeatedly the importance 334 00:12:09,845 --> 00:12:10,985 of cultural alignment, 335 00:12:11,445 --> 00:12:11,945 maintaining 336 00:12:12,565 --> 00:12:14,024 true autonomy with 337 00:12:14,360 --> 00:12:14,940 physician partners 338 00:12:15,480 --> 00:12:15,980 decision 339 00:12:16,679 --> 00:12:18,600 rights, not just with regard to the the 340 00:12:18,600 --> 00:12:21,019 clinical side of things, but but also operationally 341 00:12:21,879 --> 00:12:23,639 and the like. But that leads me to 342 00:12:23,639 --> 00:12:25,639 believe, how do we dispel some of the 343 00:12:25,639 --> 00:12:27,659 concerns that people have around 344 00:12:28,625 --> 00:12:30,085 finding that right partner, 345 00:12:30,625 --> 00:12:32,625 selecting the right partner? What I what I 346 00:12:32,625 --> 00:12:35,024 know having walked beside you through this process 347 00:12:35,024 --> 00:12:35,924 is there was, 348 00:12:36,625 --> 00:12:37,764 at every juncture, 349 00:12:38,865 --> 00:12:41,825 decision rights emanating from the physician partners about 350 00:12:41,825 --> 00:12:43,664 who they were going to partner with from 351 00:12:43,664 --> 00:12:44,839 a capital perspective, 352 00:12:45,220 --> 00:12:46,659 you know, on a going forward basis. Just 353 00:12:46,659 --> 00:12:48,740 like you alluded to when they hire someone 354 00:12:48,740 --> 00:12:50,339 in or the types of patients that they're 355 00:12:50,339 --> 00:12:53,220 talking taking on, but can you unpack that 356 00:12:53,220 --> 00:12:54,740 a little bit more? How are you able 357 00:12:54,740 --> 00:12:55,480 to find 358 00:12:56,019 --> 00:12:58,514 the right partner? Yeah. I think it's it's 359 00:12:58,674 --> 00:13:00,695 two things. It's designing it 360 00:13:01,075 --> 00:13:04,835 from the very beginning and not wavering. Mhmm. 361 00:13:04,835 --> 00:13:07,415 Right? Yep. So when I talk about design, 362 00:13:07,875 --> 00:13:10,115 we had a a very distinct point of 363 00:13:10,115 --> 00:13:12,960 view on what we were accomplishing in our 364 00:13:12,960 --> 00:13:14,960 own community and then what we wanted to 365 00:13:14,960 --> 00:13:17,779 ultimately accomplish in in additional communities. 366 00:13:18,240 --> 00:13:20,480 And so, therefore, we made sure that when 367 00:13:20,480 --> 00:13:22,259 we talked to any potential partner 368 00:13:22,639 --> 00:13:24,740 that they believed in the exact same thing. 369 00:13:24,875 --> 00:13:27,355 Frankly, the very first conversation that I had 370 00:13:27,355 --> 00:13:30,154 with Elliot Cooperstone, the founder of Intandem Capital, 371 00:13:30,154 --> 00:13:32,495 who we ultimately did a deal with, is 372 00:13:33,195 --> 00:13:34,575 he he asked me 373 00:13:35,034 --> 00:13:37,034 Jason, he asked me. He's like, Levi, how 374 00:13:37,034 --> 00:13:39,419 do you accomplish the triple aim? Now the 375 00:13:39,419 --> 00:13:42,059 quadruple aim or the quintuple aim, but how 376 00:13:42,059 --> 00:13:44,620 exactly are you accomplishing the triple aim? And 377 00:13:44,620 --> 00:13:46,299 we ask that question, that is something that 378 00:13:46,299 --> 00:13:47,360 we actually have 379 00:13:47,980 --> 00:13:50,459 on on our dashboards, on our KPIs. We 380 00:13:50,459 --> 00:13:52,379 are monitoring how we're accomplishing that goal. I 381 00:13:52,379 --> 00:13:54,524 could be lining up when he asked that 382 00:13:54,524 --> 00:13:56,764 question. Yeah. And