Latest / Becker’s Healthcare Podcast / Leading Through Growth, Scale, and Change in Orthopedics with Dr. Brian Cole

Transcript

Leading Through Growth, Scale, and Change in Orthopedics with Dr. Brian Cole · Becker’s Healthcare Podcast

• 0:02
  - The playbook for running a successful ASC in
• 0:04
  - 2026
• 0:06
  - looks almost nothing like it did a few
• 0:07
  - years ago.
• 0:08
  - And the one for 2029
• 0:10
  - probably won't look like this one either.
• 0:12
  - Case complexity is increasing. Payer models are shifting.
• 0:16
  - Technology is creating new possibilities
• 0:18
  - and new cost pressures at the same time.
• 0:21
  - The spine and orthopedic leaders who are staying
• 0:24
  - ahead aren't just keeping up with the changes.
• 0:27
  - They are in rooms where the changes get
• 0:28
  - talked about honestly.
• 0:30
  - Becker's twenty third annual spine, orthopedic, and pain
• 0:33
  - management driven ASC conference is such a space.
• 0:37
  - More than 1,000 attendees,
• 0:39
  - 275
• 0:40
  - plus physician and ASC speakers, three days of
• 0:43
  - programming across the clinical,
• 0:45
  - operational, and strategic
• 0:47
  - with CME credits available.
• 0:49
  - Join us June eleventh through the thirteenth
• 0:52
  - for the agenda and event details. Visit Becker's
• 0:55
  - Hospital Review and click on the events tab
• 0:57
  - in the upper
• 0:58
  - right. This is Gracelyn Keller with the Becker's
• 1:00
  - Healthcare Podcast, and we are recording live at
• 1:02
  - the twenty third annual Spine Orthopedic and Pain
• 1:05
  - Management Driven ASC Conference.
• 1:07
  - I'm currently joined by doctor Brian Cole, who
• 1:09
  - is the chair of Orthopedics at Rush, a
• 1:11
  - managing partner at Midwest Orthopedics,
• 1:14
  - and a sports medicine orthopedic surgeon. So doctor
• 1:16
  - Cole, thank you for being here. I'll have
• 1:18
  - you start off by briefly introducing yourself and
• 1:20
  - telling us a little bit more about your
• 1:22
  - roles and organizations
• 1:24
  - and what currently is commanding most of your
• 1:25
  - time and attention as leader.
• 1:28
  - So thank you, and, great to be here.
• 1:29
  - And, congratulations to Becker's to another successful meeting.
• 1:33
  - So,
• 1:34
  - I am basically, my day job is, essentially
• 1:37
  - at least a four pronged.
• 1:39
  - I am a orthopedic surgeon. I say most
• 1:42
  - relevant because I my job is to take
• 1:43
  - care of people. I do shoulder, elbow, knee
• 1:45
  - surgery, and, I'm,
• 1:48
  - a partner at Midwest Orthopedics at Rush.
• 1:51
  - I also serve as team physician for a
• 1:53
  - number of Chicago sports teams, but,
• 1:55
  - probably the most involved has been the Chicago
• 1:57
  - Bulls for the last twenty one years or
• 2:00
  - so. My administrative role is actually pretty significant
• 2:03
  - as well because I'm
• 2:04
  - a managing partner of Midwest Orthopedics at Rush,
• 2:06
  - which is a
• 2:08
  - multispecialty,
• 2:09
  - academic
• 2:10
  - orthopedic group, one of the largest in the
• 2:12
  - region.
• 2:13
  - And, having recently aggregated with two other groups,
• 2:16
  - we've now have a substantial footprint now in
• 2:18
  - the Midwest and, as a private independent orthopedic
• 2:21
  - group. And then, as importantly, I'm the chair
• 2:24
  - of the Department of Orthopedic Surgery, which has
• 2:26
  - been around for nearly fifty years, which is,
• 2:29
  - the education and research,
• 2:31
  - side of the equation, which is we have
• 2:33
  - at least,
• 2:34
  - 20 basic scientists and technicians and,
• 2:37
  - who perform basic science research in orthopedics,
• 2:40
  - as well as, collaboratively working on the residency
• 2:43
  - and the fellowship training programs.
