<![CDATA[Scaling Specialty Growth]]>aa570c88-dfca-5a47-89dd-062c49c0b772Tue, 06 Oct 2026 07:00:27 +0000Captivate.fmHatchhttps://artwork.captivate.fm/b3e7b7ab-06c1-4408-8898-24cc610d415f/Scaling-Specialty-Growth-Logo-100.jpgScaling Specialty GrowthHatchHatchIn specialty healthcare, growth is not optional. The challenge is growing while maintaining operational excellence and a world-class experience for your staff, partners,and most importantly, your patients. Scaling Specialty Growth is the podcast for leaders responsible for turning their organization’s growth goals into an operational reality. Each week, hosts Chris Poole and Joe Zboch go deep with a guest who’s doing the work. You’ll get an inside look at the strategy and nuance behind the systems they’ve built to scale sustainable growth. If you're looking for real stories from leaders in competitive specialty markets, this show is for you.https://scaling-specialty-growth.captivate.fmfalseepisodicnopodcastGrowth comes from the people, not the numbers | Sandy Fragale, CEO, OSMS | Ep. 26Growth comes from the people, not the numbers | Sandy Fragale, CEO, OSMS | Ep. 26Most specialty practices can tell you how their growth shows up in the numbers. Fewer can tell you what holds the organization together while it grows.

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Joe Zboch sits down with Sandy Fragale, CEO of Orthopedic and Sports Medicine Specialists (OSMS). OSMS is an independent practice serving Northeast Wisconsin with nine locations. It has grown from five physicians to 40, and much of that growth came in the last five years.

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Sandy is a CPA who used to lead with numbers. Now she leads with people. She walks through the merger that became her practice's turning point and how OSMS sends its culture into every new location. She also explains why a two-question pulse survey is her early warning signal for operations.

ㅤ

If you're looking to scale referral operations, visit Hatch.

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👤 Guest Bio

Sandy Fragale is the CEO of Orthopedic and Sports Medicine Specialists (OSMS). It's a physician-owned orthopedics, sports medicine, rheumatology and pain management practice based in Green Bay, Wisconsin. A CPA by background, she started her career at KPMG and joined OSMS in 2001. The Greater Green Bay Chamber named her its 2024 Business Person of the Year, and she is a 2026 Wisconsin Titan 100 honoree. She also serves on the board of OrthoForum Value Network.

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📌 What We Cover

  • Why Sandy stopped believing the numbers drive growth, and what drives it instead
  • The "no special flowers" rule every OSMS physician knows
  • How two merged practices were doing okay financially but constantly fighting, and how that became the turning point
  • Building four core values with every shareholder, physician and employee in one room, and why OSMS added Be Invested
  • Staffing the Oshkosh, Fox Valley and Marinette locations with physicians and staff who already know the culture
  • Why a receptionist can matter as much as a physician shareholder when patients spend less than 20% of their time with a physician
  • How adding a chief operating officer gave growth a counterweight
  • The two-question pulse survey that signals when operations need attention

ㅤ

🔗 Resources Mentioned


]]>Most specialty practices can tell you how their growth shows up in the numbers. Fewer can tell you what holds the organization together while it grows.

ㅤ

Joe Zboch sits down with Sandy Fragale, CEO of Orthopedic and Sports Medicine Specialists (OSMS). OSMS is an independent practice serving Northeast Wisconsin with nine locations. It has grown from five physicians to 40, and much of that growth came in the last five years.

ㅤ

Sandy is a CPA who used to lead with numbers. Now she leads with people. She walks through the merger that became her practice's turning point and how OSMS sends its culture into every new location. She also explains why a two-question pulse survey is her early warning signal for operations.

ㅤ

If you're looking to scale referral operations, visit Hatch.

ㅤ

👤 Guest Bio

Sandy Fragale is the CEO of Orthopedic and Sports Medicine Specialists (OSMS). It's a physician-owned orthopedics, sports medicine, rheumatology and pain management practice based in Green Bay, Wisconsin. A CPA by background, she started her career at KPMG and joined OSMS in 2001. The Greater Green Bay Chamber named her its 2024 Business Person of the Year, and she is a 2026 Wisconsin Titan 100 honoree. She also serves on the board of OrthoForum Value Network.

ㅤ

📌 What We Cover

  • Why Sandy stopped believing the numbers drive growth, and what drives it instead
  • The "no special flowers" rule every OSMS physician knows
  • How two merged practices were doing okay financially but constantly fighting, and how that became the turning point
  • Building four core values with every shareholder, physician and employee in one room, and why OSMS added Be Invested
  • Staffing the Oshkosh, Fox Valley and Marinette locations with physicians and staff who already know the culture
  • Why a receptionist can matter as much as a physician shareholder when patients spend less than 20% of their time with a physician
  • How adding a chief operating officer gave growth a counterweight
  • The two-question pulse survey that signals when operations need attention

ㅤ

🔗 Resources Mentioned


]]>3ed3061d-4584-4df2-9bb6-70cc025e55f9Tue, 06 Oct 2026 03:00:00 -040019:33falsefull2626Why 500 new leads didn't become new patients | Daniel Goldberg, SVP of Marketing and Growth, United Musculoskeletal Partners | Ep. 25Why 500 new leads didn't become new patients | Daniel Goldberg, SVP of Marketing and Growth, United Musculoskeletal Partners | Ep. 25A practice runs better campaigns, the form submissions climb, and the new patient numbers barely move. Daniel Goldberg has watched that happen enough times to know the problem usually sits behind the front desk, not in the ad account. He joins Joe Zboch on Scaling Specialty Growth to talk about what he asks before he spends a dollar at United Musculoskeletal Partners.

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Daniel makes the case that marketing and operations should have a symbiotic relationship instead of a siloed one, and he backs it with the metrics his team actually watches: time to contact and capture rate. He also walks through what changed in the referral market as primary care independence dropped, why a four-day triage delay costs a practice more than one patient, and how UMP built the scheduling templates that let them promise a 24 to 48 hour appointment and keep it.

ㅤㅤ

👤 Guest Bio

Daniel Goldberg is Senior Vice President of Marketing and Growth at United Musculoskeletal Partners, the physician-owned musculoskeletal management services organization behind orthopedic and spine practices in Georgia, Texas, and Colorado. He has spent 15 years in MSK practice marketing, including four years as SVP of Marketing and Communications at HOPCo and a decade running his own firm working exclusively with orthopedic, spine, and neurosurgery practices.

ㅤ

📌 What We Cover

  • Why 500 new leads didn't translate to new volume when the practice still had two people in the call center and one person at the front desk
  • The first question Daniel asked operations at UMP: if the phone rings twice as much, do we have enough people to answer it
  • Time to contact and capture rate as the two numbers that expose leakage, using the example of 1,000 referrals and 450 captures
  • The downstream cost of slow triage, where the patient calls their PCP asking why the orthopedic doctor hasn't called, and the PCP sends the next referral somewhere easier
  • How primary care independence went from more than 50% to roughly 25%, and what that means when the other 75% are aligned with health systems, payers, or MSOs
  • Why an unaffiliated practice won't appear in a health system's referral dropdown, and why manual routing is a path most coordinators won't take
  • Employer carve-outs and site of service: how shared savings arrangements change which facility a referral can go to
  • Georgia's workers' comp panel structure, and what keeps a practice on the panel after they get on it
  • Building provider templates and new patient slots first so the 24 to 48 hour promise survives contact with the schedule
  • Daniel's advice to a practice marketing leader: size your real capacity, then find where the demand lives, then spend

ㅤ

🔗 Resources Mentioned


]]>A practice runs better campaigns, the form submissions climb, and the new patient numbers barely move. Daniel Goldberg has watched that happen enough times to know the problem usually sits behind the front desk, not in the ad account. He joins Joe Zboch on Scaling Specialty Growth to talk about what he asks before he spends a dollar at United Musculoskeletal Partners.

ㅤ

Daniel makes the case that marketing and operations should have a symbiotic relationship instead of a siloed one, and he backs it with the metrics his team actually watches: time to contact and capture rate. He also walks through what changed in the referral market as primary care independence dropped, why a four-day triage delay costs a practice more than one patient, and how UMP built the scheduling templates that let them promise a 24 to 48 hour appointment and keep it.

ㅤㅤ

👤 Guest Bio

Daniel Goldberg is Senior Vice President of Marketing and Growth at United Musculoskeletal Partners, the physician-owned musculoskeletal management services organization behind orthopedic and spine practices in Georgia, Texas, and Colorado. He has spent 15 years in MSK practice marketing, including four years as SVP of Marketing and Communications at HOPCo and a decade running his own firm working exclusively with orthopedic, spine, and neurosurgery practices.

ㅤ

📌 What We Cover

  • Why 500 new leads didn't translate to new volume when the practice still had two people in the call center and one person at the front desk
  • The first question Daniel asked operations at UMP: if the phone rings twice as much, do we have enough people to answer it
  • Time to contact and capture rate as the two numbers that expose leakage, using the example of 1,000 referrals and 450 captures
  • The downstream cost of slow triage, where the patient calls their PCP asking why the orthopedic doctor hasn't called, and the PCP sends the next referral somewhere easier
  • How primary care independence went from more than 50% to roughly 25%, and what that means when the other 75% are aligned with health systems, payers, or MSOs
  • Why an unaffiliated practice won't appear in a health system's referral dropdown, and why manual routing is a path most coordinators won't take
  • Employer carve-outs and site of service: how shared savings arrangements change which facility a referral can go to
  • Georgia's workers' comp panel structure, and what keeps a practice on the panel after they get on it
  • Building provider templates and new patient slots first so the 24 to 48 hour promise survives contact with the schedule
  • Daniel's advice to a practice marketing leader: size your real capacity, then find where the demand lives, then spend

ㅤ

🔗 Resources Mentioned


]]>9573f424-de53-4300-8017-5801c4e951afTue, 29 Sep 2026 03:00:00 -040018:49falsefull2525Growing revenue when you can't add providers | Holleigh Seales, Practice Administrator, Rheumatology Associates | Ep. 24Growing revenue when you can't add providers | Holleigh Seales, Practice Administrator, Rheumatology Associates | Ep. 24Most growth advice assumes you can add providers. Holleigh Seales can't. Rheumatology Associates in Birmingham runs seven physicians and nine providers total, the physician owners settled on that number deliberately, and the building has limited space and limited people to run new operations.

ㅤ

So revenue has to come from inside the footprint. This episode walks through how that actually happens: wellness infusions as a cash option for immunocompromised patients, GLP-1s through a local compounding pharmacy, an in-house dispensary that took four years of vetting before the timing was right, and a concierge model she's still building consensus around.

ㅤ

Joe Zboch of Hatch talks with Holleigh Seales about the pilot method behind all of it, why she runs every new service line herself before handing it to staff, and what a four-day workweek has done for a practice where people have stayed 10 to 20 years.

ㅤ

👤 Guest Bio

Holleigh Seales is the practice administrator at Rheumatology Associates in Birmingham, Alabama, where she has spent eight years, the last four running the practice. All 60 staff report directly to her. Before Rheumatology Associates she spent a decade at PainSouth as practice manager, coming up through marketing and referral management. She also serves on the board of directors of Bundles of Hope Diaper Bank.

ㅤ

📌 What We Cover

  • Why a medium-sized rheumatology practice with no CEO or CFO puts every operational decision on one desk, and what that does to how you prioritize
  • The four-day workweek: how it started with physician-owned admin Fridays and why employees driving an hour to an hour and a half each way made the math obvious
  • Piloting a new service with one to three providers first, selected by interest, comfort with technology, and how they manage change
  • Four to five years of vetting in-office dispensing alongside other Birmingham rheumatology practices before pulling the trigger
  • How Medicare's Part D maximum out-of-pocket change made it possible to take back ownership of treating Advantage patients in-house
  • Reading referral patterns for gaps: inflammatory patients get prioritized, while a large osteoporosis population comes in behind them
  • Wellness infusions and GLP-1s as cash services in a specialty where biologics are expensive and reimbursement keeps declining
  • The annual patient letter with her direct contact information, and why patients reveal what you need next
  • Running the concierge pilot on her own shoulders so no one inherits a bottleneck she hasn't found yet

ㅤ

🔗 Resources Mentioned


]]>Most growth advice assumes you can add providers. Holleigh Seales can't. Rheumatology Associates in Birmingham runs seven physicians and nine providers total, the physician owners settled on that number deliberately, and the building has limited space and limited people to run new operations.

ㅤ

So revenue has to come from inside the footprint. This episode walks through how that actually happens: wellness infusions as a cash option for immunocompromised patients, GLP-1s through a local compounding pharmacy, an in-house dispensary that took four years of vetting before the timing was right, and a concierge model she's still building consensus around.

ㅤ

Joe Zboch of Hatch talks with Holleigh Seales about the pilot method behind all of it, why she runs every new service line herself before handing it to staff, and what a four-day workweek has done for a practice where people have stayed 10 to 20 years.

ㅤ

👤 Guest Bio

Holleigh Seales is the practice administrator at Rheumatology Associates in Birmingham, Alabama, where she has spent eight years, the last four running the practice. All 60 staff report directly to her. Before Rheumatology Associates she spent a decade at PainSouth as practice manager, coming up through marketing and referral management. She also serves on the board of directors of Bundles of Hope Diaper Bank.

ㅤ

📌 What We Cover

  • Why a medium-sized rheumatology practice with no CEO or CFO puts every operational decision on one desk, and what that does to how you prioritize
  • The four-day workweek: how it started with physician-owned admin Fridays and why employees driving an hour to an hour and a half each way made the math obvious
  • Piloting a new service with one to three providers first, selected by interest, comfort with technology, and how they manage change
  • Four to five years of vetting in-office dispensing alongside other Birmingham rheumatology practices before pulling the trigger
  • How Medicare's Part D maximum out-of-pocket change made it possible to take back ownership of treating Advantage patients in-house
  • Reading referral patterns for gaps: inflammatory patients get prioritized, while a large osteoporosis population comes in behind them
  • Wellness infusions and GLP-1s as cash services in a specialty where biologics are expensive and reimbursement keeps declining
  • The annual patient letter with her direct contact information, and why patients reveal what you need next
  • Running the concierge pilot on her own shoulders so no one inherits a bottleneck she hasn't found yet

ㅤ

🔗 Resources Mentioned


]]>6044f4f9-ca9a-45ce-8f18-b51a1eb781e4Tue, 22 Sep 2026 03:00:00 -040021:35falsefull2424Why bigger is better, especially for independents | Alejandro Fernandez, CEO, Synergy Orthopedics | Ep. 23Why bigger is better, especially for independents | Alejandro Fernandez, CEO, Synergy Orthopedics | Ep. 23Growth is not optional for an independent orthopedic group. Growth without the operations underneath it turns into a backlog nobody can work through. Joe Zboch talks with Alejandro Fernandez, CEO of Synergy Orthopedics, about why access is a strategy and operations problem first, with technology in service of that.