so I I think that's 383 00:13:56,764 --> 00:13:57,264 when 384 00:13:57,644 --> 00:13:59,745 when we knew that what we had designed 385 00:13:59,804 --> 00:14:01,024 on the type of partner 386 00:14:01,404 --> 00:14:03,725 was was truly feasible. We eliminated a lot 387 00:14:03,725 --> 00:14:06,125 of partners, potential partners, because they didn't see 388 00:14:06,125 --> 00:14:07,690 it the exact same way. So I think 389 00:14:07,690 --> 00:14:10,169 it's designing that from the very beginning on 390 00:14:10,169 --> 00:14:12,250 on the type of individuals you want to 391 00:14:12,250 --> 00:14:14,409 partner with. And I think maybe for a 392 00:14:14,409 --> 00:14:17,209 lot of musculoskeletal groups, they've inherited a lot 393 00:14:17,209 --> 00:14:19,049 of partners, but maybe they won't design it 394 00:14:19,049 --> 00:14:21,209 from the beginning. We were so fortunate to 395 00:14:21,209 --> 00:14:23,904 get to design it and then select and 396 00:14:23,904 --> 00:14:26,384 then grow as a result. The other key 397 00:14:26,384 --> 00:14:28,964 part of design is even designing 398 00:14:29,264 --> 00:14:30,964 those control mechanisms. 399 00:14:32,065 --> 00:14:34,464 So we had before we did the transaction, 400 00:14:34,464 --> 00:14:36,399 we had heard a lot of, I would 401 00:14:36,399 --> 00:14:38,820 consider them now misnomers going through the transaction 402 00:14:38,879 --> 00:14:39,379 around, 403 00:14:40,480 --> 00:14:42,980 autonomy and control. And so we sat down 404 00:14:43,200 --> 00:14:45,600 as a group, and we defined exactly what 405 00:14:45,600 --> 00:14:46,100 decisions 406 00:14:46,879 --> 00:14:47,940 we make now 407 00:14:48,345 --> 00:14:50,345 and decisions that would need to be made 408 00:14:50,345 --> 00:14:52,745 if we had a different partner. We listed 409 00:14:52,745 --> 00:14:54,345 them out. I think it was, like, 50 410 00:14:54,345 --> 00:14:55,245 different decisions. 411 00:14:56,024 --> 00:14:58,664 And then we organized around how decisions should 412 00:14:58,664 --> 00:15:01,065 be made as we continue to grow, first 413 00:15:01,065 --> 00:15:01,804 and foremost. 414 00:15:02,519 --> 00:15:04,220 And and I think that's where people 415 00:15:04,600 --> 00:15:07,639 mostly get stuck is most of the evolution 416 00:15:07,639 --> 00:15:09,480 of of large groups is is really how 417 00:15:09,480 --> 00:15:11,639 do you make sure that everybody wins in 418 00:15:11,639 --> 00:15:13,100 larger and larger enterprises. 419 00:15:13,800 --> 00:15:15,560 And so we first started with what are 420 00:15:15,560 --> 00:15:17,654 the decisions we need to make and who 421 00:15:17,654 --> 00:15:20,235 makes those decisions as we grow, and then 422 00:15:20,615 --> 00:15:23,014 who makes those decisions if we have a 423 00:15:23,014 --> 00:15:23,995 a potential partner. 424 00:15:24,695 --> 00:15:27,174 And as a follow-up to the maybe the 425 00:15:27,174 --> 00:15:29,674 the second conversation that I had with Elliot, 426 00:15:30,200 --> 00:15:31,720 I asked him how he was gonna address 427 00:15:31,720 --> 00:15:33,339 that, and he sent me a document 428 00:15:33,639 --> 00:15:36,759 on how they thought about partnering with physician 429 00:15:36,759 --> 00:15:37,500 led organizations, 430 00:15:37,879 --> 00:15:39,659 physician practice management platforms, 431 00:15:39,960 --> 00:15:41,339 and our analysis, 432 00:15:41,720 --> 00:15:44,679 our decision making process, and their thoughts on 433 00:15:44,679 --> 00:15:45,580 decision making 434 00:15:46,125 --> 00:15:49,085 process mirrored almost entirely. Wow. And so that's 435 00:15:49,085 --> 00:15:50,445 when we knew we had the right partner. 