Latest / Becker’s Healthcare -- Pediatric Leadership Podcast / Larry Epstein, MPA, CMPE, Chief Executive Officer of Pediatric Urology Associates (PUA)

Transcript

Larry Epstein, MPA, CMPE, Chief Executive Officer of Pediatric Urology Associates (PUA) · Becker’s Healthcare -- Pediatric Leadership Podcast

• 0:00
  This is Randy Homan with the Becker's Healthcare Podcast.
• 0:03
  I'm thrilled today to be joined by Lawrence Epstein.
• 0:06
  He's the CEO at Pediatric Urology Associates, PC Lawrence,
• 0:10
  would you please introduce yourself and tell us a little bit about your
• 0:13
  background?
• 0:15
  Well, I go by Larry.
• 0:17
  I've been in ambulatory physician practice management
• 0:22
  as I've been told to reference it these days for the last 32 years.
• 0:27
  Uh, my current role is as a CEO of a subspecialty pediatric practice,
• 0:32
  which is a dinosaur in the field and we'll get into that more detail, uh,
• 0:37
  as being independent for the last three and a half years in the tri-state
• 0:42
  New York area with a specific emphasis in urology.
• 0:46
  Perfect. Thank you. What are your top priorities today?
• 0:50
  Well, today our,
• 0:52
  our real top priorities are building back are base provider
• 0:56
  group. Uh,
• 0:57
  we've lost a couple of providers recently due to a variety of functions,
• 1:02
  some of them pre pandemic changes into practice as well as post
• 1:07
  pandemic, uh, stress on the group. Uh,
• 1:10
  and that that's not just physicians but uh,
• 1:14
  nurse practitioners and PAs who are independent providers under our specialty.
• 1:18
  Uh, as well as just trying to manage our cash flow,
• 1:24
  uh, to meet the needs of a growing cost base and a growing,
• 1:30
  uh, employee request base for more money on a day to day basis for the obvious
• 1:34
  reasons of heightened inflation and heightened cost pressures.
• 1:39
  Mm-hmm. , definitely. How are you trying to do that?
• 1:42
  Uh, variety of ways. Uh,
• 1:44
  we're going back for the nurse practitioners and looking at not keeping them
• 1:49
  as uh, base salaried or hour lead employees,
• 1:53
  but uh,
• 1:55
  putting them on some type of productivity arrangement which that we had gotten
• 1:59
  off of, uh, pre pandemic due to really equal,
• 2:06
  uh, allocation of, uh, time and scheduling.
• 2:09
  But the pandemic has really thrown out for a loop. Uh,
• 2:12
  and we have a lot more part-timers who are not working the same level and some
• 2:17
  of the more senior people are working full-time are causing some concern that
• 2:22
  they're just not getting fair share of their, their dollars worked,
• 2:27
  uh, for the physicians, um,
• 2:29
  we are looking at a lot of capital infusion alternatives from either health
• 2:33
  systems or private equity or venture capital. Depending on, uh,
• 2:38
  different opportunities that are placed on my desk on a day to day basis or
• 2:42
  things that we search out, uh, we are looking to, uh,
• 2:46
  build some other product lines or ancillary service lines in non-contiguous
• 2:51
  states that don't compete with us in the tri-state area. Uh,
• 2:56
  we can go into that a little further in a little bit. And uh,
• 3:00
  we're just looking at trying to cut our cost base, uh,
• 3:03
  our base fundamentals in rent and supply costs and whatever we can do to manage
• 3:08
  our expenses as best we can.
• 3:12
  Mm-hmm. great goals, I would say.
• 3:14
  How do you anticipate your role and teams will evolve over the next 18 months?
• 3:21
  Uh,
• 3:21
  my role is probably gonna change depending on our merger partner or or practice
• 3:26
  partner. Uh, to be honest with you, uh,
• 3:29
  if we do merge into a health system and I've gone through these MNAs and over
• 3:33
  the past 10 to 12 years and, uh,
• 3:36
  those relationships change dramatically depending on the need of the,
• 3:41
  and the value structure of that health system.
• 3:43
  But we're also trying to find ways to strengthen our human
• 3:48
  resources so they're not stretched as far as they would be cuz we've
• 3:54
  probably thinned down our administrative infrastructure a lot since the pandemic
• 3:59
  and we're using a lot of technological toolkits to help improve
• 4:03
  data gathering, uh, revenue recovery, et cetera.
• 4:08
  Mm-hmm. . And then our last question,
• 4:10
  what are you most excited about right now and what makes you nervous?
• 4:14
  What I'm excited about is that there still seems to be a growing need
• 4:19
  for our services. Uh, even within heightened competition in our market.
• 4:24
  We're probably in the most, uh,
• 4:26
  aggressive market in the country in terms of medical services.
• 4:30
  And what makes me fearful is the same thing because of that heightened
• 4:33
  competition in our market, uh, we have, uh,
• 4:37
  had to react to just to keep up with technology
• 4:42
  and other facets of,
• 4:45
  of investment that some parts of the country have had not to do as much
• 4:49
  cuz they don't have the same level of competition.
• 4:53
  Definitely.
• 4:53
  And do you wanna say a little bit about where pediatric associates are so that
• 4:58
  people understand why this competition is so fierce?
• 5:01
  Okay. So we are in tri-state, New York, Metro New York area,
• 5:05
  so we are surrounded by pretty much every academic medical center from
• 5:10
  Philadelphia up through, uh, Hartford, Connecticut, and pediatric urology.
• 5:14
  While there's only approximately 800 practicing pediatric urologists in the
• 5:19
  United States, about 20% of 'em practic in this area.
• 5:24
  So that,
• 5:26
  and the population doesn't account for having enough base of disease
• 5:31
  to help feed your, uh, doctors and especially in high end surgical cases.
• 5:36
  But at the same time, uh,
• 5:38
  the incidents of some other services have have grown and the needs have grown.
• 5:44
  Uh, so we're just trying to keep pace with those academic medical centers, uh,
• 5:49
  so they don't even tear away at our,
• 5:51
  our patient base and or invade our patient base to a point where we
• 5:56
  have to move our service to this to another location or another area.
• 6:00
  Mm-hmm. , definitely. Well, Larry,
• 6:03
  it was a pleasure speaking with you today and I look forward to connecting with
• 6:06
  you again soon.
• 6:07
  Been a pleasure. Thanks again. Be well.