ㅤ

Alex runs the largest private orthopedic group in San Diego: over 50 providers across 15 locations, plus physical therapy sites, an MRI center, and an ASC. They get into payer contracts as the real ceiling on access, why open scheduling became a basic expectation instead of an advantage, what makes workers' comp both attractive and unforgiving, and how falling MRI reimbursement pushed the group toward AI-assisted imaging for throughput. Alex also explains why a practice playbook is out the window six months after you build it, and where he expects AI to change the work first.

ㅤ

👤 Guest Bio

Alejandro Fernandez is CEO of Synergy Orthopedic Specialists in San Diego, the largest independent orthopedic group in the region, with more than 50 providers across 15 locations plus physical therapy, imaging, and an ambulatory surgery center. He has spent 30 years running multi-site physician practices across dermatology, GI, and orthopedics, including CEO roles at Gastro Health in Miami and NavaDerm Partners in New York. The American Alliance of Orthopaedic Executives named him Practice Executive of the Year in 2024.

ㅤ

📌 What We Cover

  • Why access starts with payer contracts and credentialing rather than marketing or a booking page
  • How a bigger group moves business from the higher cost of care into the lowest cost of care, and why payers reward it
  • Why very few programs pay for quality and almost all of them still pay for volume
  • What open scheduling looks like when it works: filling tomorrow's 10:00 AM no-show by texting the people already waiting
  • How to give a health system a reason to partner with you when PCPs are getting acquired
  • Why the sports teams run through workers' comp, and what a specialized team for prior authorizations and RFAs makes possible
  • How falling MRI reimbursement and rising magnet costs turned throughput into the margin
  • Why the playbook you built six months ago is out the window, and where Alex expects AI to change RCM first

ㅤ

🔗 Resources Mentioned

  • Synergy Orthopedic Specialists
  • American Alliance of Orthopaedic Executives, which named Alex Practice Executive of the Year in 2024
  • GE, referenced as the scanner platform for the group's AI imaging device
  • OpenAI, ChatGPT, and Claude, named as the general purpose tools the practice is not using for its playbook work
  • U.S. Department of Labor, the workers' comp carrier for the group's federal patient volume
  • Hatch

]]>Growth is not optional for an independent orthopedic group. Growth without the operations underneath it turns into a backlog nobody can work through. Joe Zboch talks with Alejandro Fernandez, CEO of Synergy Orthopedics, about why access is a strategy and operations problem first, with technology in service of that.

ㅤ

Alex runs the largest private orthopedic group in San Diego: over 50 providers across 15 locations, plus physical therapy sites, an MRI center, and an ASC. They get into payer contracts as the real ceiling on access, why open scheduling became a basic expectation instead of an advantage, what makes workers' comp both attractive and unforgiving, and how falling MRI reimbursement pushed the group toward AI-assisted imaging for throughput. Alex also explains why a practice playbook is out the window six months after you build it, and where he expects AI to change the work first.

ㅤ

👤 Guest Bio

Alejandro Fernandez is CEO of Synergy Orthopedic Specialists in San Diego, the largest independent orthopedic group in the region, with more than 50 providers across 15 locations plus physical therapy, imaging, and an ambulatory surgery center. He has spent 30 years running multi-site physician practices across dermatology, GI, and orthopedics, including CEO roles at Gastro Health in Miami and NavaDerm Partners in New York. The American Alliance of Orthopaedic Executives named him Practice Executive of the Year in 2024.

ㅤ

📌 What We Cover

  • Why access starts with payer contracts and credentialing rather than marketing or a booking page
  • How a bigger group moves business from the higher cost of care into the lowest cost of care, and why payers reward it
  • Why very few programs pay for quality and almost all of them still pay for volume
  • What open scheduling looks like when it works: filling tomorrow's 10:00 AM no-show by texting the people already waiting
  • How to give a health system a reason to partner with you when PCPs are getting acquired
  • Why the sports teams run through workers' comp, and what a specialized team for prior authorizations and RFAs makes possible
  • How falling MRI reimbursement and rising magnet costs turned throughput into the margin
  • Why the playbook you built six months ago is out the window, and where Alex expects AI to change RCM first

ㅤ

🔗 Resources Mentioned

  • Synergy Orthopedic Specialists
  • American Alliance of Orthopaedic Executives, which named Alex Practice Executive of the Year in 2024
  • GE, referenced as the scanner platform for the group's AI imaging device
  • OpenAI, ChatGPT, and Claude, named as the general purpose tools the practice is not using for its playbook work
  • U.S. Department of Labor, the workers' comp carrier for the group's federal patient volume
  • Hatch

]]>af9a6561-4bbd-49b7-a8fd-7a34a92df2d0Tue, 15 Sep 2026 03:00:00 -040022:16falsefull2323What to check before a health system partnership | Larry Epstein, CEO, Pediatric Urology Associates | Ep. 22What to check before a health system partnership | Larry Epstein, CEO, Pediatric Urology Associates | Ep. 22Independent specialty practices keep hitting the same wall. Reimbursement is set by the government market, the cost side keeps climbing, and owner compensation flattens out underneath both. Joe Zboch talks with Larry Epstein, CEO of Pediatric Urology Associates, about what a practice CEO actually does when top-line growth runs out of room. Larry was brought in during a leadership changeover seven years ago, spent the first stretch assessing where the market was shifting and whether enough kids were still being born to support the service, and then took the group through partnership talks that ended with a health system merger. He walks through why three or four private equity reviews went nowhere, what "plan B" looked like, and the checklist he runs before signing with a health system. If you're weighing growth paths for a specialty group, this is the operational version of that conversation.

ㅤ

👤 Guest Bio

Larry Epstein is CEO of Pediatric Urology Associates, a multi-state subspecialty surgical practice built around pediatric urological care and research. He has run clinical administration for health systems and medical groups with budgets up to 50 million and as many as 500 FTEs, led mergers and acquisitions at the regional health system level, driven EMR implementations, and turned around revenue cycle performance. The practice joined NYU Langone Health, where Larry moved into a regional practices role.

ㅤ

📌 What We Cover

  • Why operating margins for independent specialty groups have been shrinking since the RVU system took hold, and what that forces a practice to do about service lines and ancillary revenue
  • How independent groups in the Metro New York market went from 75 to 80 percent of practices down to under 35 percent in about twenty years
  • Why the birth rate is a growth constraint for a pediatric subspecialty, and what Larry assessed first when he arrived
  • Why three or four private equity reviews went nowhere: no drug revenue and no owned surgical services to support the valuation
  • What "plan B" looked like, including the ER and NICU coverage relationships that opened the health system conversation
  • The red flags to listen for when a partner describes their 24 to 36 month plan for your service line
  • How an in-office ultrasound credentialing conflict nearly stalled integration, and the 12 to 24 month commitment that resolved it
  • Why referring physicians and patient access are the two things that protect volume through a transition

ㅤ

🔗 Resources Mentioned

  • Hatch
  • Pediatric Urology Associates
  • NYU Langone Health

]]>Independent specialty practices keep hitting the same wall. Reimbursement is set by the government market, the cost side keeps climbing, and owner compensation flattens out underneath both. Joe Zboch talks with Larry Epstein, CEO of Pediatric Urology Associates, about what a practice CEO actually does when top-line growth runs out of room. Larry was brought in during a leadership changeover seven years ago, spent the first stretch assessing where the market was shifting and whether enough kids were still being born to support the service, and then took the group through partnership talks that ended with a health system merger. He walks through why three or four private equity reviews went nowhere, what "plan B" looked like, and the checklist he runs before signing with a health system. If you're weighing growth paths for a specialty group, this is the operational version of that conversation.

ㅤ

👤 Guest Bio

Larry Epstein is CEO of Pediatric Urology Associates, a multi-state subspecialty surgical practice built around pediatric urological care and research. He has run clinical administration for health systems and medical groups with budgets up to 50 million and as many as 500 FTEs, led mergers and acquisitions at the regional health system level, driven EMR implementations, and turned around revenue cycle performance. The practice joined NYU Langone Health, where Larry moved into a regional practices role.

ㅤ

📌 What We Cover

  • Why operating margins for independent specialty groups have been shrinking since the RVU system took hold, and what that forces a practice to do about service lines and ancillary revenue
  • How independent groups in the Metro New York market went from 75 to 80 percent of practices down to under 35 percent in about twenty years
  • Why the birth rate is a growth constraint for a pediatric subspecialty, and what Larry assessed first when he arrived
  • Why three or four private equity reviews went nowhere: no drug revenue and no owned surgical services to support the valuation
  • What "plan B" looked like, including the ER and NICU coverage relationships that opened the health system conversation
  • The red flags to listen for when a partner describes their 24 to 36 month plan for your service line
  • How an in-office ultrasound credentialing conflict nearly stalled integration, and the 12 to 24 month commitment that resolved it
  • Why referring physicians and patient access are the two things that protect volume through a transition

ㅤ

🔗 Resources Mentioned

  • Hatch
  • Pediatric Urology Associates
  • NYU Langone Health

]]>432be0f9-093f-418b-a43d-f4befdfdae61Tue, 08 Sep 2026 03:00:00 -040022:58falsefull2222Operational excellence is the rate limiting factor for growth | Cecily Sheats, Executive Director, Creekside Surgery Center | Ep. 21Operational excellence is the rate limiting factor for growth | Cecily Sheats, Executive Director, Creekside Surgery Center | Ep. 21Growth is not the hard part. Holding the operation together while you grow is. On this episode, Joe Zboch talks with Cecily Sheats, executive director and administrator at Creekside Surgery Center in Anchorage, about why operational excellence is a prerequisite for growth rather than a reward for it.

ㅤ

Alaska makes the point unavoidable. The nearest referral centers are often Seattle or Portland, patients travel farther than Dallas to New York City for critical care, and you cannot solve a gap by posting a role and waiting. Cecily walks through the process improvement available before you spend on FTEs or technology, the three-legged stool behind her employee incentive model, and how she sets goals when no benchmark exists.

ㅤ

She also gets specific about what her team actually does: department-level strategic planning, sticky notes and spirit animals in the break room, and a review process rebuilt so people walk out with something. Brought to you by Hatch.

ㅤ

👤 Guest Bio

Cecily Sheats, MBA, is executive director and administrator at Creekside Surgery Center, a four OR ambulatory surgery center in Anchorage with 50 staff seeing up to 3,000 patients a year. She is also president of the Alaska Healthcare Executives Network, the independent Alaska chapter of ACHE. Before Creekside she ran cardiac, neuroscience, and orthopedic service lines for Providence in Anchorage, and she has worked in healthcare operations across California, Louisiana, and Colorado.

ㅤ

📌 What We Cover

  • Why the rate limiting factor for growth is usually the lack of operational excellence, not the lack of demand
  • The process improvement available before you invest in FTEs or technology
  • What "dare to reimagine, even in crowded spaces" looks like in an organization that remembers every idea that flopped
  • How department-level strategic planning replaces the plan that ends up on a shelf collecting dust
  • The three-legged stool behind her employee incentive model: organizational goal, personal accountability, team SMART goals
  • How to build a unit of measurement when there is no benchmark, starting with "what are we solving for"
  • Mapping the referral process end to end with partner practices when nobody shares an EMR
  • The difference between "hey, great job" and "hey, I noticed," and why reviews became development sessions

ㅤ

🔗 Resources Mentioned


]]>Growth is not the hard part. Holding the operation together while you grow is. On this episode, Joe Zboch talks with Cecily Sheats, executive director and administrator at Creekside Surgery Center in Anchorage, about why operational excellence is a prerequisite for growth rather than a reward for it.

ㅤ

Alaska makes the point unavoidable. The nearest referral centers are often Seattle or Portland, patients travel farther than Dallas to New York City for critical care, and you cannot solve a gap by posting a role and waiting. Cecily walks through the process improvement available before you spend on FTEs or technology, the three-legged stool behind her employee incentive model, and how she sets goals when no benchmark exists.

ㅤ

She also gets specific about what her team actually does: department-level strategic planning, sticky notes and spirit animals in the break room, and a review process rebuilt so people walk out with something. Brought to you by Hatch.

ㅤ

👤 Guest Bio

Cecily Sheats, MBA, is executive director and administrator at Creekside Surgery Center, a four OR ambulatory surgery center in Anchorage with 50 staff seeing up to 3,000 patients a year. She is also president of the Alaska Healthcare Executives Network, the independent Alaska chapter of ACHE. Before Creekside she ran cardiac, neuroscience, and orthopedic service lines for Providence in Anchorage, and she has worked in healthcare operations across California, Louisiana, and Colorado.

ㅤ

📌 What We Cover

  • Why the rate limiting factor for growth is usually the lack of operational excellence, not the lack of demand
  • The process improvement available before you invest in FTEs or technology
  • What "dare to reimagine, even in crowded spaces" looks like in an organization that remembers every idea that flopped
  • How department-level strategic planning replaces the plan that ends up on a shelf collecting dust
  • The three-legged stool behind her employee incentive model: organizational goal, personal accountability, team SMART goals
  • How to build a unit of measurement when there is no benchmark, starting with "what are we solving for"
  • Mapping the referral process end to end with partner practices when nobody shares an EMR
  • The difference between "hey, great job" and "hey, I noticed," and why reviews became development sessions

ㅤ

🔗 Resources Mentioned


]]>529e211a-d39b-4a3e-8421-f5e6a14050a1Tue, 01 Sep 2026 03:00:00 -040025:51falsefull2121The patient experience doesn’t stop after the front door | Kaydi Siebeck, Patient Access Manager, Moreland OB-GYN Associates | Ep. 20The patient experience doesn’t stop after the front door | Kaydi Siebeck, Patient Access Manager, Moreland OB-GYN Associates | Ep. 20Digitizing the front door usually gets framed as a tradeoff against the patient experience. Kaydi Siebeck runs patient access at Moreland OB-GYN Associates in Wisconsin, and she draws the line somewhere specific: the system takes the administrative tasks so her staff has more time for the phone call and the front desk conversation.

ㅤ

She joins Joe Zboch of Hatch to talk through nine years of change at the front door, from paper charts running alongside an electronic medical record to a nurse care team model built inside the EMR. She covers what patient survey feedback and phone routing data told them, why patients kept asking for staff members by name, and what broke during the schedule build. She also gets into compassion training, what's your why, and why Moreland still answers every call live with no automated system.