436 00:15:50,445 --> 00:15:52,205 And that's what I just I really think 437 00:15:52,205 --> 00:15:54,764 this is all about is designing how you 438 00:15:54,764 --> 00:15:56,684 want to grow, designing on what you want 439 00:15:56,684 --> 00:15:59,264 to achieve, and then making sure any selection 440 00:15:59,644 --> 00:16:00,384 of a partner 441 00:16:01,019 --> 00:16:03,420 is is fully aligned with with what you 442 00:16:03,420 --> 00:16:04,240 have designed. 443 00:16:05,019 --> 00:16:07,100 Well, I know that any partner, be it 444 00:16:07,100 --> 00:16:09,180 a physician partner, your patients, which I know 445 00:16:09,180 --> 00:16:10,240 you treat as partners, 446 00:16:10,700 --> 00:16:12,240 or a capital partner, 447 00:16:12,700 --> 00:16:14,080 there's always this 448 00:16:14,779 --> 00:16:15,680 thought around 449 00:16:16,334 --> 00:16:19,694 growth. Right? And almost a dictatorial growth. Like, 450 00:16:19,694 --> 00:16:21,534 you have to achieve certain metrics and those 451 00:16:21,534 --> 00:16:22,975 types of things. I do know that you 452 00:16:22,975 --> 00:16:24,674 guys have been incredibly successful 453 00:16:25,454 --> 00:16:26,194 in growing, 454 00:16:27,214 --> 00:16:30,254 subsequent to consummating the transaction, but would love 455 00:16:30,254 --> 00:16:30,834 to get 456 00:16:31,209 --> 00:16:33,850 just some more insight into what have been 457 00:16:33,850 --> 00:16:35,149 those growth levers 458 00:16:35,850 --> 00:16:38,089 that you've pursued. And although I know it 459 00:16:38,089 --> 00:16:40,250 was very design centric, have there been any 460 00:16:40,250 --> 00:16:41,389 of those that have emanated 461 00:16:42,009 --> 00:16:44,835 from the partnership with Intandem that maybe were 462 00:16:45,075 --> 00:16:47,154 unanticipated. So maybe start with, okay, these are 463 00:16:47,154 --> 00:16:48,995 the things that you thought prescriptively were gonna 464 00:16:48,995 --> 00:16:49,815 come to fruition. 465 00:16:50,115 --> 00:16:52,134 And, wow, these are some of the unintended 466 00:16:52,274 --> 00:16:52,774 unintended 467 00:16:53,154 --> 00:16:55,975 consequences or benefits that emanated from the partnership. 468 00:16:57,169 --> 00:16:58,549 Yeah. I I think the 469 00:16:59,329 --> 00:17:02,389 the number one thing that has emanated from 470 00:17:02,850 --> 00:17:03,509 our partnership 471 00:17:04,849 --> 00:17:05,589 post transaction 472 00:17:06,049 --> 00:17:06,549 is 473 00:17:07,089 --> 00:17:08,549 really the thought of 474 00:17:09,105 --> 00:17:09,845 not fearful 475 00:17:10,625 --> 00:17:13,984 growth, but really responsible growth all centered around 476 00:17:13,984 --> 00:17:16,484 the idea of there's so much demand 477 00:17:16,865 --> 00:17:17,924 for our services. 478 00:17:18,384 --> 00:17:20,785 And it it's almost shame on us if 479 00:17:20,785 --> 00:17:23,799 we're not meeting that demand Yes. On on 480 00:17:23,799 --> 00:17:25,660 what it is demanded by the patients. 481 00:17:25,960 --> 00:17:28,200 Do we have the access points in the 482 00:17:28,200 --> 00:17:30,140 right locations? Do we have technology 483 00:17:30,759 --> 00:17:31,259 based, 484 00:17:31,880 --> 00:17:32,779 access points? 