This is Randy Homan with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Lawrence Epstein.
He's the CEO at Pediatric Urology Associates, PC Lawrence,
would you please introduce yourself and tell us a little bit about your
background?
Well, I go by Larry.
I've been in ambulatory physician practice management
as I've been told to reference it these days for the last 32 years.
Uh, my current role is as a CEO of a subspecialty pediatric practice,
which is a dinosaur in the field and we'll get into that more detail, uh,
as being independent for the last three and a half years in the tri-state
New York area with a specific emphasis in urology.
Perfect. Thank you. What are your top priorities today?
Well, today our,
our real top priorities are building back are base provider
group. Uh,
we've lost a couple of providers recently due to a variety of functions,
some of them pre pandemic changes into practice as well as post
pandemic, uh, stress on the group. Uh,
and that that's not just physicians but uh,
nurse practitioners and PAs who are independent providers under our specialty.
Uh, as well as just trying to manage our cash flow,
uh, to meet the needs of a growing cost base and a growing,
uh, employee request base for more money on a day to day basis for the obvious
reasons of heightened inflation and heightened cost pressures.
Mm-hmm. , definitely. How are you trying to do that?
Uh, variety of ways. Uh,
we're going back for the nurse practitioners and looking at not keeping them
as uh, base salaried or hour lead employees,
but uh,
putting them on some type of productivity arrangement which that we had gotten
off of, uh, pre pandemic due to really equal,
uh, allocation of, uh, time and scheduling.
But the pandemic has really thrown out for a loop. Uh,
and we have a lot more part-timers who are not working the same level and some
of the more senior people are working full-time are causing some concern that
they're just not getting fair share of their, their dollars worked,
uh, for the physicians, um,
we are looking at a lot of capital infusion alternatives from either health
systems or private equity or venture capital. Depending on, uh,
different opportunities that are placed on my desk on a day to day basis or
things that we search out, uh, we are looking to, uh,
build some other product lines or ancillary service lines in non-contiguous
states that don't compete with us in the tri-state area. Uh,
we can go into that a little further in a little bit. And uh,
we're just looking at trying to cut our cost base, uh,
our base fundamentals in rent and supply costs and whatever we can do to manage
our expenses as best we can.
Mm-hmm. great goals, I would say.
How do you anticipate your role and teams will evolve over the next 18 months?
Uh,
my role is probably gonna change depending on our merger partner or or practice
partner. Uh, to be honest with you, uh,
if we do merge into a health system and I've gone through these MNAs and over
the past 10 to 12 years and, uh,
those relationships change dramatically depending on the need of the,
and the value structure of that health system.
But we're also trying to find ways to strengthen our human
resources so they're not stretched as far as they would be cuz we've
probably thinned down our administrative infrastructure a lot since the pandemic
and we're using a lot of technological toolkits to help improve
data gathering, uh, revenue recovery, et cetera.
Mm-hmm. . And then our last question,
what are you most excited about right now and what makes you nervous?
What I'm excited about is that there still seems to be a growing need
for our services. Uh, even within heightened competition in our market.
We're probably in the most, uh,
aggressive market in the country in terms of medical services.
And what makes me fearful is the same thing because of that heightened
competition in our market, uh, we have, uh,
had to react to just to keep up with technology
and other facets of,
of investment that some parts of the country have had not to do as much
cuz they don't have the same level of competition.
Definitely.
And do you wanna say a little bit about where pediatric associates are so that
people understand why this competition is so fierce?
Okay. So we are in tri-state, New York, Metro New York area,
so we are surrounded by pretty much every academic medical center from
Philadelphia up through, uh, Hartford, Connecticut, and pediatric urology.
While there's only approximately 800 practicing pediatric urologists in the
United States, about 20% of 'em practic in this area.
So that,
and the population doesn't account for having enough base of disease
to help feed your, uh, doctors and especially in high end surgical cases.
But at the same time, uh,
the incidents of some other services have have grown and the needs have grown.
Uh, so we're just trying to keep pace with those academic medical centers, uh,
so they don't even tear away at our,
our patient base and or invade our patient base to a point where we
have to move our service to this to another location or another area.
Mm-hmm. , definitely. Well, Larry,
it was a pleasure speaking with you today and I look forward to connecting with
you again soon.
Been a pleasure. Thanks again. Be well.