ㅤ

👤 Guest Bio

Kaydi Siebeck is Patient Access Manager at Moreland OB-GYN Associates, S.C., the largest independent OB-GYN group in the Waukesha, Wisconsin area, serving the community since 1960 and delivering through its partnerships with ProHealth Care hospitals. She runs scheduling, registration, and insurance verification, and leads the practice's system transitions and access technology work. She is a 20-year breast cancer survivor.

ㅤ

📌 What We Cover

  • Why the practice ran paper charts and an electronic medical record side by side, and what COVID forced them to look at
  • Where technology takes over: e-check-in, document upload, automatic messages, orders and referrals placed
  • Why Moreland answers every call live with no automated system, and what patients say about it
  • "What's your why" and compassion training as a way to get buy-in for change and keep staff on board
  • The nurse care team model: one schedule per provider's nurse, reserved rooms, blocked time for follow-up calls
  • The survey comments and phone routing data behind the decision, including patients asking for specific staff by name
  • What the soft opening caught: appointment types the system couldn't build and not enough rooms
  • Where growth comes from for an OB-GYN specialist: family practice referrals, high schools, networking through the affiliated health system

ㅤ

🔗 Resources Mentioned


]]>Digitizing the front door usually gets framed as a tradeoff against the patient experience. Kaydi Siebeck runs patient access at Moreland OB-GYN Associates in Wisconsin, and she draws the line somewhere specific: the system takes the administrative tasks so her staff has more time for the phone call and the front desk conversation.

ㅤ

She joins Joe Zboch of Hatch to talk through nine years of change at the front door, from paper charts running alongside an electronic medical record to a nurse care team model built inside the EMR. She covers what patient survey feedback and phone routing data told them, why patients kept asking for staff members by name, and what broke during the schedule build. She also gets into compassion training, what's your why, and why Moreland still answers every call live with no automated system.

ㅤ

👤 Guest Bio

Kaydi Siebeck is Patient Access Manager at Moreland OB-GYN Associates, S.C., the largest independent OB-GYN group in the Waukesha, Wisconsin area, serving the community since 1960 and delivering through its partnerships with ProHealth Care hospitals. She runs scheduling, registration, and insurance verification, and leads the practice's system transitions and access technology work. She is a 20-year breast cancer survivor.

ㅤ

📌 What We Cover

  • Why the practice ran paper charts and an electronic medical record side by side, and what COVID forced them to look at
  • Where technology takes over: e-check-in, document upload, automatic messages, orders and referrals placed
  • Why Moreland answers every call live with no automated system, and what patients say about it
  • "What's your why" and compassion training as a way to get buy-in for change and keep staff on board
  • The nurse care team model: one schedule per provider's nurse, reserved rooms, blocked time for follow-up calls
  • The survey comments and phone routing data behind the decision, including patients asking for specific staff by name
  • What the soft opening caught: appointment types the system couldn't build and not enough rooms
  • Where growth comes from for an OB-GYN specialist: family practice referrals, high schools, networking through the affiliated health system

ㅤ

🔗 Resources Mentioned


]]>666d4ab0-1441-4ee0-96c4-24f87a2912abTue, 25 Aug 2026 03:00:00 -040019:18falsefull2020Orthopedic growth after your referral base shifts | Thomas Fondren, CEO, Advanced Orthopedics of Oklahoma | Ep. 19Orthopedic growth after your referral base shifts | Thomas Fondren, CEO, Advanced Orthopedics of Oklahoma | Ep. 19Patients want the robot and the better brace. Reimbursement is moving the other way, and the practice sits in the middle of that distance every single day. Joe Zboch, Director of Marketing at Hatch, talks with Thomas Fondren, CEO of Advanced Orthopedics of Oklahoma, about what it takes to run aggressive growth goals and stay lean enough to support them.

ㅤ

Thomas walks through geographic diversification, service line diversification, and payer diversification at a physician-owned ortho group in Tulsa with 24 physicians and more than 300 employees. He explains why his company went self-insured in January of '26, what that taught him about selling to local employers, and why he shut down a bone health program that was clinically sound and financially underwater. He also gets specific about where AI is worth touching right now and where his group has not pulled the lever yet.

ㅤ

👤 Guest Bio

Thomas Fondren is CEO of Advanced Orthopedics of Oklahoma, the largest independent physician-owned orthopedic and sports medicine group in Northeast Oklahoma. He stepped into the role in 2023 after roughly three decades in Oklahoma healthcare administration, including senior clinic operations and business development roles at Oklahoma City's physician-owned Healthcare Partners Investments. He is a University of Oklahoma graduate.

ㅤ

📌 What We Cover

  • Why the gap between patient expectations and payer reimbursement keeps widening, and how the practice manages it through payer relationships
  • Diversification on three angles at once: geographic, service line, and payer, including orthobiologics, eight PT clinics, and an incoming rheumatologist with infusions
  • Why cost and ROI get asked at the back end of the strategic plan, not the front
  • What the practice learned about its own spend after going self-insured: pharmacy first, orthopedics second, and it owns both
  • Building executive forums for local execs and HR benefits leaders, and what happened when Thomas ran this playbook in Oklahoma City
  • Why the bone health program got canceled even though the drugs work
  • The three or four AI categories worth touching: document management, prior auth, and coding
  • Why the exec team's relationship with the board and shareholders decides whether an 18-month project survives month seven

ㅤ

🔗 Resources Mentioned

  • Hatch — episode sponsor
  • Advanced Orthopedics of Oklahoma
  • Ascension St. John
  • Transcarent, Carrum Health, Contigo Health, Ready Rebound

]]>Patients want the robot and the better brace. Reimbursement is moving the other way, and the practice sits in the middle of that distance every single day. Joe Zboch, Director of Marketing at Hatch, talks with Thomas Fondren, CEO of Advanced Orthopedics of Oklahoma, about what it takes to run aggressive growth goals and stay lean enough to support them.

ㅤ

Thomas walks through geographic diversification, service line diversification, and payer diversification at a physician-owned ortho group in Tulsa with 24 physicians and more than 300 employees. He explains why his company went self-insured in January of '26, what that taught him about selling to local employers, and why he shut down a bone health program that was clinically sound and financially underwater. He also gets specific about where AI is worth touching right now and where his group has not pulled the lever yet.

ㅤ

👤 Guest Bio

Thomas Fondren is CEO of Advanced Orthopedics of Oklahoma, the largest independent physician-owned orthopedic and sports medicine group in Northeast Oklahoma. He stepped into the role in 2023 after roughly three decades in Oklahoma healthcare administration, including senior clinic operations and business development roles at Oklahoma City's physician-owned Healthcare Partners Investments. He is a University of Oklahoma graduate.

ㅤ

📌 What We Cover

  • Why the gap between patient expectations and payer reimbursement keeps widening, and how the practice manages it through payer relationships
  • Diversification on three angles at once: geographic, service line, and payer, including orthobiologics, eight PT clinics, and an incoming rheumatologist with infusions
  • Why cost and ROI get asked at the back end of the strategic plan, not the front
  • What the practice learned about its own spend after going self-insured: pharmacy first, orthopedics second, and it owns both
  • Building executive forums for local execs and HR benefits leaders, and what happened when Thomas ran this playbook in Oklahoma City
  • Why the bone health program got canceled even though the drugs work
  • The three or four AI categories worth touching: document management, prior auth, and coding
  • Why the exec team's relationship with the board and shareholders decides whether an 18-month project survives month seven

ㅤ

🔗 Resources Mentioned

  • Hatch — episode sponsor
  • Advanced Orthopedics of Oklahoma
  • Ascension St. John
  • Transcarent, Carrum Health, Contigo Health, Ready Rebound

]]>ada717d8-354e-4ba3-84a6-f1a2665c5b79Tue, 18 Aug 2026 03:00:00 -040019:43falsefull1919Access is different depending on where the patient came from | Jason Muchow, CEO, Advanced Bone & Joint | Ep. 18Access is different depending on where the patient came from | Jason Muchow, CEO, Advanced Bone & Joint | Ep. 18Marketing is working, the phones are ringing, and then a new patient hits a completely different scheduling path than an established one. Joe Zboch talks with Jason Muchow, CEO of Advanced Bone & Joint, about what happens when you map that gap on purpose.

ㅤ

Jason is five months into the seat at a physician-led orthopedic practice that has been in the St. Louis metro for over 40 years. He walks through his first 90 days, the patient journey mapping exercise his team ran from the point of decision through discharge and billing, and what he learned about where ABJ's patients actually come from now. The primary care base that used to refer consistently is mostly employed by the three health systems headquartered nearby. Word of mouth carries more weight. And employers, squeezed by medical spend running ten percent plus year over year, are becoming a referral channel of their own.

ㅤ

You'll hear how ABJ separates friction caused by a tool from friction caused by how a tool was implemented, why a new EMR was not the move in month five, and how access gets framed differently depending on whether the patient came from Google, an employer, or a workers' comp adjuster. Hatch powers the 24/7/365 injury chat Jason mentions.

ㅤ

👤 Guest Bio

Jason Muchow, MHA, ATC, BCS-O, is CEO of Advanced Bone & Joint, a physician-owned orthopedic practice serving the St. Louis metro from St. Peters, O'Fallon, and Wentzville. He spent nearly 17 years at Mercy, most recently leading orthopedics and sports medicine for Mercy Clinic and operations for Mercy St. Louis, where he helped design the Mercy Center for Performance Medicine & Specialty Care. He started his career as a certified athletic trainer and is a founding board member of the Athletic Trainers in the Physician Practice Society.

ㅤ

📌 What We Cover

  • Why the first 90 days went to listening sessions and anonymous surveys instead of a reorg
  • The board's day-two charge: execute on growth and sustain the team already in place
  • Mapping the patient journey from the point of decision through discharge, billing, and payment
  • How to tell whether friction comes from the tool, the implementation, the training, or a bolt-on under the EMR
  • Why online scheduling only worked for established patients, and what new patients had to do instead
  • What happened to the local primary care referral base over the last ten years
  • Word of mouth as a referral source in a market with 40 years of history behind it
  • Employers and brokers as a new access conversation, and where orthopedic urgent care fits against the ED

ㅤ

🔗 Resources Mentioned


]]>Marketing is working, the phones are ringing, and then a new patient hits a completely different scheduling path than an established one. Joe Zboch talks with Jason Muchow, CEO of Advanced Bone & Joint, about what happens when you map that gap on purpose.

ㅤ

Jason is five months into the seat at a physician-led orthopedic practice that has been in the St. Louis metro for over 40 years. He walks through his first 90 days, the patient journey mapping exercise his team ran from the point of decision through discharge and billing, and what he learned about where ABJ's patients actually come from now. The primary care base that used to refer consistently is mostly employed by the three health systems headquartered nearby. Word of mouth carries more weight. And employers, squeezed by medical spend running ten percent plus year over year, are becoming a referral channel of their own.

ㅤ

You'll hear how ABJ separates friction caused by a tool from friction caused by how a tool was implemented, why a new EMR was not the move in month five, and how access gets framed differently depending on whether the patient came from Google, an employer, or a workers' comp adjuster. Hatch powers the 24/7/365 injury chat Jason mentions.

ㅤ

👤 Guest Bio

Jason Muchow, MHA, ATC, BCS-O, is CEO of Advanced Bone & Joint, a physician-owned orthopedic practice serving the St. Louis metro from St. Peters, O'Fallon, and Wentzville. He spent nearly 17 years at Mercy, most recently leading orthopedics and sports medicine for Mercy Clinic and operations for Mercy St. Louis, where he helped design the Mercy Center for Performance Medicine & Specialty Care. He started his career as a certified athletic trainer and is a founding board member of the Athletic Trainers in the Physician Practice Society.

ㅤ

📌 What We Cover

  • Why the first 90 days went to listening sessions and anonymous surveys instead of a reorg
  • The board's day-two charge: execute on growth and sustain the team already in place
  • Mapping the patient journey from the point of decision through discharge, billing, and payment
  • How to tell whether friction comes from the tool, the implementation, the training, or a bolt-on under the EMR
  • Why online scheduling only worked for established patients, and what new patients had to do instead
  • What happened to the local primary care referral base over the last ten years
  • Word of mouth as a referral source in a market with 40 years of history behind it
  • Employers and brokers as a new access conversation, and where orthopedic urgent care fits against the ED

ㅤ

🔗 Resources Mentioned


]]>4e20fca3-cf02-42bc-a092-519dadf85060Tue, 11 Aug 2026 03:00:00 -040022:52falsefull1818Expanding orthopedic access without adding physicians | Alissa Ashley-High, Practice Administrator, Orthopaedic Associates of Marlborough | Ep. 17Expanding orthopedic access without adding physicians | Alissa Ashley-High, Practice Administrator, Orthopaedic Associates of Marlborough | Ep. 17Growth in a four-physician orthopedic practice doesn't look anything like growth in a health system, and the decisions that keep an independent group viable rarely show up in a strategy deck. This episode gets into what those decisions actually are: how a high-cost injectable came off the shelf when reimbursement stopped working, how it came back, and how a practice expanded patient access without hiring a physician or adding an office hour.

ㅤ

Joe Zboch talks with Alissa Ashley-High, practice administrator at Orthopaedic Associates of Marlborough in Massachusetts, about balancing operational excellence against growth goals when there are no unlimited resources to fall back on. Alissa walks through the three questions every investment has to pass, the AAOE member benefit that made a money-losing service viable again, and OAM NOW, the virtual orthopedic urgent care partnership she launched this past year.

ㅤ

If you're looking to scale referral operations to drive growth and efficiency, visit Hatch.

ㅤ

👤 Guest Bio

Alissa Ashley-High is the practice administrator at Orthopaedic Associates of Marlborough, an independent orthopedic group that has served the same Massachusetts community for over 50 years. She has led operations there for more than eight years and has been a nurse since 2005, a clinical background that shapes how she runs the practice today. She sits on the board of the American Alliance of Orthopaedic Executives, where she works across its membership, education, and advocacy councils, and she speaks at the AAOE Women in Medical Practice Management Conference.

ㅤ

📌 What We Cover

  • Why growth and operational excellence can't compete in a practice without unlimited resources, and the three questions every investment has to answer first
  • How sitting next to the core turns everyday conversation into the practice's operational feedback loop
  • What a hyaluronic acid injection actually cost in staff hours before the practice stopped doing it
  • How an AAOE peer-reviewed vendor relationship brought that service back without making it a revenue play
  • OAM NOW, the virtual orthopedic urgent care partnership that expanded access without adding physicians or office hours
  • Competing with Boston when you have no parking fees and no hidden facility fees
  • Taking prior authorization and Medicare reimbursement to Capitol Hill with AAOE and AAOS
  • Moving from 50 years of word of mouth into reviews, social, and a survey platform feeding Healthgrades, Yelp, WebMD, and Google

ㅤ

🔗 Resources Mentioned


]]>Growth in a four-physician orthopedic practice doesn't look anything like growth in a health system, and the decisions that keep an independent group viable rarely show up in a strategy deck. This episode gets into what those decisions actually are: how a high-cost injectable came off the shelf when reimbursement stopped working, how it came back, and how a practice expanded patient access without hiring a physician or adding an office hour.