485 00:17:33,160 --> 00:17:36,255 Can we get essentially patients through our system 486 00:17:36,255 --> 00:17:39,875 from initial diagnosis, through imaging, through potentially OR 487 00:17:39,934 --> 00:17:41,875 into therapy, and even then 488 00:17:42,174 --> 00:17:44,015 we'll call it return to sport, which is, 489 00:17:44,255 --> 00:17:46,674 an acquisition we did post transaction. We 490 00:17:47,055 --> 00:17:49,170 bought a company that was really focused on 491 00:17:49,250 --> 00:17:51,730 what what happens after physical therapy. So it's 492 00:17:51,730 --> 00:17:53,910 just building out that that entire continuum 493 00:17:54,289 --> 00:17:55,910 and and meeting the demand. 494 00:17:56,609 --> 00:17:59,330 But I think, you know, the challenge with 495 00:17:59,330 --> 00:18:00,070 that is 496 00:18:01,090 --> 00:18:03,250 you typically in in a group practice, you 497 00:18:03,250 --> 00:18:05,025 have maybe one way of thinking about how 498 00:18:05,025 --> 00:18:07,664 you're accomplishing those goals. When you have people 499 00:18:07,664 --> 00:18:10,484 that have built and scaled businesses in 500 00:18:10,865 --> 00:18:12,484 similar or adjacent 501 00:18:12,865 --> 00:18:13,365 related 502 00:18:13,825 --> 00:18:16,225 specialties within health care or with in other 503 00:18:16,225 --> 00:18:17,605 health care domains, 504 00:18:18,269 --> 00:18:20,109 you start to think about things a little 505 00:18:20,109 --> 00:18:22,269 differently, and you start to measure things a 506 00:18:22,269 --> 00:18:23,009 little differently. 507 00:18:23,390 --> 00:18:25,309 And and you move it maybe a a 508 00:18:25,309 --> 00:18:27,789 pace that is all anchored around how do 509 00:18:27,789 --> 00:18:29,390 we meet the demand that the patients have. 510 00:18:29,390 --> 00:18:31,950 And so I think the gist is our 511 00:18:31,950 --> 00:18:32,769 our approach 512 00:18:34,105 --> 00:18:36,505 is is slightly tweaked more around how do 513 00:18:36,505 --> 00:18:38,664 we bring new thoughts to the table on 514 00:18:38,664 --> 00:18:39,484 how do we accomplish 515 00:18:39,785 --> 00:18:42,184 that goal that has not changed. And I 516 00:18:42,184 --> 00:18:43,964 think, again, that's somewhat of a 517 00:18:44,424 --> 00:18:45,240 a myth is 518 00:18:45,720 --> 00:18:48,119 is forced growth. That's not it at all. 519 00:18:48,119 --> 00:18:49,799 It's how do we meet the demand of 520 00:18:49,799 --> 00:18:50,380 the patients. 521 00:18:50,759 --> 00:18:52,920 And then what has been enhanced is let's 522 00:18:52,920 --> 00:18:55,640 think about meeting that demand a couple different 523 00:18:55,640 --> 00:18:57,579 ways that maybe we haven't because, 524 00:18:58,005 --> 00:19:00,105 you know, we've done it that way forever. 525 00:19:00,325 --> 00:19:01,924 And that's a challenge when you're trying to 526 00:19:01,924 --> 00:19:04,025 grow and you're trying to meet patient's expectations. 527 00:19:04,404 --> 00:19:05,865 Yeah. That makes a ton of sense. 528 00:19:06,164 --> 00:19:08,005 So you've you've given a a a great 529 00:19:08,005 --> 00:19:10,184 list, a comprehensive list of 530 00:19:11,130 --> 00:19:12,589 some really compelling 531 00:19:13,210 --> 00:19:14,269 organic growth 532 00:19:14,730 --> 00:19:16,269 pathways that you can pursue. 