• 2:46
  - Wonderful. Well, thank you for taking the time
• 2:48
  - to be here. And let's start our
• 2:50
  - conversation with, in a year marked by rapid
• 2:52
  - change, what recent decision or pivot required the
• 2:55
  - most leadership conviction from you, particularly when it
• 2:57
  - came to aligning people, resources, or capabilities?
• 3:01
  - We've recognized over the last,
• 3:03
  - three to five years how important
• 3:05
  - size and scale is. You know, we live
• 3:07
  - in a world in health care where it's
• 3:09
  - one of the few businesses
• 3:11
  - as a provider where
• 3:13
  - our cost structure
• 3:14
  - is exposed to sort of a free market
• 3:16
  - economy, yet our revenue structure is not. And
• 3:19
  - that mismatch creates lots of additional challenges that
• 3:22
  - we have to adapt to. So what we
• 3:23
  - have recognized is that,
• 3:25
  - we needed to get, bigger, more aligned with
• 3:28
  - other like minded organizations. So probably one of
• 3:31
  - the most significant transformative
• 3:33
  - things that we've done have included
• 3:35
  - an aggregation with, like minded groups, like quality
• 3:38
  - groups,
• 3:40
  - to create an entity that is called Ortho
• 3:42
  - Midwest,
• 3:43
  - which is essentially an an aggregation of of
• 3:46
  - regional groups that's expanded our footprint, improves, significant,
• 3:50
  - administrative efficiencies and sort of the economics as
• 3:53
  - well as, I would say, giving us a
• 3:55
  - an important seat, dealing with some of the
• 3:57
  - headwinds that we see day to day, as
• 4:00
  - per as health care providers.
• 4:02
  - And thinking about that, how did it change
• 4:05
  - your assumptions or challenge your assumptions, and what
• 4:07
  - did that change about your approach to decision
• 4:10
  - making, talent, or organizational readiness today?
• 4:13
  - Yeah. It's a tougher question. I would say
• 4:16
  - that, when leading organizations,
• 4:18
  - it's important that people are heard,
• 4:21
  - that,
• 4:23
  - unanimity
• 4:23
  - is often difficult to achieve, but building consensus
• 4:27
  - vis a vis working with ideas from multiple
• 4:29
  - stakeholders. You know, what happens is as you
• 4:31
  - do get bigger, you also have, more stakeholders,
• 4:34
  - who have opinions that engage or disengage at
• 4:37
  - various times. So managing,
• 4:39
  - the sorry. I would say almost the HR
• 4:41
  - side of it is remains one of the
• 4:43
  - biggest challenges,
• 4:45
  - to sort of move an organization forward. So
• 4:47
  - I would say that when you're when you're
• 4:49
  - dealing with organizational structure, one of the the
• 4:51
  - the I'd say the the biggest challenge, but
• 4:53
  - also what's particularly satisfying is how do you
• 4:55
  - create the most alignment so that that to
• 4:56
  - meet the needs of most knowing that with
• 4:58
  - every decision, there's gonna be sort of winners
• 5:00
  - and losers. That being said, as long as
• 5:02
  - it moves the organization forward knowing that it's
• 5:04
  - impossible to achieve unanimity
• 5:06
  - with most complex decisions, I think accepting that,
• 5:08
  - but then continue and embrace it has been,
• 5:10
  - you know, one of the biggest challenge, but
• 5:12
  - also remain very satisfying from a cultural perspective.
• 5:16
  - And shifting gears slightly, when you think about
• 5:18
  - the forces reshaping health care right now, where
• 5:20
  - do you believe leaders need to be more
• 5:22
  - decisive, especially while balancing speed, risk, and having
• 5:25
  - the right teams in place?
• 5:27
  - I would say that, you know, the the
• 5:29
  - first thing
• 5:31
  - is always whatever decisions are made whatever decisions
• 5:34
  - are made, they have have to really respect
• 5:37
  - an underlying culture. So if you always go
• 5:39
  - back to culture of an organization
• 5:42
  - and
• 5:43
  - understand that that's why people are present, that's
• 5:45
  - why they're there, that's why they're engaged,
• 5:47
  - Making hard decisions that at its very core
• 5:50
  - represent the culture is probably
• 5:52
  - one of the most important aspects of maintaining
• 5:55
  - sort of a sustainable
• 5:56
  - environment.