ㅤ

Joe Zboch talks with Alissa Ashley-High, practice administrator at Orthopaedic Associates of Marlborough in Massachusetts, about balancing operational excellence against growth goals when there are no unlimited resources to fall back on. Alissa walks through the three questions every investment has to pass, the AAOE member benefit that made a money-losing service viable again, and OAM NOW, the virtual orthopedic urgent care partnership she launched this past year.

ㅤ

If you're looking to scale referral operations to drive growth and efficiency, visit Hatch.

ㅤ

👤 Guest Bio

Alissa Ashley-High is the practice administrator at Orthopaedic Associates of Marlborough, an independent orthopedic group that has served the same Massachusetts community for over 50 years. She has led operations there for more than eight years and has been a nurse since 2005, a clinical background that shapes how she runs the practice today. She sits on the board of the American Alliance of Orthopaedic Executives, where she works across its membership, education, and advocacy councils, and she speaks at the AAOE Women in Medical Practice Management Conference.

ㅤ

📌 What We Cover

  • Why growth and operational excellence can't compete in a practice without unlimited resources, and the three questions every investment has to answer first
  • How sitting next to the core turns everyday conversation into the practice's operational feedback loop
  • What a hyaluronic acid injection actually cost in staff hours before the practice stopped doing it
  • How an AAOE peer-reviewed vendor relationship brought that service back without making it a revenue play
  • OAM NOW, the virtual orthopedic urgent care partnership that expanded access without adding physicians or office hours
  • Competing with Boston when you have no parking fees and no hidden facility fees
  • Taking prior authorization and Medicare reimbursement to Capitol Hill with AAOE and AAOS
  • Moving from 50 years of word of mouth into reviews, social, and a survey platform feeding Healthgrades, Yelp, WebMD, and Google

ㅤ

🔗 Resources Mentioned


]]>2f7d0548-1c8d-483c-ab5d-25efca1abb01Tue, 04 Aug 2026 03:00:00 -040021:20falsefull1717When growth sits at the center of the org chart | Blair Primis, Chief Growth Officer, OrthoCarolina | Ep. 16When growth sits at the center of the org chart | Blair Primis, Chief Growth Officer, OrthoCarolina | Ep. 16Growth inside a private specialty practice usually gets split across departments. Marketing runs demand, operations owns the front desk and the contact center, online scheduling belongs to IT and Epic, and real estate decisions come out of finance. This episode is about what changes when a practice stops splitting it up and builds a growth department instead.

ㅤ

Joe Zboch talks with Blair Primis, Chief Growth Officer at OrthoCarolina, a physician-owned, physician-led orthopedic practice with over 130 docs and 40 locations across North Carolina. Blair walks through the three lanes his team occupies, the full funnel marketing attribution engine they spent five to seven months building, and what it turned up about their own online scheduling process.

ㅤ

He also gets into the harder half of the work: standing in front of 80 to 90 shareholders at a physician retreat and asking them to move their slots around. Presented by Hatch.

ㅤ

👤 Guest Bioㅤ

Blair Primis is Chief Growth Officer at OrthoCarolina, where he leads marketing, patient experience, and growth strategy. A Duke University graduate with more than 25 years in marketing, he worked at McCann-Erickson and McKinney before moving to corporate marketing at McDonald's. He first joined OrthoCarolina in 2009 and rose to Senior Vice President, later serving as Chief Marketing Officer at Flagship Specialty Partners before returning to OrthoCarolina in 2025.

ㅤ

📌 What We Cover

  • Why a growth department is still novel in private practice and mostly lives inside health systems
  • The three lanes OrthoCarolina's growth team occupies: demand, supply, and experience, each with its own director
  • How hub and spoke works in practice, with growth at the center liaising out to operations, IT, legal, and the ASC team
  • The four or five data sources feeding the team, including Epic, Freshpaint, and Placer.ai
  • What the full funnel marketing attribution engine uncovered: too many questions for patients to answer before booking online
  • Why showing friction publicly invites competitors into your market
  • Schedule first, solve later, and why the behavior change was harder than the data work
  • The franchise parallel from McDonald's and why it maps onto a physician-owned practice

ㅤ

🔗 Resources Mentioned

  • Epic — electronic health record
  • Freshpaint — privacy and compliance platform for marketing
  • Placer.ai — third-party location and foot traffic data
  • Google Ads and Google Business Profile
  • Jerry Seinfeld keynote, on why he ended Seinfeld after nine seasons
  • McDonald's corporate marketing and the franchise owner-operator model
  • Hatch

]]>Growth inside a private specialty practice usually gets split across departments. Marketing runs demand, operations owns the front desk and the contact center, online scheduling belongs to IT and Epic, and real estate decisions come out of finance. This episode is about what changes when a practice stops splitting it up and builds a growth department instead.

ㅤ

Joe Zboch talks with Blair Primis, Chief Growth Officer at OrthoCarolina, a physician-owned, physician-led orthopedic practice with over 130 docs and 40 locations across North Carolina. Blair walks through the three lanes his team occupies, the full funnel marketing attribution engine they spent five to seven months building, and what it turned up about their own online scheduling process.

ㅤ

He also gets into the harder half of the work: standing in front of 80 to 90 shareholders at a physician retreat and asking them to move their slots around. Presented by Hatch.

ㅤ

👤 Guest Bioㅤ

Blair Primis is Chief Growth Officer at OrthoCarolina, where he leads marketing, patient experience, and growth strategy. A Duke University graduate with more than 25 years in marketing, he worked at McCann-Erickson and McKinney before moving to corporate marketing at McDonald's. He first joined OrthoCarolina in 2009 and rose to Senior Vice President, later serving as Chief Marketing Officer at Flagship Specialty Partners before returning to OrthoCarolina in 2025.

ㅤ

📌 What We Cover

  • Why a growth department is still novel in private practice and mostly lives inside health systems
  • The three lanes OrthoCarolina's growth team occupies: demand, supply, and experience, each with its own director
  • How hub and spoke works in practice, with growth at the center liaising out to operations, IT, legal, and the ASC team
  • The four or five data sources feeding the team, including Epic, Freshpaint, and Placer.ai
  • What the full funnel marketing attribution engine uncovered: too many questions for patients to answer before booking online
  • Why showing friction publicly invites competitors into your market
  • Schedule first, solve later, and why the behavior change was harder than the data work
  • The franchise parallel from McDonald's and why it maps onto a physician-owned practice

ㅤ

🔗 Resources Mentioned

  • Epic — electronic health record
  • Freshpaint — privacy and compliance platform for marketing
  • Placer.ai — third-party location and foot traffic data
  • Google Ads and Google Business Profile
  • Jerry Seinfeld keynote, on why he ended Seinfeld after nine seasons
  • McDonald's corporate marketing and the franchise owner-operator model
  • Hatch

]]>c4026820-a44d-4051-830f-4733807486ceTue, 28 Jul 2026 03:00:00 -040022:01falsefull1616Using therapy sites to test a market before building an ASC | Jessie Brovold, COO, OAW | Ep. 15Using therapy sites to test a market before building an ASC | Jessie Brovold, COO, OAW | Ep. 15Growth in a specialty practice sounds like a good problem to have. Keeping the wheels on while you scale is the hard part. In Episode 15 of Scaling Specialty Growth, Joe Zboch talks with Jessie Brovold, COO of Orthopaedic Associates of Wisconsin, about what it takes to run a competitive orthopedic practice with a growth mindset without burning out the team.

ㅤ

Jessie walks through how OAW decides where to expand: pulling patient data by zip code and by department, studying the referrals that came in but never became visits, and using physical therapy as the first, lowest-cost way to test demand in a market before committing to a clinic or a surgery center. This one is for operations and access leaders who are building the plane while flying it. Hatch sponsors the show.

ㅤ

👤 Guest Bio

Jessie Brovold is the COO of Orthopaedic Associates of Wisconsin, an independent, physician-owned orthopedic group serving southeastern Wisconsin. She started her career as an athletic trainer, boots on the ground in clinic, and still holds her license today. Over more than 16 years at OAW, she has led operations through the practice's expansion, from small satellite sites to new therapy locations and surgery center growth, while sitting at the board table every month with the group's physician partners.

ㅤ

📌 What We Cover

  • Why the best operations leaders can still do the frontline job in a pinch, and how that earns buy-in from the team
  • Building the plane while flying it: keeping systems running and staff from burning out during a growth phase
  • Access is not one thing. A patient will drive an hour for a one-time consult, but wants therapy in their backyard when it's three visits a week
  • How to run an access gap analysis: patient data by zip code and department, county-level views, and the competitors already in a market
  • The referrals that came in but never hit your books, and why the unclosed ones tell you where your access is too thin
  • Why therapy is the wedge OAW opens first to validate demand before committing to a clinic or an ASC
  • Four therapy sites in two years: two acquired with the lease and equipment at a discount, two built new, one co-located with the surgery center
  • Advice for a first big build: bring the whole operations team in early, make lists so you don't start from zero, and use GPOs and peer forums

ㅤ

🔗 Resources Mentioned

  • Hatch, the show's sponsor, for scaling referral operations
  • GPOs (group purchasing organizations) and industry forums, referenced as resources for practices taking on their first major expansion

]]>Growth in a specialty practice sounds like a good problem to have. Keeping the wheels on while you scale is the hard part. In Episode 15 of Scaling Specialty Growth, Joe Zboch talks with Jessie Brovold, COO of Orthopaedic Associates of Wisconsin, about what it takes to run a competitive orthopedic practice with a growth mindset without burning out the team.

ㅤ

Jessie walks through how OAW decides where to expand: pulling patient data by zip code and by department, studying the referrals that came in but never became visits, and using physical therapy as the first, lowest-cost way to test demand in a market before committing to a clinic or a surgery center. This one is for operations and access leaders who are building the plane while flying it. Hatch sponsors the show.

ㅤ

👤 Guest Bio

Jessie Brovold is the COO of Orthopaedic Associates of Wisconsin, an independent, physician-owned orthopedic group serving southeastern Wisconsin. She started her career as an athletic trainer, boots on the ground in clinic, and still holds her license today. Over more than 16 years at OAW, she has led operations through the practice's expansion, from small satellite sites to new therapy locations and surgery center growth, while sitting at the board table every month with the group's physician partners.

ㅤ

📌 What We Cover

  • Why the best operations leaders can still do the frontline job in a pinch, and how that earns buy-in from the team
  • Building the plane while flying it: keeping systems running and staff from burning out during a growth phase
  • Access is not one thing. A patient will drive an hour for a one-time consult, but wants therapy in their backyard when it's three visits a week
  • How to run an access gap analysis: patient data by zip code and department, county-level views, and the competitors already in a market
  • The referrals that came in but never hit your books, and why the unclosed ones tell you where your access is too thin
  • Why therapy is the wedge OAW opens first to validate demand before committing to a clinic or an ASC
  • Four therapy sites in two years: two acquired with the lease and equipment at a discount, two built new, one co-located with the surgery center
  • Advice for a first big build: bring the whole operations team in early, make lists so you don't start from zero, and use GPOs and peer forums

ㅤ

🔗 Resources Mentioned

  • Hatch, the show's sponsor, for scaling referral operations
  • GPOs (group purchasing organizations) and industry forums, referenced as resources for practices taking on their first major expansion

]]>be61d2d2-9812-4c91-afec-7601989f200eTue, 21 Jul 2026 03:00:00 -040022:41falsefull1515Centralizing operations without erasing the local brand | Jarett Landman, Former VP of Operations, Spire Orthopedic Partners | Ep. 14Centralizing operations without erasing the local brand | Jarett Landman, Former VP of Operations, Spire Orthopedic Partners | Ep. 14Specialty healthcare growth isn't optional, but scaling with operational excellence is the hard part. This episode gets into what that looks like when independent orthopedic practices come together under an MSO, and what has to stay local for it to hold.

ㅤ

Joe Zboch talks with Jarett Landman, former VP of Operations at Spire Orthopedic Partners, about balancing the operational needs of the business against the pressure to grow quickly but responsibly. They cover why physicians are banding together, how to centralize the back office without confusing patients, and how to bring a new practice into the group without making it feel like it's swallowing an elephant.

ㅤ

Scaling Specialty Growth is hosted by Joe Zboch, Director of Marketing at Hatch.

ㅤ

👤 Guest Bio

Jarett Landman is the former VP of Operations at Spire Orthopedic Partners, a PE-backed ortho group, where he led the Massachusetts regional market across nine locations and 450 employees. He describes himself as a servant leader. He started as a physician assistant treating patients and worked his way into the executive side, spending nearly 15 years on the independent physician practice level before moving to the private equity side. He calls himself a lifelong healthcare executive.

ㅤ

📌 What We Cover

  • Why physicians are banding together: rising rent, talent costs, technology costs, and downward pressure from payers cutting into margin
  • The three pathways practices take: capital partners on the private equity side, aggregating independently, or joining hospital systems
  • Why the local brand and physician names stay put while the infrastructure underneath gets centralized
  • The name-on-the-Velcro principle: physicians care that patient care is safe and stable, not how the RCM processes run behind it
  • Why data aggregation comes before putting every practice on the same EHR
  • How to onboard a new practice stepwise over six months to a year so it stays digestible
  • Using performance data mirrored back to a practice as a starting point for conversation, not as a stick
  • The three factors to weigh before joining an MSO: rightness of fit, how partners are perceived in the market, and long-term succession

ㅤ

🔗 Resources Mentioned

  • Spire Orthopedic Partners
  • Northeast Orthopaedic Alliance
  • PELTO
  • Hatch

]]>Specialty healthcare growth isn't optional, but scaling with operational excellence is the hard part. This episode gets into what that looks like when independent orthopedic practices come together under an MSO, and what has to stay local for it to hold.

ㅤ

Joe Zboch talks with Jarett Landman, former VP of Operations at Spire Orthopedic Partners, about balancing the operational needs of the business against the pressure to grow quickly but responsibly. They cover why physicians are banding together, how to centralize the back office without confusing patients, and how to bring a new practice into the group without making it feel like it's swallowing an elephant.

ㅤ

Scaling Specialty Growth is hosted by Joe Zboch, Director of Marketing at Hatch.