533 00:19:17,130 --> 00:19:19,869 Being an m and a quant geek junkie 534 00:19:19,930 --> 00:19:22,589 myself, I'm I'm always thinking about the acquisitive 535 00:19:22,730 --> 00:19:24,490 side of the business, and I know that 536 00:19:24,490 --> 00:19:26,565 was a a big part of the message 537 00:19:26,565 --> 00:19:28,884 that we that the capabilities that we knew 538 00:19:28,884 --> 00:19:30,744 you and your team could deliver 539 00:19:31,204 --> 00:19:32,884 to the marketplace. But can you unpack a 540 00:19:32,884 --> 00:19:34,884 little bit how how that side of the 541 00:19:34,884 --> 00:19:36,724 process is going? What do you see going 542 00:19:36,724 --> 00:19:38,884 on in the market? How receptive have people 543 00:19:38,884 --> 00:19:41,190 been? Are you been able to generate things 544 00:19:41,190 --> 00:19:43,589 on a proprietary basis? Just unpack some of 545 00:19:43,589 --> 00:19:45,690 the potential acquisitive or inorganic, 546 00:19:46,150 --> 00:19:47,670 pathways that exist to you guys from a 547 00:19:47,670 --> 00:19:48,410 growth perspective. 548 00:19:48,950 --> 00:19:50,950 Yeah. I I think it just goes back 549 00:19:50,950 --> 00:19:53,974 to what we talked about briefly earlier 550 00:19:55,474 --> 00:19:58,515 is as we've developed this system thinking and 551 00:19:58,515 --> 00:20:00,694 we've been doing it for ten years, 552 00:20:01,315 --> 00:20:04,115 our singular hope is that we can help 553 00:20:04,115 --> 00:20:06,515 others do that in their own markets, how 554 00:20:06,515 --> 00:20:08,990 they can take care of more patients, do 555 00:20:08,990 --> 00:20:11,309 it slightly better to have the capital in 556 00:20:11,309 --> 00:20:12,609 order to grow and 557 00:20:13,069 --> 00:20:13,890 and essentially 558 00:20:14,269 --> 00:20:15,890 invest in their wish list. 559 00:20:16,349 --> 00:20:19,630 And so we have been very selective on 560 00:20:19,630 --> 00:20:22,429 who really sees the opportunity around growing their 561 00:20:22,429 --> 00:20:23,409 individual practices, 562 00:20:23,845 --> 00:20:26,585 really thinking about it comprehensively across the continuum, 563 00:20:26,805 --> 00:20:29,684 operating and managing across the continuum. So we've 564 00:20:29,684 --> 00:20:31,065 been very selective because, 565 00:20:31,445 --> 00:20:33,525 you know, ultimately, what what this is all 566 00:20:33,525 --> 00:20:35,785 about is alignment. And if we're not aligned 567 00:20:35,845 --> 00:20:38,289 in how we think about delivering musculoskeletal 568 00:20:38,590 --> 00:20:40,769 care or orthopedic care, you know, partnerships 569 00:20:41,470 --> 00:20:43,309 won't work. And so we're gonna be selective 570 00:20:43,309 --> 00:20:43,809 first, 571 00:20:44,269 --> 00:20:46,910 but we do have what we consider our 572 00:20:46,910 --> 00:20:49,549 our comprehensive playbooks. So all of those things 573 00:20:49,549 --> 00:20:50,849 that we've learned around 574 00:20:51,355 --> 00:20:53,355 building this in Omaha over the past ten 575 00:20:53,355 --> 00:20:55,355 years, we have codified that. We've put it 576 00:20:55,355 --> 00:20:56,174 on paper. 577 00:20:56,554 --> 00:20:59,115 And it's really exciting, frankly, to share that 578 00:20:59,115 --> 00:21:00,634 with other groups to say, this is what 579 00:21:00,634 --> 00:21:02,974 we did. Here's how we think this applies 580 00:21:03,115 --> 00:21:06,174 potentially in in your geography, for your community. 