Scaling Specialty Growth

Hatch
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In 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.

  1. 6h ago

    Growing revenue when you can't add providers | Holleigh Seales, Practice Administrator, Rheumatology Associates | Ep. 24

    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 prioritizeThe 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 obviousPiloting a new service with one to three providers first, selected by interest, comfort with technology, and how they manage changeFour to five years of vetting in-office dispensing alongside other Birmingham rheumatology practices before pulling the triggerHow Medicare's Part D maximum out-of-pocket change made it possible to take back ownership of treating Advantage patients in-houseReading referral patterns for gaps: inflammatory patients get prioritized, while a large osteoporosis population comes in behind themWellness infusions and GLP-1s as cash services in a specialty where biologics are expensive and reimbursement keeps decliningThe annual patient letter with her direct contact information, and why patients reveal what you need nextRunning the concierge pilot on her own shoulders so no one inherits a bottleneck she hasn't found yet ㅤ 🔗 Resources Mentioned National Organization of Rheumatology Management (NORM)Bundles of Hope Diaper BankHatch

  2. Sep 15

    Why bigger is better, especially for independents | Alejandro Fernandez, CEO, Synergy Orthopedics | Ep. 23

    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 pageHow a bigger group moves business from the higher cost of care into the lowest cost of care, and why payers reward itWhy very few programs pay for quality and almost all of them still pay for volumeWhat open scheduling looks like when it works: filling tomorrow's 10:00 AM no-show by texting the people already waitingHow to give a health system a reason to partner with you when PCPs are getting acquiredWhy the sports teams run through workers' comp, and what a specialized team for prior authorizations and RFAs makes possibleHow falling MRI reimbursement and rising magnet costs turned throughput into the marginWhy 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 SpecialistsAmerican Alliance of Orthopaedic Executives, which named Alex Practice Executive of the Year in 2024GE, referenced as the scanner platform for the group's AI imaging deviceOpenAI, ChatGPT, and Claude, named as the general purpose tools the practice is not using for its playbook workU.S. Department of Labor, the workers' comp carrier for the group's federal patient volumeHatch

  3. Sep 8

    What to check before a health system partnership | Larry Epstein, CEO, Pediatric Urology Associates | Ep. 22

    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 revenueHow independent groups in the Metro New York market went from 75 to 80 percent of practices down to under 35 percent in about twenty yearsWhy the birth rate is a growth constraint for a pediatric subspecialty, and what Larry assessed first when he arrivedWhy three or four private equity reviews went nowhere: no drug revenue and no owned surgical services to support the valuationWhat "plan B" looked like, including the ER and NICU coverage relationships that opened the health system conversationThe red flags to listen for when a partner describes their 24 to 36 month plan for your service lineHow an in-office ultrasound credentialing conflict nearly stalled integration, and the 12 to 24 month commitment that resolved itWhy referring physicians and patient access are the two things that protect volume through a transition ㅤ 🔗 Resources Mentioned HatchPediatric Urology AssociatesNYU Langone Health

  4. Sep 1

    Operational excellence is the rate limiting factor for growth | Cecily Sheats, Executive Director, Creekside Surgery Center | Ep. 21

    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 demandThe process improvement available before you invest in FTEs or technologyWhat "dare to reimagine, even in crowded spaces" looks like in an organization that remembers every idea that floppedHow department-level strategic planning replaces the plan that ends up on a shelf collecting dustThe three-legged stool behind her employee incentive model: organizational goal, personal accountability, team SMART goalsHow 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 EMRThe difference between "hey, great job" and "hey, I noticed," and why reviews became development sessions ㅤ 🔗 Resources Mentioned Creekside Surgery CenterAlaska Healthcare Executives NetworkProvidenceSimon SinekLean Six SigmaSMART goalsHatch

  5. Aug 25

    The patient experience doesn’t stop after the front door | Kaydi Siebeck, Patient Access Manager, Moreland OB-GYN Associates | Ep. 20