ㅤ

👤 Guest Bio

Jarett Landman is the former VP of Operations at Spire Orthopedic Partners, a PE-backed ortho group, where he led the Massachusetts regional market across nine locations and 450 employees. He describes himself as a servant leader. He started as a physician assistant treating patients and worked his way into the executive side, spending nearly 15 years on the independent physician practice level before moving to the private equity side. He calls himself a lifelong healthcare executive.

ㅤ

📌 What We Cover

  • Why physicians are banding together: rising rent, talent costs, technology costs, and downward pressure from payers cutting into margin
  • The three pathways practices take: capital partners on the private equity side, aggregating independently, or joining hospital systems
  • Why the local brand and physician names stay put while the infrastructure underneath gets centralized
  • The name-on-the-Velcro principle: physicians care that patient care is safe and stable, not how the RCM processes run behind it
  • Why data aggregation comes before putting every practice on the same EHR
  • How to onboard a new practice stepwise over six months to a year so it stays digestible
  • Using performance data mirrored back to a practice as a starting point for conversation, not as a stick
  • The three factors to weigh before joining an MSO: rightness of fit, how partners are perceived in the market, and long-term succession

ㅤ

🔗 Resources Mentioned

  • Spire Orthopedic Partners
  • Northeast Orthopaedic Alliance
  • PELTO
  • Hatch

]]>01f6cfbd-f163-4e3b-b01d-f42602bf6c9cTue, 14 Jul 2026 03:00:00 -040020:07falsefull1414Hearing the unheard before turnover shows up | Olivia Wolf, Healthcare Executive, Host of The Stuck(ish) Podcast | Ep. 13Hearing the unheard before turnover shows up | Olivia Wolf, Healthcare Executive, Host of The Stuck(ish) Podcast | Ep. 13Turnover, low engagement, and dropping productivity are the symptoms every practice leader can see. This episode is about the culture problem underneath them, and how to catch it before it becomes a fracture. Host Joe Zboch, Director of Marketing at Hatch, sits down with Olivia Wolf, a healthcare executive and consultant who has spent her career in orthopedic practice management. Olivia makes the case that technical skills have taken the front seat while the relational side has gone bone on bone. She talks through how leaders can hear the unheard, why purpose is the retention lever most practices ignore, and what it looks like to grow inward instead of always recruiting outward. If you run a practice feeling the pressure to scale, this one names the work most people skip.

ㅤ

👤 Guest Bio

Olivia Wolf is a healthcare executive and consultant who got her start at age 14 posting charges in a hospital billing department. She has spent her career in orthopedic practice management and revenue cycle, served on the board of directors for AAOE, and is a certified professional coder with an MBA from Creighton. She also hosts her own leadership podcast, The Stuck(ish) Podcast.

ㅤ

📌 What We Cover

  • Why turnover, low productivity, and disengagement are lagging symptoms, not the actual problem
  • How to hear the unheard: the Sunday scaries, showing up late, calling in sick, and the tone shifts that come first
  • Purpose as a retention driver, and why healthcare attracts people willing to go above and beyond until that purpose disappears
  • Connecting the monotonous work, like credentialing and copay collection, back to the patient in pain who wants answers
  • Making rounds and observing your team without slipping into micromanaging or auditing
  • The orthopedic surgeon who flipped out over an X-ray, and the shame underneath the loud complaint
  • Why growth sometimes means pruning: stop recruiting, bulk up revenue cycle, invest in your team
  • The uncomfortable question behind staff retention: what about your culture makes it appealing to leave

ㅤ

🔗 Resources Mentioned

  • The Stuck(ish) Podcast, hosted by Olivia Wolf
  • CAQH, the centralized credentialing database referenced during the enrollment discussion
  • Amy Seehafer, COO at OSMS, cited by Joe for framing growth as a game staff play together
  • Dr. Matthew Slater, cited by Joe for strong team investment and retention
  • Hatch, sponsor of Scaling Specialty Growth

]]>Turnover, low engagement, and dropping productivity are the symptoms every practice leader can see. This episode is about the culture problem underneath them, and how to catch it before it becomes a fracture. Host Joe Zboch, Director of Marketing at Hatch, sits down with Olivia Wolf, a healthcare executive and consultant who has spent her career in orthopedic practice management. Olivia makes the case that technical skills have taken the front seat while the relational side has gone bone on bone. She talks through how leaders can hear the unheard, why purpose is the retention lever most practices ignore, and what it looks like to grow inward instead of always recruiting outward. If you run a practice feeling the pressure to scale, this one names the work most people skip.

ㅤ

👤 Guest Bio

Olivia Wolf is a healthcare executive and consultant who got her start at age 14 posting charges in a hospital billing department. She has spent her career in orthopedic practice management and revenue cycle, served on the board of directors for AAOE, and is a certified professional coder with an MBA from Creighton. She also hosts her own leadership podcast, The Stuck(ish) Podcast.

ㅤ

📌 What We Cover

  • Why turnover, low productivity, and disengagement are lagging symptoms, not the actual problem
  • How to hear the unheard: the Sunday scaries, showing up late, calling in sick, and the tone shifts that come first
  • Purpose as a retention driver, and why healthcare attracts people willing to go above and beyond until that purpose disappears
  • Connecting the monotonous work, like credentialing and copay collection, back to the patient in pain who wants answers
  • Making rounds and observing your team without slipping into micromanaging or auditing
  • The orthopedic surgeon who flipped out over an X-ray, and the shame underneath the loud complaint
  • Why growth sometimes means pruning: stop recruiting, bulk up revenue cycle, invest in your team
  • The uncomfortable question behind staff retention: what about your culture makes it appealing to leave

ㅤ

🔗 Resources Mentioned

  • The Stuck(ish) Podcast, hosted by Olivia Wolf
  • CAQH, the centralized credentialing database referenced during the enrollment discussion
  • Amy Seehafer, COO at OSMS, cited by Joe for framing growth as a game staff play together
  • Dr. Matthew Slater, cited by Joe for strong team investment and retention
  • Hatch, sponsor of Scaling Specialty Growth

]]>1413a1d7-7798-49da-8686-16a5f9fe15d2Tue, 07 Jul 2026 03:00:00 -040023:30falsefull1313How to keep growing when staff turnover is a given | Jeremy Fournier, Director of Operations, Advanced Orthopedics New England | Ep. 12How to keep growing when staff turnover is a given | Jeremy Fournier, Director of Operations, Advanced Orthopedics New England | Ep. 12This episode looks at a problem every mid-size specialty group knows: when you don't own the surgery center and don't have physical therapy under your roof, your growth depends on referral relationships you don't fully control. Joe Zboch, Director of Marketing at Hatch, sits down with Jeremy Fournier, Director of Operations at Advanced Orthopedics New England. Jeremy walks through how a clinical background shapes the way he runs operations, why he took over referral-source communication himself, how his team turned durable medical equipment leakage into an in-house program, and what they track every Wednesday to find the places they're hurting. It's a grounded conversation about diversifying referral streams and keeping patients from getting bounced around.

ㅤ

👤 Guest Bio

Jeremy Fournier is Director of Operations at Advanced Orthopedics New England, a physician-owned orthopedic group in Connecticut. He has spent 19 years with the practice, starting on the clinical side as an X-ray tech casting fractures and bracing patients before moving into operations. That hands-on history shapes how he thinks about staffing, training, and the day-to-day reality his teams carry.

ㅤ

📌 What We Cover

  • Why Jeremy plans for turnover instead of fighting it, when a third of his medical assistants are on track to med school or PA school
  • Taking over the referral-source communication piece personally, so PT groups can shadow a surgeon and learn what to do for a SLAP tear and what to avoid
  • The physician access hotline: a private number, given only to referral sources, that rings straight to a scheduling manager
  • Running an orthopedic urgent care that bills as a specialist visit, not as urgent care
  • Spotting leakage in the DME program and building it in-house, then applying the same lens to pain management and physiatry
  • The one-stop-shop goal: keeping patients from being referred across town twice
  • Tracking patient volume, no-show rates, call volume, and third next available since 2016, reviewed every Wednesday by a leadership team where each person owns a metric

ㅤ

🔗 Resources Mentioned

  • Hatch, referral management software for specialty care (sponsor)
  • Brian Hayes, Executive Director, Advanced Orthopedics New England
  • The practice's private EMR and self-scheduling registration system (named generically in the episode)

]]>This episode looks at a problem every mid-size specialty group knows: when you don't own the surgery center and don't have physical therapy under your roof, your growth depends on referral relationships you don't fully control. Joe Zboch, Director of Marketing at Hatch, sits down with Jeremy Fournier, Director of Operations at Advanced Orthopedics New England. Jeremy walks through how a clinical background shapes the way he runs operations, why he took over referral-source communication himself, how his team turned durable medical equipment leakage into an in-house program, and what they track every Wednesday to find the places they're hurting. It's a grounded conversation about diversifying referral streams and keeping patients from getting bounced around.

ㅤ

👤 Guest Bio

Jeremy Fournier is Director of Operations at Advanced Orthopedics New England, a physician-owned orthopedic group in Connecticut. He has spent 19 years with the practice, starting on the clinical side as an X-ray tech casting fractures and bracing patients before moving into operations. That hands-on history shapes how he thinks about staffing, training, and the day-to-day reality his teams carry.

ㅤ

📌 What We Cover

  • Why Jeremy plans for turnover instead of fighting it, when a third of his medical assistants are on track to med school or PA school
  • Taking over the referral-source communication piece personally, so PT groups can shadow a surgeon and learn what to do for a SLAP tear and what to avoid
  • The physician access hotline: a private number, given only to referral sources, that rings straight to a scheduling manager
  • Running an orthopedic urgent care that bills as a specialist visit, not as urgent care
  • Spotting leakage in the DME program and building it in-house, then applying the same lens to pain management and physiatry
  • The one-stop-shop goal: keeping patients from being referred across town twice
  • Tracking patient volume, no-show rates, call volume, and third next available since 2016, reviewed every Wednesday by a leadership team where each person owns a metric

ㅤ

🔗 Resources Mentioned

  • Hatch, referral management software for specialty care (sponsor)
  • Brian Hayes, Executive Director, Advanced Orthopedics New England
  • The practice's private EMR and self-scheduling registration system (named generically in the episode)

]]>dd651195-23d5-4845-becf-7c26d27b6081Tue, 30 Jun 2026 03:00:00 -040022:02falsefull1212Keeping referrals flowing during an EHR migration | Ken Takenaka, Director of Operations, Orthopedic + Fracture Specialists | Ep. 11Keeping referrals flowing during an EHR migration | Ken Takenaka, Director of Operations, Orthopedic + Fracture Specialists | Ep. 11Switching electronic health record systems is one of the riskiest projects a growing specialty practice will take on, and the danger isn't always where teams expect it. On this episode of Scaling Specialty Growth, Joe Zboch sits down with Ken Takenaka, Director of Operations at Orthopedic + Fracture Specialists, a 32-provider physician-owned ortho practice in Portland, Oregon. Ken came up through the clinical side, more than a decade as a certified athletic trainer and a first assistant in the operating room, before moving into operations leadership. They get into what it took to run an EHR conversion this year without losing referral volume, how Ken decides when to move fast and when to hit the brakes, and why honesty beats optimism when you're asking a whole organization to work in two systems at once. If you're scaling referral operations while keeping the day-to-day running, this conversation is for you. Hatch sponsors the show.

ㅤ

👤 Guest Bio

Ken Takenaka is Director of Operations at Orthopedic + Fracture Specialists, a physician-owned orthopedic practice serving the Portland, Oregon metro since 1933. He spent more than a decade as a certified athletic trainer and a first assistant in the operating room before moving into operations leadership, which gives him a clinical fluency most operators don't have. Today he oversees operations for a roughly 32-provider practice that runs its own ambulatory surgery center and in-house MRI, and he helped lead the practice's recent EHR conversion.

ㅤ

📌 What We Cover

  • How a clinical background changes the way you read operations and talk to physician owners
  • The brakes-on-a-car model for supporting aggressive growth without becoming a blocker
  • Running an EHR conversion with a team that already trusts each other
  • Why honesty about a rocky road beats overselling a smooth one
  • Protecting referral channels when community partners are faxing to old numbers and using old portals
  • Knowing what to measure, and which dips are direct signals versus indirect ones
  • Treating your system's data structure as a goldmine your team can actually use
  • The career advice: growth happens after hours, and complete strangers will help if you ask

ㅤ

🔗 Resources Mentioned


]]>Switching electronic health record systems is one of the riskiest projects a growing specialty practice will take on, and the danger isn't always where teams expect it. On this episode of Scaling Specialty Growth, Joe Zboch sits down with Ken Takenaka, Director of Operations at Orthopedic + Fracture Specialists, a 32-provider physician-owned ortho practice in Portland, Oregon. Ken came up through the clinical side, more than a decade as a certified athletic trainer and a first assistant in the operating room, before moving into operations leadership. They get into what it took to run an EHR conversion this year without losing referral volume, how Ken decides when to move fast and when to hit the brakes, and why honesty beats optimism when you're asking a whole organization to work in two systems at once. If you're scaling referral operations while keeping the day-to-day running, this conversation is for you. Hatch sponsors the show.

ㅤ

👤 Guest Bio

Ken Takenaka is Director of Operations at Orthopedic + Fracture Specialists, a physician-owned orthopedic practice serving the Portland, Oregon metro since 1933. He spent more than a decade as a certified athletic trainer and a first assistant in the operating room before moving into operations leadership, which gives him a clinical fluency most operators don't have. Today he oversees operations for a roughly 32-provider practice that runs its own ambulatory surgery center and in-house MRI, and he helped lead the practice's recent EHR conversion.

ㅤ

📌 What We Cover

  • How a clinical background changes the way you read operations and talk to physician owners
  • The brakes-on-a-car model for supporting aggressive growth without becoming a blocker
  • Running an EHR conversion with a team that already trusts each other
  • Why honesty about a rocky road beats overselling a smooth one
  • Protecting referral channels when community partners are faxing to old numbers and using old portals
  • Knowing what to measure, and which dips are direct signals versus indirect ones
  • Treating your system's data structure as a goldmine your team can actually use
  • The career advice: growth happens after hours, and complete strangers will help if you ask

ㅤ

🔗 Resources Mentioned


]]>1e023893-207f-490f-a833-c00e39ad3de0Tue, 23 Jun 2026 03:00:00 -040020:20falsefull1111Why manual referral tracking scales a practice backward | Misty Sullivan, Care Center Administrator, Proliance Rainier Orthopedic Institute | Ep. 10Why manual referral tracking scales a practice backward | Misty Sullivan, Care Center Administrator, Proliance Rainier Orthopedic Institute | Ep. 10Referrals are how an independent specialty practice grows, and right now most of that work still runs on spreadsheets, paper, and someone's memory. This episode looks at what happens when a practice gets serious about the referral process and treats it as a growth driver instead of a cost of doing business. Joe Zboch sits down with Misty Sullivan, care center administrator at Proliance Rainier Orthopedic Institute, to talk through balancing aggressive growth goals with operational excellence. They get into why customer service has to come first, why access to care is part of the growth conversation, and why manual tracking quietly scales a practice backward. Misty also explains the visibility gap that keeps her up at night, the metrics she wishes she could track, and where an operations leader should actually start. The episode is brought to you by Hatch.