581 00:21:06,769 --> 00:21:09,089 That's really exciting, but the best part that 582 00:21:09,089 --> 00:21:10,849 really gets me excited is is the fact 583 00:21:10,849 --> 00:21:13,109 that there's also a whole host of things 584 00:21:13,569 --> 00:21:15,409 that we don't know, that we could learn 585 00:21:15,409 --> 00:21:18,069 from other groups. And when you start sharing 586 00:21:18,369 --> 00:21:21,809 those ideas, those best practices across multiple different 587 00:21:21,809 --> 00:21:22,309 markets, 588 00:21:22,744 --> 00:21:25,305 that is the enhancement. And then when you're 589 00:21:25,305 --> 00:21:26,765 sharing the rewards 590 00:21:27,305 --> 00:21:30,025 through a holding company and everybody's invested in 591 00:21:30,025 --> 00:21:33,545 that holding company, everybody wins. Everybody wins in 592 00:21:33,545 --> 00:21:36,265 this model when you share those those things 593 00:21:36,265 --> 00:21:38,470 that are might be unique by community, might 594 00:21:38,470 --> 00:21:40,710 be unique by market, might be unique because 595 00:21:40,710 --> 00:21:41,450 of experiences. 596 00:21:41,910 --> 00:21:44,309 When you start sharing those things and everybody 597 00:21:44,309 --> 00:21:45,929 is winning and everybody is rewarded, 598 00:21:46,390 --> 00:21:48,710 that is pretty amazing. But it's gonna be 599 00:21:48,710 --> 00:21:50,414 selective. We are gonna make sure that, you 600 00:21:50,494 --> 00:21:52,494 know, we're gonna partner with the groups that 601 00:21:52,494 --> 00:21:54,734 that see delivering Musculoskeletal Care the way we 602 00:21:54,734 --> 00:21:56,494 do. I love that. It makes a ton 603 00:21:56,494 --> 00:21:57,075 of sense. 604 00:21:57,455 --> 00:21:59,134 It may take a minute just to throw 605 00:21:59,134 --> 00:22:00,275 you a quick curve ball. 606 00:22:00,575 --> 00:22:03,234 And and ingratiation aside, I know the caliber 607 00:22:03,375 --> 00:22:05,154 of leader you are. I know 608 00:22:05,559 --> 00:22:07,660 how difficult it is to manage 609 00:22:08,759 --> 00:22:11,480 a group of orthopedic surgeons that that pride 610 00:22:11,480 --> 00:22:14,140 themselves on their independent thought process. 611 00:22:14,680 --> 00:22:16,200 I think you'd once told me it's almost 612 00:22:16,200 --> 00:22:18,220 like not just herding cats, herding crickets, 613 00:22:18,704 --> 00:22:20,484 but you are great at galvanizing 614 00:22:21,345 --> 00:22:22,085 all of 615 00:22:22,704 --> 00:22:26,164 these independent thought leaders, these type a personalities 616 00:22:26,625 --> 00:22:27,684 into a unified 617 00:22:28,144 --> 00:22:28,644 vision. 618 00:22:29,265 --> 00:22:31,319 What I've haven't unpacked with you yet is 619 00:22:31,799 --> 00:22:34,519 if we had one of your physician partners 620 00:22:34,519 --> 00:22:37,099 sitting here at answering some of these questions, 621 00:22:37,639 --> 00:22:40,059 how similar or disparate might their answers 622 00:22:40,440 --> 00:22:41,579 be? Are are they 623 00:22:41,960 --> 00:22:42,940 are they as enthusiastic 624 00:22:43,639 --> 00:22:45,339 two years into this process 625 00:22:46,075 --> 00:22:48,394 as you? Maybe more, maybe less. We just 626 00:22:48,394 --> 00:22:50,555 love to get your assessment on that. What 627 00:22:50,555 --> 00:22:51,375 I sincerely 628 00:22:51,674 --> 00:22:52,654 feel is 629 00:22:53,115 --> 00:22:55,455 how many CEOs of health care companies 630 00:22:55,994 --> 00:22:58,910 would love to have the type of engagement 631 00:22:58,970 --> 00:23:02,029 that we have in a physician owned musculoskeletal 632 00:23:02,570 --> 00:23:03,070 company. 