Latest / Becker’s Healthcare Podcast / Leading an Independent Spine Practice Through Growth and Innovation with Dr. Dominic Maggio

Transcript

Leading an Independent Spine Practice Through Growth and Innovation with Dr. Dominic Maggio · Becker’s Healthcare Podcast

• 0:02
  - The playbook for running a successful ASC in
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  - 2026
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  - looks almost nothing like it did a few
• 0:07
  - years ago.
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  - And the one for 2029
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  - probably won't look like this one either.
• 0:12
  - Case complexity is increasing. Payer models are shifting.
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  - Technology is creating new possibilities
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  - and new cost pressures at the same time.
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  - The spine and orthopedic leaders who are staying
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  - ahead aren't just keeping up with the changes.
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  - They are in rooms where the changes get
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  - talked about honestly. Becker's twenty third annual Spine
• 0:29
  - Orthopedic and Pain honestly. Becker's twenty third annual
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  - Spine Orthopedic and Pain Management Driven ASC Conference
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  - is such a space.
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  - More than 1,000 attendees,
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  - 275
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  - plus physician and ASC speakers, three days of
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  - programming across the clinical,
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  - operational, and strategic
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  - with CME credits available.
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  - Join us June eleventh through the thirteenth. For
• 0:52
  - the agenda and event details, visit Becker's Hospital
• 0:55
  - Review and click on the events tab in
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  - the upper right.
• 0:59
  - This is Gracelyn Keller with the Becker's Healthcare
• 1:01
  - Podcast, and we are recording live at the
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  - twenty third annual Spine Orthopedic and Pain Management
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  - Driven ASC Conference.
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  - I'm currently joined by doctor Dominic Maggio, who
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  - is the owner, CEO, and a neurosurgeon
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  - at Legacy Spine and Neurological Specialists.
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  - Thanks so much for being here. I'll have
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  - you start by briefly introducing yourself, telling us
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  - more about your role and the scope of
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  - your organization,
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  - including what is currently commanding most of your
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  - attention as leader.
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  - Hey there. I'm happy to be here. My
• 1:28
  - name is Dominic Maggio. I'm a neurosurgeon.
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  - And like you mentioned, I'm the owner of
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  - Legacy Spine and Neurologic Specialists in Little Rock,
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  - Arkansas.
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  - I did my
• 1:39
  - residency at University of Virginia and National Institutes
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  - of Health.
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  - I did a fellowship,
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  - in,
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  - Ohio State
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  - School of Medicine,
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  - and then I came here,
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  - mostly because
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  - I was always interested in the opportunity of
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  - one day owning
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  - a surgery center.
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  - I thought early on
• 2:00
  - that a lot of medicine and especially spine
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  - surgery was
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  - evolving towards being able to be performed in
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  - an outpatient setting.
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  - I thought that that would
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  - really have some headwinds going into the future.
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  - And I also like the idea of being
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  - able
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  - to be more of an entrepreneurial role where
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  - I was able to
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  - control
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  - a lot of the operations,
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  - start to finish of the patient care experience
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  - and really be able to make it better,
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  - for the people that I was treating with
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  - the surgery.
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  - So that's kinda who I am and why
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  - I'm here.
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  - And in a year marked by rapid change,
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  - what recent decision or pivot required the most
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  - leadership conviction from you, particularly when it came
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  - to aligning people, resources, or capabilities?
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  - Oh, I have to say,
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  - in our practice, we have about 50 employees
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  - and take care of the whole
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  - gamut. We have an imaging center with MRI
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  - in our clinic
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  - in addition to the ASC.
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  - We have,
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  - we do a lot of conservative care with
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  - spinal injections
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  - and also a lot of surgery.
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  - And so there's
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  - a lot of
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  - different
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  - decisions that are made on a daily basis
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  - in order to keep things
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  - running well and improve things.
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  - And we've been looking into
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  - other imaging systems that we're
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  - close to finalizing,
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  - but I don't I don't have, like, one
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  - good experience that happened. I mean, we really
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  - have a big team, and we rely on
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  - a lot of different people that help make
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  - decisions,
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  - others, like, negotiating payer contracts,
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  - looking at different implant costs,
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  - making sure that we're running
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  - a lean
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  - surgery center operation,
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  - but also having
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  - all of the important things necessary to give
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  - really high vol high quality care.
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  - So I don't have a good specific example,
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  - but there's just
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  - lot of different things on a daily basis
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  - that make big decisions to give people the
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  - care they need.
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  - Well, it sounds like you,
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  - have spent a lot of time finding the
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  - right
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  - people and ensuring that your team is staffed
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  - with
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  - the right people to run your surgical practice.
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  - So I'm curious,