ㅤ

👤 Guest Bio

Misty Sullivan is care center administrator at Proliance Rainier Orthopedic Institute and the Surgery Center at Rainier, a seven-physician orthopedic private practice in the Pacific Northwest and part of the larger Proliance Surgeons group. She oversees roughly 70 employees across a clinic, MRI, X-ray, a four-room surgery center, and a satellite location. She has spent years improving the referral process inside the broader Proliance organization and has also helped primary care clinics learn to process referrals.

ㅤ

📌 What We Cover

  • Why customer service and access to care sit at the front of every growth decision, and why promising referrals you can't see for three months breaks both ㅤ
  • How manual tracking on Excel and paper stops working as a practice grows, and why it costs time, manpower, and money ㅤ
  • The visibility gap leadership often can't see: no single view of how many referrals came in, where they came from, or who worked them ㅤ
  • Why SharePoint and Teams aren't built for processing referrals, including no keyword customization and no way to flag urgency ㅤ
  • The four metrics Misty tracks: referrals received, receipt to first attempt to contact, receipt to schedule, and the reason a patient couldn't be scheduled ㅤ
  • How a process map and training documentation help a lean team onboard, cross-train, and promote from within ㅤ
  • Where to start when getting serious about referral operations: staffing first, then process, then technology

ㅤ

🔗 Resources Mentioned

  • Hatch referral database
  • Qlik (data and reporting)
  • Microsoft SharePoint and Microsoft Teams
  • Excel
  • Puyallup Sumner Chamber of Commerce
  • SWOT analysis
  • Contact Misty: m.sullivan@proliancesurgeons.com

]]>Referrals are how an independent specialty practice grows, and right now most of that work still runs on spreadsheets, paper, and someone's memory. This episode looks at what happens when a practice gets serious about the referral process and treats it as a growth driver instead of a cost of doing business. Joe Zboch sits down with Misty Sullivan, care center administrator at Proliance Rainier Orthopedic Institute, to talk through balancing aggressive growth goals with operational excellence. They get into why customer service has to come first, why access to care is part of the growth conversation, and why manual tracking quietly scales a practice backward. Misty also explains the visibility gap that keeps her up at night, the metrics she wishes she could track, and where an operations leader should actually start. The episode is brought to you by Hatch.

ㅤ

👤 Guest Bio

Misty Sullivan is care center administrator at Proliance Rainier Orthopedic Institute and the Surgery Center at Rainier, a seven-physician orthopedic private practice in the Pacific Northwest and part of the larger Proliance Surgeons group. She oversees roughly 70 employees across a clinic, MRI, X-ray, a four-room surgery center, and a satellite location. She has spent years improving the referral process inside the broader Proliance organization and has also helped primary care clinics learn to process referrals.

ㅤ

📌 What We Cover

  • Why customer service and access to care sit at the front of every growth decision, and why promising referrals you can't see for three months breaks both ㅤ
  • How manual tracking on Excel and paper stops working as a practice grows, and why it costs time, manpower, and money ㅤ
  • The visibility gap leadership often can't see: no single view of how many referrals came in, where they came from, or who worked them ㅤ
  • Why SharePoint and Teams aren't built for processing referrals, including no keyword customization and no way to flag urgency ㅤ
  • The four metrics Misty tracks: referrals received, receipt to first attempt to contact, receipt to schedule, and the reason a patient couldn't be scheduled ㅤ
  • How a process map and training documentation help a lean team onboard, cross-train, and promote from within ㅤ
  • Where to start when getting serious about referral operations: staffing first, then process, then technology

ㅤ

🔗 Resources Mentioned

  • Hatch referral database
  • Qlik (data and reporting)
  • Microsoft SharePoint and Microsoft Teams
  • Excel
  • Puyallup Sumner Chamber of Commerce
  • SWOT analysis
  • Contact Misty: m.sullivan@proliancesurgeons.com

]]>2d9a1723-d2ec-42c0-8fbb-de10f1f2e4b6Tue, 16 Jun 2026 03:00:00 -040024:26falsefull1010Not all growth is good growth | Michelle Winfield-Hanrahan, Chief Clinical Access Officer, UAMS | Ep. 9Not all growth is good growth | Michelle Winfield-Hanrahan, Chief Clinical Access Officer, UAMS | Ep. 9Most specialty groups treat growth as the goal and figure the operations will catch up. This episode is about why that order is backwards. Host Joe Zboch of Hatch sits down with Michelle Winfield-Hanrahan, Chief Clinical Access Officer at the University of Arkansas for Medical Sciences, to work through one idea she opens with and never lets go of: not all growth is good growth. They talk through what it takes to actually support volume, the capacity, the workforce, the financial backing, and the quality of care, before anyone says yes to it. You'll hear how she breaks down a problem when ten people in a room can't agree on what it is, why a referral is a wealth of data most groups ignore, and what changes when you treat the front door as a growth driver instead of the cost of doing business.

ㅤ

👤 Guest Bio

Michelle Winfield-Hanrahan is Chief Clinical Access Officer and Associate Vice Chancellor for Access at UAMS, Arkansas' only academic medical center and the state's only adult Level 1 trauma center. There she oversees enterprise access, care management, utilization, transfers, clinical command operations, and oncology nursing. She came to the role from a nursing foundation and years as a healthcare access consultant, which is where she watched a lot of the patterns she talks about play out across institutions.

ㅤ

📌 What We Cover

  • Why not all growth is good growth, and the four things volume has to line up with before it counts: capacity, workforce, financial backing, and quality of care. ㅤ
  • The hidden gap that sinks a rollout: a group opens a new practice but nobody budgeted the two people needed at the registration desk to check patients in. ㅤ
  • How Michelle triages a problem when a room can't agree, by starting with what most people name rather than jumping straight to the goal. ㅤ
  • The people, process, technology order she works in, and why technology is sometimes the wrong place to start. ㅤ
  • The legacy-work test: figure out where a workflow came from, then ask whether it's still relevant today. ㅤ
  • Why a referral is a wealth of data about what your community and referring providers actually think of you. ㅤ
  • Her 24-hour rule: every referred patient gets reached out to within a day, and why closing the loop with the referring provider keeps volume coming. ㅤ
  • The failed phone line: a competitor's payer went out of network, the institution blasted flyers and a dedicated number, then put one person on a line taking 100 calls an hour.

ㅤ

🔗 Resources Mentioned

  • Service Fanatics: How to Build Superior Patient Experience the Cleveland Clinic Way by James Merlino, MD (the book Michelle's team was reading) ㅤ
  • MyChart, referenced as one of the channels for reaching referred patients ㅤ
  • Hatch, for scaling referral operations to drive growth and efficiency

]]>Most specialty groups treat growth as the goal and figure the operations will catch up. This episode is about why that order is backwards. Host Joe Zboch of Hatch sits down with Michelle Winfield-Hanrahan, Chief Clinical Access Officer at the University of Arkansas for Medical Sciences, to work through one idea she opens with and never lets go of: not all growth is good growth. They talk through what it takes to actually support volume, the capacity, the workforce, the financial backing, and the quality of care, before anyone says yes to it. You'll hear how she breaks down a problem when ten people in a room can't agree on what it is, why a referral is a wealth of data most groups ignore, and what changes when you treat the front door as a growth driver instead of the cost of doing business.

ㅤ

👤 Guest Bio

Michelle Winfield-Hanrahan is Chief Clinical Access Officer and Associate Vice Chancellor for Access at UAMS, Arkansas' only academic medical center and the state's only adult Level 1 trauma center. There she oversees enterprise access, care management, utilization, transfers, clinical command operations, and oncology nursing. She came to the role from a nursing foundation and years as a healthcare access consultant, which is where she watched a lot of the patterns she talks about play out across institutions.

ㅤ

📌 What We Cover

  • Why not all growth is good growth, and the four things volume has to line up with before it counts: capacity, workforce, financial backing, and quality of care. ㅤ
  • The hidden gap that sinks a rollout: a group opens a new practice but nobody budgeted the two people needed at the registration desk to check patients in. ㅤ
  • How Michelle triages a problem when a room can't agree, by starting with what most people name rather than jumping straight to the goal. ㅤ
  • The people, process, technology order she works in, and why technology is sometimes the wrong place to start. ㅤ
  • The legacy-work test: figure out where a workflow came from, then ask whether it's still relevant today. ㅤ
  • Why a referral is a wealth of data about what your community and referring providers actually think of you. ㅤ
  • Her 24-hour rule: every referred patient gets reached out to within a day, and why closing the loop with the referring provider keeps volume coming. ㅤ
  • The failed phone line: a competitor's payer went out of network, the institution blasted flyers and a dedicated number, then put one person on a line taking 100 calls an hour.

ㅤ

🔗 Resources Mentioned

  • Service Fanatics: How to Build Superior Patient Experience the Cleveland Clinic Way by James Merlino, MD (the book Michelle's team was reading) ㅤ
  • MyChart, referenced as one of the channels for reaching referred patients ㅤ
  • Hatch, for scaling referral operations to drive growth and efficiency

]]>dc0f27e8-9f3e-4aa9-b331-c8b4d836f175Tue, 09 Jun 2026 03:00:00 -040024:16falsefull99What ops leaders actually think about AI | Ep. 8What ops leaders actually think about AI | Ep. 8This episode steps back from the guest chair. Joe Zboch, director of marketing at Hatch and host of Scaling Specialty Growth, recaps what five COOs and operations leaders at scaling practices taught him about the job. The throughline surprised him.

ㅤ

He expected operators to be mechanical and formula-driven. What he heard instead was that operations is about people and communication, and that the people part really is the operating system. Listeners get the top three takeaways from the first run of episodes: why people come before process and technology, why you can't optimize before you stabilize, and what operations leaders actually think about AI. It's a short reflection on what it takes to be an operations leader, and a read on where the show is headed next.

ㅤ

📌 What we cover

  • Why people and communication, not a secret-sauce framework, turned out to be the real operating system
  • People first, process second, technology third as the actual order of operations
  • How a quarterly staff forum at DMOS lets feedback bubble up from the roots of the practice to the top
  • The start-small rule: a few chords before the whole song, and why you can't optimize before you stabilize
  • Treating change like a game the team plays together, so tough becomes fun
  • Setting KPIs and milestones so you can right the ship when a plan goes wayward
  • What operations leaders actually think about AI: grow with the staff you have, and let it clear the low-value tasks that lead to burnout
  • Why turnover in coordinator, contact center, and access center roles drops with training and a people-forward approach

]]>This episode steps back from the guest chair. Joe Zboch, director of marketing at Hatch and host of Scaling Specialty Growth, recaps what five COOs and operations leaders at scaling practices taught him about the job. The throughline surprised him.

ㅤ

He expected operators to be mechanical and formula-driven. What he heard instead was that operations is about people and communication, and that the people part really is the operating system. Listeners get the top three takeaways from the first run of episodes: why people come before process and technology, why you can't optimize before you stabilize, and what operations leaders actually think about AI. It's a short reflection on what it takes to be an operations leader, and a read on where the show is headed next.

ㅤ

📌 What we cover

  • Why people and communication, not a secret-sauce framework, turned out to be the real operating system
  • People first, process second, technology third as the actual order of operations
  • How a quarterly staff forum at DMOS lets feedback bubble up from the roots of the practice to the top
  • The start-small rule: a few chords before the whole song, and why you can't optimize before you stabilize
  • Treating change like a game the team plays together, so tough becomes fun
  • Setting KPIs and milestones so you can right the ship when a plan goes wayward
  • What operations leaders actually think about AI: grow with the staff you have, and let it clear the low-value tasks that lead to burnout
  • Why turnover in coordinator, contact center, and access center roles drops with training and a people-forward approach

]]>a8448c77-ff13-47fc-adcb-30103b946921Tue, 02 Jun 2026 03:00:00 -040011:01falsefull88Why deep integration is the harder path in GI | Jenn Muina, Divisional VP, Gastro Health | Ep. 7Why deep integration is the harder path in GI | Jenn Muina, Divisional VP, Gastro Health | Ep. 7Roll-ups are common in specialty healthcare. Deep integration is not. On episode 7 of Scaling Specialty Growth, Joe Zboch sits down with Jenn Muina, Divisional VP for Florida at Gastro Health, to talk about what it actually takes to fold an acquired GI practice into a national specialty operation. Jenn ran M&A integration at Gastro Health before her current role, so she knows the work from the inside.

ㅤ

The conversation covers why Gastro Health chose deep technical integration over a federated model, how the team listens to the front desk before changing anything, and what becomes possible when an entire network sits on one EHR instance. For operators scaling specialty groups through acquisition, this is the playbook from someone who's done the integration work. Brought to you by Hatch.

ㅤ

👤 Guest Bio

Jenn Muina is Divisional Vice President for Florida at Gastro Health, where she leads operations across the founding division of a 7-state, 400+ physician GI platform. Before her current role, she was Director of Integration at Gastro Health, where she co-led M&A integrations and system implementations that shaped the company's operating model. She holds an MBA in Healthcare from Florida International University and is a Lean Six Sigma Green Belt.

ㅤ

📌 What We Cover

  • Why Gastro Health chose deep technical integration over leaving acquired practices on separate systems
  • Building a cross-functional integration team that operates as change agents
  • Listening to front desk staff, schedulers, and intake coordinators before introducing any change
  • How a single EHR instance across divisions makes care-gap data finally addressable
  • Closing recall gaps for patients who would otherwise drift out of the panel
  • The pilot-first approach to new technology and new processes
  • AI as a complement to existing teams, not a replacement
  • Treating AI as both a workflow accelerator and an enabler of net-new workflows

ㅤ

🔗 Resources Mentioned


]]>Roll-ups are common in specialty healthcare. Deep integration is not. On episode 7 of Scaling Specialty Growth, Joe Zboch sits down with Jenn Muina, Divisional VP for Florida at Gastro Health, to talk about what it actually takes to fold an acquired GI practice into a national specialty operation. Jenn ran M&A integration at Gastro Health before her current role, so she knows the work from the inside.

ㅤ

The conversation covers why Gastro Health chose deep technical integration over a federated model, how the team listens to the front desk before changing anything, and what becomes possible when an entire network sits on one EHR instance. For operators scaling specialty groups through acquisition, this is the playbook from someone who's done the integration work. Brought to you by Hatch.