• 5:58
  - We have a lot of forces that are
• 6:01
  - not directly in our control, but meeting those
• 6:03
  - forces requires
• 6:05
  - it's it's a big lift, and it and
• 6:07
  - it's a it requires a concerted effort by
• 6:09
  - all the stakeholders that are involved in helping
• 6:11
  - move the needle. So from my perspective, some
• 6:14
  - of the biggest challenges are, again, that we
• 6:16
  - live with the we work and live in
• 6:17
  - an environment as health care providers where at
• 6:19
  - our basic core where there we our desire
• 6:21
  - is to help take care of people, to
• 6:22
  - provide access by quality, to minimize complications, to
• 6:26
  - do it in an economically sensible way.
• 6:28
  - At the same time, we've gotta navigate forces
• 6:31
  - that are outside the organization.
• 6:33
  - But what brings the satisfaction day to day
• 6:36
  - is is the culture of an organization that
• 6:38
  - we work for and leaning into that. And
• 6:40
  - that's something as simple as a mission statement,
• 6:43
  - or a vision statement and and staying in
• 6:46
  - touch with that. At the same time, making
• 6:48
  - decisions that are aligned with that, that keeps
• 6:50
  - people at the table, keeps them happy with
• 6:51
  - what they do, keeps them motivated,
• 6:53
  - and keeps them engaged and keeps them loyal
• 6:55
  - to the organization. And that that to me
• 6:57
  - has been a prevailing tenant,
• 6:59
  - when I've been in a position to work
• 7:01
  - collaboratively with with others, all of whom have
• 7:03
  - important opinions that sort of factor into the
• 7:06
  - the success of the organization.
• 7:08
  - And as we wrap up our conversation,
• 7:11
  - I'd love to know that while uncertainty has
• 7:14
  - become the norm, what leadership habits or mindsets
• 7:17
  - have been most critical in keeping your organization
• 7:19
  - and your people moving forward?
• 7:21
  - What's been most important for me, I is
• 7:24
  - when I reflect back on very big decisions
• 7:26
  - that we've made is the ability to
• 7:29
  - base
• 7:30
  - important decisions on principles.
• 7:33
  - So identifying the principles that are uniformly important
• 7:36
  - to others
• 7:37
  - and then making decisions based on those principles
• 7:41
  - without sort of re reverse engineering the outcome.
• 7:44
  - The challenge is that, you know, very hard
• 7:47
  - decisions that impact
• 7:49
  - many people,
• 7:51
  - will never achieve
• 7:53
  - unanimity because as I've already alluded to, there's
• 7:55
  - always gonna be someone who comes out on
• 7:57
  - top and who's someone who's as I did,
• 7:59
  - it's a winner and a loser scenario. And
• 8:01
  - it's not a loser may be a little
• 8:02
  - bit harsh, but some people are benefited more
• 8:04
  - than others.
• 8:05
  - But if the principles guide the decision making,
• 8:09
  - it's very hard to argue,
• 8:11
  - based upon principle,
• 8:12
  - at least in an honest way,
• 8:14
  - when something when a decision is made that
• 8:17
  - doesn't necessarily benefit all people in the same
• 8:20
  - way. So, it goes back to a general
• 8:22
  - principle of maintaining
• 8:24
  - identifying the culture of an organization, creating a
• 8:27
  - sustainable path to maintain that,
• 8:29
  - making sure people are heard, taking ideas and
• 8:32
  - incorporating them into the final solution where it
• 8:33
  - makes sense, but making a cutoff and a
• 8:36
  - hard decision that may not,
• 8:38
  - benefit all all part all all individuals at
• 8:40
  - the same time. And at the same time,
• 8:42
  - just leaning back on the principles that led
• 8:44
  - to that decision making process to begin with.
• 8:47
  - Absolutely. Well, doctor Cole, thank you so much
• 8:49
  - for joining me today on the Becker's Healthcare
• 8:51
  - podcast to share these thoughts and insights. And,
• 8:53
  - again, we are recording live at the twenty
• 8:55
  - third annual Spine Orthopedic and Pain Management Driven
• 8:58
  - ASC Conference.
• 8:59
  - Thank you,
• 9:02
  - Grace. Okay.