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  - how has running a large team challenged your
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  - assumptions or
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  - perhaps changed how you approach decision making?
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  - Well,
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  - I think that it's always important to
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  - really be
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  - detail oriented
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  - and,
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  - granular in a lot of the approaches,
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  - but then also
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  - have a really good team in place.
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  - Because at the end of the day,
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  - the company is really a culmination of
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  - the experience and intelligence of everyone that works
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  - there, and they need to be empowered. And,
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  - there needs to be,
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  - really good communication amongst everybody.
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  - And so
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  - a lot of times, we
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  - look at
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  - different costs of of things on a you
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  - know, I do that on a very granular
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  - level, but then also big picture, whether it's
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  - negotiating
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  - with large insurance companies like Blue Cross, which
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  - we recently did,
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  - or
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  - getting
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  - different health insurances for everybody.
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  - But, you know, we we it's important to
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  - create good working environments that everyone really loves
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  - what they're doing,
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  - and then that just
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  - ebbs into the the patients because
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  - the
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  - nurses and,
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  - our staff interacts with patients
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  - all the time. And we really
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  - wanna have a good culture and,
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  - something that rubs off on the patients so
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  - that they know that this is a really
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  - special place to work at and and to
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  - receive care from.
• 6:02
  - And shifting gears, when you think about the
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  - forces that are currently reshaping health care, where
• 6:07
  - do you believe leaders need to be more
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  - decisive, especially while balancing things like speed, risk,
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  - and having the right teams?
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  - Yeah. Well, it's it's always important to
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  - really be considerate when making a big decision
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  - and then just
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  - making it and moving on and not dwelling
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  - on the decision for an extended period of
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  - time.
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  - And it's important to be efficient,
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  - but it's also important to be really thoughtful
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  - and know that a lot of times those
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  - decisions you make that are big, they're one
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  - way, and you could only go forward from
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  - that. So So it's a bit of a
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  - balance. You don't wanna
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  - just stay in limbo and then be scared
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  - to make the decision, kinda
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  - need to
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  - make it happen
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  - and make the right one. And I think,
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  - we've been very lucky that at a practice
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  - for a long time, and it's been a
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  - really well run practice,
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  - and
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  - came into a situation that was a great
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  - one. And now that,
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  - we've
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  - been at kind of
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  - the ownership role,
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  - just having to continue to to thrive and
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  - continue to expand
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  - strategically
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  - and not just in all directions.
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  - And And as uncertainty has become the norm,
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  - what leadership habit or mindset has been the
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  - most critical in keeping your organization and people
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  - moving forward?
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  - So you always have to be open minded.
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  - You have to be especially in spine surgery
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  - where there's a lot of different technologies that
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  - are coming out,
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  - you need to keep an eye open to
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  - the new technologies that have a really good
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  - chance of improving patient care and giving your
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  - patients the opportunity to
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  - have the newest and most innovative
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  - techniques to make them feel better,
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  - but you also don't want them to be,
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  - experimented on, essentially. And so the doctor is
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  - the one that really is
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  - in in doctoral,
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  - the the the last buffer to know what,
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  - in his opinion, is gonna be the best
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  - thing for the patient.
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  - And it goes into also
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  - from,
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  - an owner and operational role. Like, we need
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  - to make sure that we're not putting in
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  - technologies that just sound good but don't actually
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  - make the patient care better at the end
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  - of the day because there's a lot of
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  - them out there.
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  - And sometimes it'll just kinda muddle muddy the
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  - water a little bit.
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  - And if you have a really good system
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  - in place, you need to continue and just
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  - continue to add strategically
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  - by keeping an open mindset to all the
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  - new things that are coming out and really
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  - critically evaluating them.
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  - Absolutely. Well, thank you so much for joining
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  - me on the Becker's Healthcare podcast today to
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  - share these thoughts and insights. Again, we're recording
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  - live at the 20.
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  - Thank you so much.