ㅤ

👤 Guest Bio

Jenn Muina is Divisional Vice President for Florida at Gastro Health, where she leads operations across the founding division of a 7-state, 400+ physician GI platform. Before her current role, she was Director of Integration at Gastro Health, where she co-led M&A integrations and system implementations that shaped the company's operating model. She holds an MBA in Healthcare from Florida International University and is a Lean Six Sigma Green Belt.

ㅤ

📌 What We Cover

  • Why Gastro Health chose deep technical integration over leaving acquired practices on separate systems
  • Building a cross-functional integration team that operates as change agents
  • Listening to front desk staff, schedulers, and intake coordinators before introducing any change
  • How a single EHR instance across divisions makes care-gap data finally addressable
  • Closing recall gaps for patients who would otherwise drift out of the panel
  • The pilot-first approach to new technology and new processes
  • AI as a complement to existing teams, not a replacement
  • Treating AI as both a workflow accelerator and an enabler of net-new workflows

ㅤ

🔗 Resources Mentioned


]]>c2fc3922-64fb-407a-8cd0-7e8d4150826bTue, 26 May 2026 03:00:00 -040021:28falsefull77The patient experience is a process problem | Matthew Slater, Administrative Director of Orthopaedic Surgery, UC San Diego Health | Ep. 6The patient experience is a process problem | Matthew Slater, Administrative Director of Orthopaedic Surgery, UC San Diego Health | Ep. 6Patient experience used to be a fuzzy concept in specialty healthcare. It's not anymore. In Episode 6 of Scaling Specialty Growth, Joe Zboch talks with Matthew Slater, Administrative Director of Orthopaedic Surgery at UC San Diego Health, about what it actually takes to grow a specialty practice in a crowded market without letting the operational foundation crack.

ㅤ

They get into the connection between staff experience and patient experience, why most negative reviews are process problems and not care problems, the post-visit text that moved their experience scores, and how strategic hiring tied to access gaps is shaping a growth plan that runs out to 2034. Matthew also previews a new four-story musculoskeletal and neuro-focused building opening in 2029, and closes with a piece of advice pulled from his time as a flight nurse: stop being afraid of the decision.

ㅤ

👤 Guest Bio

Matthew Slater, DHA, MHA, LVN is Administrative Director of Orthopaedic Surgery at UC San Diego Health, where he leads ambulatory operations, access, and patient experience for the nationally ranked Department of Orthopaedic Surgery, the first program in California to earn the Joint Commission's Advanced Certification in Spine Surgery. Before UC San Diego, Matthew held leadership roles at UCLA Health and served as Director of Ambulatory Operations at Barton Health. He serves on the American Alliance of Orthopaedic Executives (AAOE) Education Council.

ㅤ

📌 What We Cover

  • Why staff experience is the foundation that patient experience sits on, and how UC San Diego Health cut turnover by listening and promoting within
  • The post-visit text message that lifted experience scores in the "patient knew what to do after their appointment" category
  • Why most negative reviews are process problems, not care problems
  • A group-interview hiring philosophy where only nines and tens get hired
  • Strategic provider recruiting tied to specific access gaps in subspecialties like hand, foot, and ankle, PM&R, and joints
  • How almost 90% of joints now go home same day, and what that means for how MSK care gets built going forward
  • A growth plan running out to 2034 and a new four-story MSK and neuro building opening in 2029
  • A flight-nurse-era leadership principle: you don't need more data, you need a decision and the willingness to pivot

ㅤ

🔗 Resources Mentioned


]]>Patient experience used to be a fuzzy concept in specialty healthcare. It's not anymore. In Episode 6 of Scaling Specialty Growth, Joe Zboch talks with Matthew Slater, Administrative Director of Orthopaedic Surgery at UC San Diego Health, about what it actually takes to grow a specialty practice in a crowded market without letting the operational foundation crack.

ㅤ

They get into the connection between staff experience and patient experience, why most negative reviews are process problems and not care problems, the post-visit text that moved their experience scores, and how strategic hiring tied to access gaps is shaping a growth plan that runs out to 2034. Matthew also previews a new four-story musculoskeletal and neuro-focused building opening in 2029, and closes with a piece of advice pulled from his time as a flight nurse: stop being afraid of the decision.

ㅤ

👤 Guest Bio

Matthew Slater, DHA, MHA, LVN is Administrative Director of Orthopaedic Surgery at UC San Diego Health, where he leads ambulatory operations, access, and patient experience for the nationally ranked Department of Orthopaedic Surgery, the first program in California to earn the Joint Commission's Advanced Certification in Spine Surgery. Before UC San Diego, Matthew held leadership roles at UCLA Health and served as Director of Ambulatory Operations at Barton Health. He serves on the American Alliance of Orthopaedic Executives (AAOE) Education Council.

ㅤ

📌 What We Cover

  • Why staff experience is the foundation that patient experience sits on, and how UC San Diego Health cut turnover by listening and promoting within
  • The post-visit text message that lifted experience scores in the "patient knew what to do after their appointment" category
  • Why most negative reviews are process problems, not care problems
  • A group-interview hiring philosophy where only nines and tens get hired
  • Strategic provider recruiting tied to specific access gaps in subspecialties like hand, foot, and ankle, PM&R, and joints
  • How almost 90% of joints now go home same day, and what that means for how MSK care gets built going forward
  • A growth plan running out to 2034 and a new four-story MSK and neuro building opening in 2029
  • A flight-nurse-era leadership principle: you don't need more data, you need a decision and the willingness to pivot

ㅤ

🔗 Resources Mentioned


]]>f853000c-bbba-47e5-a58c-81e7eb6f3988Tue, 19 May 2026 03:00:00 -040025:11falsefull66Growing without adding more people | Ross Rigdon, COO, Raleigh Orthopaedic | Ep. 5Growing without adding more people | Ross Rigdon, COO, Raleigh Orthopaedic | Ep. 5Wake County adds 52 net new residents every single day. For a regional orthopedic practice, that's both a tailwind and a pressure test. More patients means more workflow to absorb, more payer rules to navigate, and less margin for operational error as the organization scales.

ㅤ

Joe Zboch sits down with Ross Rigdon, Chief Operations Officer at Raleigh Orthopaedic, to talk through what operational growth actually looks like inside one of North Carolina's largest and oldest independent orthopedic practices. Ross and Joe cover payer compliance, staffing strategy, real-time data visibility, and the implementation philosophy Ross applies to both technology and people. Hatch sponsors this episode.

ㅤ

👤 Guest Bio

Ross Rigdon is the Chief Operations Officer at Raleigh Orthopaedic, the oldest orthopedic practice in eastern and central North Carolina. He's been with the organization for over seven years, moving from Lead DME Clinician and Administrative Fellow to Director of Operations and now COO. He holds an EMT Basic certification and a BS in Exercise Science from the University of North Carolina Wilmington, and is an active member of the American Alliance of Orthopaedic Executives (AAOE).

ㅤ

📌 What We Cover

  • How UnitedHealthcare's separate documentation requirement for imaging interpretation created an immediate workflow problem for orthopedic practices, and why the answer had to come from operations, not compliance alone.
  • Why Ross frames reactive compliance and proactive technology investment as the same job, not two competing priorities.
  • The natural-language AI dashboard Ross is building with his managed IT vendor: what it queries, what it monitors, and why the point isn't AI novelty but faster access to signals already buried in the practice's own data.
  • Why Ross pushes back on the vendor promise of 30-50% staff reductions, and what he thinks the better goal actually is for growing organizations.
  • How Raleigh Orthopaedic approaches staffing retention in a market where patient demand keeps growing and replacing good people is expensive.
  • The implementation philosophy Ross applies equally to technology rollouts and people: start with something small and consistent, get a reliable baseline, then build from it.
  • What Ross tells early-career healthcare administrators about learning every department before trying to lead any of them.

ㅤ

Visit Hatch to learn more about scaling referral operations for specialty practices.

]]>Wake County adds 52 net new residents every single day. For a regional orthopedic practice, that's both a tailwind and a pressure test. More patients means more workflow to absorb, more payer rules to navigate, and less margin for operational error as the organization scales.

ㅤ

Joe Zboch sits down with Ross Rigdon, Chief Operations Officer at Raleigh Orthopaedic, to talk through what operational growth actually looks like inside one of North Carolina's largest and oldest independent orthopedic practices. Ross and Joe cover payer compliance, staffing strategy, real-time data visibility, and the implementation philosophy Ross applies to both technology and people. Hatch sponsors this episode.

ㅤ

👤 Guest Bio

Ross Rigdon is the Chief Operations Officer at Raleigh Orthopaedic, the oldest orthopedic practice in eastern and central North Carolina. He's been with the organization for over seven years, moving from Lead DME Clinician and Administrative Fellow to Director of Operations and now COO. He holds an EMT Basic certification and a BS in Exercise Science from the University of North Carolina Wilmington, and is an active member of the American Alliance of Orthopaedic Executives (AAOE).

ㅤ

📌 What We Cover

  • How UnitedHealthcare's separate documentation requirement for imaging interpretation created an immediate workflow problem for orthopedic practices, and why the answer had to come from operations, not compliance alone.
  • Why Ross frames reactive compliance and proactive technology investment as the same job, not two competing priorities.
  • The natural-language AI dashboard Ross is building with his managed IT vendor: what it queries, what it monitors, and why the point isn't AI novelty but faster access to signals already buried in the practice's own data.
  • Why Ross pushes back on the vendor promise of 30-50% staff reductions, and what he thinks the better goal actually is for growing organizations.
  • How Raleigh Orthopaedic approaches staffing retention in a market where patient demand keeps growing and replacing good people is expensive.
  • The implementation philosophy Ross applies equally to technology rollouts and people: start with something small and consistent, get a reliable baseline, then build from it.
  • What Ross tells early-career healthcare administrators about learning every department before trying to lead any of them.

ㅤ

Visit Hatch to learn more about scaling referral operations for specialty practices.

]]>cb01b339-e602-48a0-a89a-c2980ef61960Tue, 12 May 2026 03:00:00 -040021:33falsefull55Making specialty growth operations a game | Amy Seehafer, COO, OSMS | Ep. 4Making specialty growth operations a game | Amy Seehafer, COO, OSMS | Ep. 4Operations teams in specialty healthcare know what growth feels like from the inside: more clinics, more providers, more volume, and a back-office that's always running behind. This episode looks at how a COO with a fresh-eyed perspective manages that pressure without letting the organization come apart.

ㅤ

Joe Zboch sits down with Amy Seehafer, COO of Orthopedic & Sports Medicine Specialists (OSMS), a physician-owned practice with 40+ providers, 9 locations, and $100M+ in annual revenue across northeast Wisconsin. Amy came from 20 years in HR and shared services operations outside of healthcare. This is her first year and a half in the industry, and she uses that perspective to ask questions her peers stopped asking long ago.

ㅤ

👤 Guest Bio

Amy Seehafer is the COO of OSMS, where she oversees enterprise operations, people strategy, and financial performance across 9 clinical locations and $100M+ in annual revenue. She holds an MBA and dual senior HR certifications (SPHR and SHRM-SCP). Before joining OSMS in September 2024, she spent 20+ years leading shared services operations, organizational design, change management, and HR strategy across complex multi-site environments. Healthcare was new. The ops discipline wasn't.

ㅤ

📌 What We Cover

  • Why Amy's three-part framework — people, process, technology — runs in that exact order, and what happens when practices skip the first two steps
  • How OSMS implemented patient self-scheduling across 9 locations and the "stabilize before you optimize" rule that kept it from derailing
  • The stop/start/continue method OSMS uses to audit processes without the baggage of how things have always been done
  • What Amy and her team discovered by shadowing departments they don't normally work in, and what gets noticed that insiders miss
  • The Goldilocks problem of labor optimization during growth: always slightly over or under, never quite right
  • How formal project management and change management made a new clinic opening feel, in Amy's words, easy
  • Advice for directors moving toward COO-level roles: learn the inputs and outputs of the business before pulling any levers

ㅤ

🔗 Resources Mentioned


]]>Operations teams in specialty healthcare know what growth feels like from the inside: more clinics, more providers, more volume, and a back-office that's always running behind. This episode looks at how a COO with a fresh-eyed perspective manages that pressure without letting the organization come apart.

ㅤ

Joe Zboch sits down with Amy Seehafer, COO of Orthopedic & Sports Medicine Specialists (OSMS), a physician-owned practice with 40+ providers, 9 locations, and $100M+ in annual revenue across northeast Wisconsin. Amy came from 20 years in HR and shared services operations outside of healthcare. This is her first year and a half in the industry, and she uses that perspective to ask questions her peers stopped asking long ago.

ㅤ

👤 Guest Bio

Amy Seehafer is the COO of OSMS, where she oversees enterprise operations, people strategy, and financial performance across 9 clinical locations and $100M+ in annual revenue. She holds an MBA and dual senior HR certifications (SPHR and SHRM-SCP). Before joining OSMS in September 2024, she spent 20+ years leading shared services operations, organizational design, change management, and HR strategy across complex multi-site environments. Healthcare was new. The ops discipline wasn't.

ㅤ

📌 What We Cover

  • Why Amy's three-part framework — people, process, technology — runs in that exact order, and what happens when practices skip the first two steps
  • How OSMS implemented patient self-scheduling across 9 locations and the "stabilize before you optimize" rule that kept it from derailing
  • The stop/start/continue method OSMS uses to audit processes without the baggage of how things have always been done
  • What Amy and her team discovered by shadowing departments they don't normally work in, and what gets noticed that insiders miss
  • The Goldilocks problem of labor optimization during growth: always slightly over or under, never quite right
  • How formal project management and change management made a new clinic opening feel, in Amy's words, easy
  • Advice for directors moving toward COO-level roles: learn the inputs and outputs of the business before pulling any levers

ㅤ

🔗 Resources Mentioned


]]>24aa14c6-6be3-4e03-a61e-8026409fba71Tue, 05 May 2026 03:00:00 -040021:45falsefull44Workers' comp needs more than a referral | Kelli Anderson, COO, DMOS | Ep. 3Workers' comp needs more than a referral | Kelli Anderson, COO, DMOS | Ep. 3Running five clinic locations, 30 physicians, and 50+ PAs and therapists while opening a sixth site takes more than a good plan. It takes someone who knows exactly which dials to turn and when to leave them alone.

ㅤ

In this episode, Joe Zboch sits down with Kelli Anderson, COO at DMOS Orthopaedic Centers in Des Moines, Iowa, to talk about what operational growth actually looks like inside a large, independent orthopedic group.

