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

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

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

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)

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

• Hatch — referral operations software, sponsor of Scaling Specialty Growth
• Ken Takenaka on LinkedIn

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

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

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

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

• Gastro Health
• Hatch
• Jenn Muina on LinkedIn
• Joe Zboch on LinkedIn

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

• UC San Diego Health
• American Alliance of Orthopaedic Executives (AAOE)
• Epic
• MyChart
• The Joint Commission's Advanced Certification in Spine Surgery
• The Petco vaccination superstation
• Hatch

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.

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

• Orthopedic & Sports Medicine Specialists (OSMS)
• Hatch — mentioned in the episode outro

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

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

• Hatch, the referral management platform discussed throughout
• Joe Zboch on LinkedIn
• Chris Poole on LinkedIn

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

• Hatch
• Starbucks: location selection case study

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.