    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 atWhere technology takes over: e-check-in, document upload, automatic messages, orders and referrals placedWhy 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 boardThe nurse care team model: one schedule per provider's nurse, reserved rooms, blocked time for follow-up callsThe survey comments and phone routing data behind the decision, including patients asking for specific staff by nameWhat the soft opening caught: appointment types the system couldn't build and not enough roomsWhere growth comes from for an OB-GYN specialist: family practice referrals, high schools, networking through the affiliated health system ㅤ 🔗 Resources Mentioned Moreland OB-GYN AssociatesHatchScaling Specialty Growth, hosted by Joe Zboch and Chris Poole

  6. Aug 18

    Orthopedic growth after your referral base shifts | Thomas Fondren, CEO, Advanced Orthopedics of Oklahoma | Ep. 19

    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 relationshipsDiversification on three angles at once: geographic, service line, and payer, including orthobiologics, eight PT clinics, and an incoming rheumatologist with infusionsWhy cost and ROI get asked at the back end of the strategic plan, not the frontWhat the practice learned about its own spend after going self-insured: pharmacy first, orthopedics second, and it owns bothBuilding executive forums for local execs and HR benefits leaders, and what happened when Thomas ran this playbook in Oklahoma CityWhy the bone health program got canceled even though the drugs workThe three or four AI categories worth touching: document management, prior auth, and codingWhy the exec team's relationship with the board and shareholders decides whether an 18-month project survives month seven ㅤ 🔗 Resources Mentioned Hatch — episode sponsorAdvanced Orthopedics of OklahomaAscension St. JohnTranscarent, Carrum Health, Contigo Health, Ready Rebound

  7. Aug 11

    Access is different depending on where the patient came from | Jason Muchow, CEO, Advanced Bone & Joint | Ep. 18

    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 reorgThe board's day-two charge: execute on growth and sustain the team already in placeMapping the patient journey from the point of decision through discharge, billing, and paymentHow to tell whether friction comes from the tool, the implementation, the training, or a bolt-on under the EMRWhy online scheduling only worked for established patients, and what new patients had to do insteadWhat happened to the local primary care referral base over the last ten yearsWord of mouth as a referral source in a market with 40 years of history behind itEmployers and brokers as a new access conversation, and where orthopedic urgent care fits against the ED ㅤ 🔗 Resources Mentioned The First 90 Days by Michael D. WatkinsHatch, for the 24/7/365 injury chat capabilityAdvanced Bone & Joint

  8. Aug 4

    Expanding orthopedic access without adding physicians | Alissa Ashley-High, Practice Administrator, Orthopaedic Associates of Marlborough | Ep. 17

    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 firstHow sitting next to the core turns everyday conversation into the practice's operational feedback loopWhat a hyaluronic acid injection actually cost in staff hours before the practice stopped doing itHow an AAOE peer-reviewed vendor relationship brought that service back without making it a revenue playOAM NOW, the virtual orthopedic urgent care partnership that expanded access without adding physicians or office hoursCompeting with Boston when you have no parking fees and no hidden facility feesTaking prior authorization and Medicare reimbursement to Capitol Hill with AAOE and AAOSMoving from 50 years of word of mouth into reviews, social, and a survey platform feeding Healthgrades, Yelp, WebMD, and Google ㅤ 🔗 Resources Mentioned Orthopaedic Associates of MarlboroughAAOE, the American Alliance of Orthopaedic ExecutivesAAOS, the American Academy of Orthopaedic SurgeonsOAM NOW, the practice's virtual orthopedic urgent care partnershipAAOE Women in Medical Practice Management ConferenceHealthgrades, Yelp, WebMD, GoogleHatch

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In 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.

Information

  • Creator
    Hatch
  • Years Active
    2026
  • Episodes
    25
  • Rating
    Clean
  • Copyright
    © Copyright 2026 Hatch
  • Show Website
    Scaling Specialty Growth