ㅤ

The conversation covers how DMOS decided to grow their workers' comp service line, the technology gap they found, and the referral portal they built to close it, their process for surfacing ideas from staff, and how Kelli thinks about AI in a way that's grounded in actual operations rather than hype. If you're scaling a specialty group and trying to keep the clinical machine running while also building what's next, this one's for you.

ㅤ

👤 Guest Bio

Kelli Anderson is the Chief Operating Officer at DMOS Orthopaedic Centers, where she's been for over seven years, first as Director of Revenue Cycle, now running operations across all five locations. Before DMOS, she held VP and Director-level roles at Ciox Health, a national health information management company, with deep expertise in ICD-10 coding, clinical documentation, and revenue cycle optimization.

ㅤ

📌 What We Cover

  • How Kelli thinks about keeping daily operations stable while pushing major organizational growth initiatives, and why "keeping the temperature" is the actual job
  • The quarterly employee focus group model DMOS uses to surface frontline ideas, and why one of those conversations changed their social media strategy
  • How DMOS used peer benchmarking through The OrthoForum to identify workers' comp as a growth opportunity worth investing in across people, process, and technology
  • The honest assessment process DMOS ran on their workers' comp service line, feedback gathering, gap analysis, and ultimately landed on a communication portal as the fix
  • Why workers' comp referrals function more like B2B relationships than standard provider referrals, and what that means for how you build your technology stack
  • How Kelli approaches moments when a project hits a wall, fix-it mode vs. step-back mode, and how to tell which one the situation calls for
  • The framework DMOS used to choose Norwalk, Iowa, for their sixth location, zip code heat maps, housing growth data, and a little bit of luck
  • How DMOS is already deploying AI in their call center and urgent injury clinics, and Kelli's filter for deciding which AI to adopt and which to watch from a distance

ㅤ

🔗 Resources Mentioned

  • DMOS Orthopaedic Centers, a Des Moines-based independent orthopedic group, has five locations (sixth opening in Norwalk, Iowa)
  • The OrthoForum, a national organization of privately-owned orthopedic practices; DMOS has been a member for several years
  • Hatch, a referral operations platform for specialty healthcare

]]>Running five clinic locations, 30 physicians, and 50+ PAs and therapists while opening a sixth site takes more than a good plan. It takes someone who knows exactly which dials to turn and when to leave them alone.

ㅤ

In this episode, Joe Zboch sits down with Kelli Anderson, COO at DMOS Orthopaedic Centers in Des Moines, Iowa, to talk about what operational growth actually looks like inside a large, independent orthopedic group.

ㅤ

The conversation covers how DMOS decided to grow their workers' comp service line, the technology gap they found, and the referral portal they built to close it, their process for surfacing ideas from staff, and how Kelli thinks about AI in a way that's grounded in actual operations rather than hype. If you're scaling a specialty group and trying to keep the clinical machine running while also building what's next, this one's for you.

ㅤ

👤 Guest Bio

Kelli Anderson is the Chief Operating Officer at DMOS Orthopaedic Centers, where she's been for over seven years, first as Director of Revenue Cycle, now running operations across all five locations. Before DMOS, she held VP and Director-level roles at Ciox Health, a national health information management company, with deep expertise in ICD-10 coding, clinical documentation, and revenue cycle optimization.

ㅤ

📌 What We Cover

  • How Kelli thinks about keeping daily operations stable while pushing major organizational growth initiatives, and why "keeping the temperature" is the actual job
  • The quarterly employee focus group model DMOS uses to surface frontline ideas, and why one of those conversations changed their social media strategy
  • How DMOS used peer benchmarking through The OrthoForum to identify workers' comp as a growth opportunity worth investing in across people, process, and technology
  • The honest assessment process DMOS ran on their workers' comp service line, feedback gathering, gap analysis, and ultimately landed on a communication portal as the fix
  • Why workers' comp referrals function more like B2B relationships than standard provider referrals, and what that means for how you build your technology stack
  • How Kelli approaches moments when a project hits a wall, fix-it mode vs. step-back mode, and how to tell which one the situation calls for
  • The framework DMOS used to choose Norwalk, Iowa, for their sixth location, zip code heat maps, housing growth data, and a little bit of luck
  • How DMOS is already deploying AI in their call center and urgent injury clinics, and Kelli's filter for deciding which AI to adopt and which to watch from a distance

ㅤ

🔗 Resources Mentioned

  • DMOS Orthopaedic Centers, a Des Moines-based independent orthopedic group, has five locations (sixth opening in Norwalk, Iowa)
  • The OrthoForum, a national organization of privately-owned orthopedic practices; DMOS has been a member for several years
  • Hatch, a referral operations platform for specialty healthcare

]]>7f20cd68-c225-4cd2-9d1d-de6e19761db4Tue, 28 Apr 2026 03:00:00 -040022:58falsefull33The referral workflow nobody digitized | Chris Poole, CEO, Hatch | Ep. 2The referral workflow nobody digitized | Chris Poole, CEO, Hatch | Ep. 2Referral management is the front door of specialty care. Most front doors are broken. This episode of Scaling Specialty Growth gets into why: fragmented workflows, no real data, and a process that hasn't been digitized despite decades of EHR adoption everywhere else. Joe Zboch sits down with Chris Poole, CEO of Hatch, to pull apart why specialty practices are still muscling referrals through with bodies, and what it actually costs them.

ㅤ

Chris brings a rare combination of venture capital experience, early-stage healthcare startup operations, and a front-row seat to the referral data problem through Hatch's work with leading specialty groups. This conversation covers the gap between what executives think they know about their referral pipeline and what the data, if they had it, would actually show.

ㅤ

👤 Guest Bio

Chris Poole is CEO of Hatch, the referral management platform built for specialty care. Before Hatch, he served as Managing Director at 25m Health, a LifePoint Health-backed venture studio, and as CFO of MetaPhy Health, a virtual care company serving gastroenterology practices. He also spent years as a Principal at Solidus Company, LP, an early-stage venture capital firm focused on healthcare. He holds an MBA from the University of Chicago Booth School of Business.

ㅤ

📌 What We Cover

  • Why specialty practice CEOs consistently overestimate the quality and completeness of their referral data, and what they're actually working with
  • The "muscling referrals through with bodies" problem: how front offices absorb broken infrastructure with manual labor
  • Why the EHR has never been the right tool for referral management, and what it actually costs per referral to work around that ($30 on average, more for workers' comp)
  • How slow patient outreach, days or weeks after the referral is made, kills referral-to-appointment conversion before the team even gets to the phone call
  • What referral leakage looks like in practice: groups reaching out twice and stopping, leaving pools of unconverted patients untouched
  • The case for a referral-first architecture: why referral management has to be the core product, not a feature bolted onto an EHR or patient engagement tool
  • Hatch's current results: 30% reduction in administrative time per referral today, with a target of 50%+ by the end of the year, and full automation of a subset of referrals in development
  • How private digital access doors and co-branded referral portals create VIP access lanes for employers and high-value referring partners

ㅤ

🔗 Resources Mentioned


]]>Referral management is the front door of specialty care. Most front doors are broken. This episode of Scaling Specialty Growth gets into why: fragmented workflows, no real data, and a process that hasn't been digitized despite decades of EHR adoption everywhere else. Joe Zboch sits down with Chris Poole, CEO of Hatch, to pull apart why specialty practices are still muscling referrals through with bodies, and what it actually costs them.

ㅤ

Chris brings a rare combination of venture capital experience, early-stage healthcare startup operations, and a front-row seat to the referral data problem through Hatch's work with leading specialty groups. This conversation covers the gap between what executives think they know about their referral pipeline and what the data, if they had it, would actually show.

ㅤ

👤 Guest Bio

Chris Poole is CEO of Hatch, the referral management platform built for specialty care. Before Hatch, he served as Managing Director at 25m Health, a LifePoint Health-backed venture studio, and as CFO of MetaPhy Health, a virtual care company serving gastroenterology practices. He also spent years as a Principal at Solidus Company, LP, an early-stage venture capital firm focused on healthcare. He holds an MBA from the University of Chicago Booth School of Business.

ㅤ

📌 What We Cover

  • Why specialty practice CEOs consistently overestimate the quality and completeness of their referral data, and what they're actually working with
  • The "muscling referrals through with bodies" problem: how front offices absorb broken infrastructure with manual labor
  • Why the EHR has never been the right tool for referral management, and what it actually costs per referral to work around that ($30 on average, more for workers' comp)
  • How slow patient outreach, days or weeks after the referral is made, kills referral-to-appointment conversion before the team even gets to the phone call
  • What referral leakage looks like in practice: groups reaching out twice and stopping, leaving pools of unconverted patients untouched
  • The case for a referral-first architecture: why referral management has to be the core product, not a feature bolted onto an EHR or patient engagement tool
  • Hatch's current results: 30% reduction in administrative time per referral today, with a target of 50%+ by the end of the year, and full automation of a subset of referrals in development
  • How private digital access doors and co-branded referral portals create VIP access lanes for employers and high-value referring partners

ㅤ

🔗 Resources Mentioned


]]>6730fe6c-a21b-4d3f-8f6c-8daf91ccfdf5Tue, 21 Apr 2026 03:00:00 -040024:54falsefull22Rising costs and specialty org growth | Chris Poole, CEO, Hatch | Ep. 1Rising costs and specialty org growth | Chris Poole, CEO, Hatch | Ep. 1Rising costs and shrinking reimbursements are creating severe margin compression for specialty healthcare practices. To survive and expand, organizations must focus on sustainability. Joe Zboch sits down with Chris Poole to discuss the macro forces impacting operations and access leaders today.

ㅤ

They outline how practices are balancing top-line volume with minimizing operational expenses to improve patient yield. Chris explains why relying on manual paperwork and throwing bodies at administrative problems is no longer a viable path. The conversation points directly at the top of the funnel: the highly fragmented referral process.

ㅤ

Operations leaders will hear exactly why up to half of all referrals never convert to appointments. Fixing this leakage removes administrative bloat and builds stronger relationships with referring physicians. The discussion provides clear focus areas for teams working to bring down operational costs while driving patient volume.

ㅤ

👤 Guest Bio

Chris Poole is the CEO of Hatch and a three-time healthcare CEO. He is an industry veteran with experience in venture capital and health system innovation. Chris started his career as an accountant before moving into healthcare investing and operations. A decade ago, he founded a virtual care company where he learned firsthand the importance of removing administrative bloat to improve both the practice bottom line and the patient experience.

ㅤ

📌 What We Cover

  • Overcoming margin compression by balancing top-line volume with the complexity of patient yield.
  • Moving away from throwing bodies at manual tasks to create sustainable front-office models.
  • Treating the patient referral process as a strategic business function to capture critical consumer insights.
  • Identifying where patient leakage happens to prevent up to half of all referrals from falling through the net.
  • Differentiating your specialty practice through evidence-based site selection and improved patient convenience.
  • Strengthening relationships with referring physicians by modernizing the top of the funnel.

ㅤ

🔗 Resources Mentioned


]]>Rising costs and shrinking reimbursements are creating severe margin compression for specialty healthcare practices. To survive and expand, organizations must focus on sustainability. Joe Zboch sits down with Chris Poole to discuss the macro forces impacting operations and access leaders today.

ㅤ

They outline how practices are balancing top-line volume with minimizing operational expenses to improve patient yield. Chris explains why relying on manual paperwork and throwing bodies at administrative problems is no longer a viable path. The conversation points directly at the top of the funnel: the highly fragmented referral process.

ㅤ

Operations leaders will hear exactly why up to half of all referrals never convert to appointments. Fixing this leakage removes administrative bloat and builds stronger relationships with referring physicians. The discussion provides clear focus areas for teams working to bring down operational costs while driving patient volume.

ㅤ

👤 Guest Bio

Chris Poole is the CEO of Hatch and a three-time healthcare CEO. He is an industry veteran with experience in venture capital and health system innovation. Chris started his career as an accountant before moving into healthcare investing and operations. A decade ago, he founded a virtual care company where he learned firsthand the importance of removing administrative bloat to improve both the practice bottom line and the patient experience.

ㅤ

📌 What We Cover

  • Overcoming margin compression by balancing top-line volume with the complexity of patient yield.
  • Moving away from throwing bodies at manual tasks to create sustainable front-office models.
  • Treating the patient referral process as a strategic business function to capture critical consumer insights.
  • Identifying where patient leakage happens to prevent up to half of all referrals from falling through the net.
  • Differentiating your specialty practice through evidence-based site selection and improved patient convenience.
  • Strengthening relationships with referring physicians by modernizing the top of the funnel.

ㅤ

🔗 Resources Mentioned


]]>81ed96fb-1efc-4150-bee3-183477b04598Tue, 14 Apr 2026 03:00:00 -040020:50falsefull11Welcome To Scaling Specialty Growth!Welcome To Scaling Specialty Growth!Welcome to Scaling Specialty Growth

In specialty healthcare, growth is not optional. Scaling an organization while maintaining operational excellence and a world-class experience is the hard part. Welcome to Scaling Specialty Growth, the podcast dedicated to navigating those exact challenges.

Host Joe Zboch, Director of Marketing at Hatch, goes deep with the leaders who are actively doing the work. The show bridges the gap between high-level planning and daily execution.

‎ㅤ

What to Expect

Every week, Joe explores the practical realities of scaling specialty clinics. The conversations cover the entire spectrum of healthcare operations to give you actionable takeaways.

• Designing efficient front office workflows.

• Developing high-level boardroom strategies.

• Turning ambitious growth goals into a daily operational reality.

ㅤ‎

Who Should Listen

If you are responsible for leading growth and making sure those targets translate into actual operational results, this show is for you. Joe brings you the insights needed to keep your practice moving forward without sacrificing the patient experience.

]]>Welcome to Scaling Specialty Growth

In specialty healthcare, growth is not optional. Scaling an organization while maintaining operational excellence and a world-class experience is the hard part. Welcome to Scaling Specialty Growth, the podcast dedicated to navigating those exact challenges.

Host Joe Zboch, Director of Marketing at Hatch, goes deep with the leaders who are actively doing the work. The show bridges the gap between high-level planning and daily execution.

‎ㅤ

What to Expect

Every week, Joe explores the practical realities of scaling specialty clinics. The conversations cover the entire spectrum of healthcare operations to give you actionable takeaways.

• Designing efficient front office workflows.

• Developing high-level boardroom strategies.

• Turning ambitious growth goals into a daily operational reality.

ㅤ‎

Who Should Listen

If you are responsible for leading growth and making sure those targets translate into actual operational results, this show is for you. Joe brings you the insights needed to keep your practice moving forward without sacrificing the patient experience.

]]>e4a0e63e-b186-4461-bb42-2a255ff4b46dTue, 07 Apr 2026 04:00:00 -040000:29falsetrailer