633 00:23:03,529 --> 00:23:06,910 They are providers of care. They are incredibly 634 00:23:06,970 --> 00:23:08,029 important, almost 635 00:23:08,490 --> 00:23:11,369 customers within the OR, within the hospital, within 636 00:23:11,369 --> 00:23:13,944 the surgery center. They are right next to 637 00:23:13,944 --> 00:23:15,724 our team when they're delivering care. 638 00:23:16,184 --> 00:23:19,544 That insight that they have and and their 639 00:23:19,544 --> 00:23:21,865 aspirations of how to make it better, I 640 00:23:21,865 --> 00:23:24,265 mean, I feel like I'm incredibly lucky. And 641 00:23:24,265 --> 00:23:24,765 so, 642 00:23:25,269 --> 00:23:27,190 essentially, the the summation of all of these 643 00:23:27,190 --> 00:23:29,829 ideas is working side by side with our 644 00:23:29,829 --> 00:23:30,329 physicians 645 00:23:30,630 --> 00:23:33,609 to articulate this physician, to craft this vision, 646 00:23:34,069 --> 00:23:36,730 to design what we were trying to accomplish. 647 00:23:37,029 --> 00:23:39,190 It is truly a team effort, and I 648 00:23:39,190 --> 00:23:41,724 feel like I'm incredibly lucky. I think most 649 00:23:41,724 --> 00:23:44,845 organizations don't necessarily get that type of engagement 650 00:23:44,845 --> 00:23:46,605 in people they work with or that they 651 00:23:46,605 --> 00:23:49,164 serve, and we have it inherently built into 652 00:23:49,164 --> 00:23:50,684 our model. And so I just look at 653 00:23:50,684 --> 00:23:53,244 it as I'm incredibly fortunate, and I'm pretty 654 00:23:53,244 --> 00:23:53,744 confident 655 00:23:54,269 --> 00:23:56,590 that they would say the exact same things 656 00:23:56,590 --> 00:23:58,349 that that I'm saying. They couldn't be more 657 00:23:58,349 --> 00:24:00,190 excited about what we're trying to build. They 658 00:24:00,190 --> 00:24:02,769 couldn't be be more excited about our future. 659 00:24:02,990 --> 00:24:05,330 They love telling our story. They love, 660 00:24:05,869 --> 00:24:09,070 recruiting physicians into our model. I think that 661 00:24:09,070 --> 00:24:11,365 is the reason why we've been successful in 662 00:24:11,365 --> 00:24:12,505 recruiting post transaction 663 00:24:12,884 --> 00:24:14,644 is because they were so excited about it. 664 00:24:14,644 --> 00:24:16,805 I don't think that there is an ounce 665 00:24:16,805 --> 00:24:18,884 of of difference in in the way we 666 00:24:18,884 --> 00:24:20,724 think about what we're trying to build. Yeah. 667 00:24:20,724 --> 00:24:22,164 And I I know that to be true. 668 00:24:22,164 --> 00:24:24,470 I just wanted the the listeners to also 669 00:24:24,470 --> 00:24:26,869 hear that directly, and just how earnestly and 670 00:24:26,869 --> 00:24:29,109 genuinely you guys have worked to kind of 671 00:24:29,109 --> 00:24:32,069 achieve that. So, you know, last question. And 672 00:24:32,069 --> 00:24:33,929 I think everyone's keenly interested 673 00:24:35,190 --> 00:24:37,289 in what's the next next? What is 674 00:24:37,765 --> 00:24:39,845 your vision three years from now, five years 675 00:24:39,845 --> 00:24:41,224 from now? Where do you see 676 00:24:41,525 --> 00:24:43,384 SQL Ortho at that juncture? 677 00:24:44,325 --> 00:24:46,345 Yeah. I I I think that 678 00:24:46,724 --> 00:24:48,964 it gets very simple. There there's a whole 679 00:24:48,964 --> 00:24:50,404 lot of things that we can control, and 680 00:24:50,404 --> 00:24:51,924 there's a whole lot of things that we 681 00:24:51,924 --> 00:24:52,664 can't control. 682 00:24:53,039 --> 00:24:55,380 The thing that we can control is building 683 00:24:56,080 --> 00:24:58,019 a really great 684 00:24:58,480 --> 00:24:58,980 operation, 685 00:24:59,680 --> 00:25:01,759 a really great way to take care of 686 00:25:01,759 --> 00:25:02,259 orthopedic 687 00:25:02,640 --> 00:25:03,140 patients. 688 00:25:03,680 --> 00:25:05,140 If if we do that, 689 00:25:05,744 --> 00:25:06,244 then 690 00:25:06,704 --> 00:25:08,464 simply the sky's the limit. We don't we 691 00:25:08,464 --> 00:25:11,505 don't necessarily have to nail exactly what the 692 00:25:11,505 --> 00:25:13,765 five year plan looks like. We just continuously 693 00:25:14,065 --> 00:25:14,565 pursue, 694 00:25:15,664 --> 00:25:17,684 perfecting how we take care of patients, 695 00:25:18,039 --> 00:25:20,039 and and things will occur. And when it 696 00:25:20,039 --> 00:25:22,599 comes down to, frankly, the the the private 697 00:25:22,599 --> 00:25:24,839 equity model and and the growth that comes 698 00:25:24,839 --> 00:25:26,599 along with it, what we think is if 699 00:25:26,599 --> 00:25:28,220 we nail that operation, 700 00:25:28,599 --> 00:25:31,164 if if our patients have an incredible experience, 701 00:25:31,224 --> 00:25:33,224 if they have better outcomes than any of 702 00:25:33,224 --> 00:25:33,884 our competitors, 703 00:25:34,345 --> 00:25:36,585 if our team is totally aligned with what 704 00:25:36,585 --> 00:25:37,804 we're trying to accomplish, 705 00:25:38,265 --> 00:25:40,265 that there's gonna be a whole lot of 706 00:25:40,265 --> 00:25:41,865 people that would want to invest in a 707 00:25:41,865 --> 00:25:44,184 business that that accomplishes those types of goals. 708 00:25:44,184 --> 00:25:46,369 And so what we're doing is we're just 709 00:25:46,369 --> 00:25:48,690 heads down trying to figure out how we 710 00:25:48,690 --> 00:25:50,690 we take what we've learned and do that 711 00:25:50,690 --> 00:25:51,829 in additional communities, 712 00:25:52,450 --> 00:25:54,690 help other surgeons and other physicians do the 713 00:25:54,690 --> 00:25:57,349 exact same type of things, learn from them, 714 00:25:57,569 --> 00:25:59,730 and and we think that the future is 715 00:25:59,730 --> 00:26:00,789 incredibly bright. 716 00:26:01,595 --> 00:26:03,455 Fantastic. Well, thank you again for 717 00:26:03,835 --> 00:26:05,755 not just your time and insights, but but 718 00:26:05,755 --> 00:26:07,615 for your friendship. I know this has been 719 00:26:07,755 --> 00:26:10,075 a a wonderful dynamic from my vantage point, 720 00:26:10,075 --> 00:26:11,755 and I appreciate you continue to let me 721 00:26:11,755 --> 00:26:13,115 be a part of the journey. So thanks 722 00:26:13,115 --> 00:26:14,494 so much, Levi. Thanks, Jason. 723 00:26:14,809 --> 00:26:16,809 Thank you, Jason and Levi, for an excellent 724 00:26:16,809 --> 00:26:17,309 conversation. 725 00:26:17,769 --> 00:26:20,589 We also wanna thank our podcast sponsor, Quadriga 726 00:26:20,730 --> 00:26:22,970 Partners. You can tune in to more podcasts 727 00:26:22,970 --> 00:26:25,630 from Becker's Healthcare by visiting our podcast page 728 00:26:25,769 --> 00:26:27,883 at beckerspodcast.com.