Orthopedic physicians and practice managers face many critical issues to consider as they work to adapt to dramatic changes in the healthcare sector. One of the key questions is whether to practice orthopedic medicine in a hospital system or to take a more independent approach. Some orthopedic physicians discover the private practice business model is better for them.
In this episode of the Growing a Successful Orthopedic Practice Podcast, Travis Clegg, M.D., a hip and knee replacement specialist, joins Keith Landry, to discuss his journey after leaving a hospital system to gain more control over how he delivers orthopedic care.
Dr. Clegg talks about his vision to provide a concierge-like patient experience before, during and after surgeries. He also shares how he’s making sure his staff is always thinking about that goal.
Tune in to discover:
- The reason orthopedic physicians should be prepared to step up marketing efforts after they leave the hospital system
- Why doctors at some orthopedic private practices may be able to control costs better than hospitals can
- How patients are doing research to save money ahead of orthopedic surgeries
- Why fixed costs on imaging tests may save patients money
About Dr. Travis Clegg
Travis Clegg, M.D. is a hip and knee replacement specialist in Southern Indiana. He has performed more than 2,000 minimally invasive hip and knee replacements. Dr. Clegg completed his orthopedic residency training at the University of Louisville School of Medicine.
About Keith Landry
Keith Landry is Director of Public Relations at Insight Marketing Group. Keith has been a public relations consultant since 2010. He has more than 26 years of experience as a news anchor, news reporter and public affairs show host, which he uses to implement innovative public relations strategies for medical practice clients.
Episode Transcription
Dr. Travis Cleg…: Patients are getting on the internet and they’re really researching things. And so I think being able to provide not only the highest quality possible, but also being able to provide that at an affordable cost to the payers is really where the future is headed, in my opinion.
Speaker 2: Welcome to the Growing A Successful Orthopedic Practice podcast. Join us every episode to hear from fellow medical practice administrators, staff, and physicians, as we break down current issues affecting the industry and share real stories from guests on their way to growing a successful orthopedic practice. Let’s get started.
Jennifer: Hey there, welcome to Growing A Successful Orthopedic Practice. I’m [Jennifer 00:00:00:45]. Orthopedic physicians, and practice managers, face many critical issues to consider as they work to adapt to the ever changing healthcare sector. One of the key questions is whether to practice orthopedic medicine in a hospital system, or to take a more independent approach. Some orthopedic physicians discovered the private practice business model is better for them. In this episode of the Growing A Successful Orthopedic Practice podcast, Dr. Travis Clegg, a knee and hip replacement specialist, joins Keith Landry to discuss his journey after leaving a hospital system to gain more control over how he delivers orthopedic care.
Dr. Clegg talks about his vision to provide a concierge-like patient experience before, during and after surgeries. He also shares how he’s making sure that his staff is always thinking about that goal. Now, like I said, Dr. Travis Clegg is a hip and knee replacement specialist. He is located in Southern Indiana. He’s performed more than 2000 minimally invasive hip and knee replacements. Dr. Clegg completed his orthopedic residency training at the University of Louisville School of Medicine.
Keith Landry is director of public relations at Insight Marketing Group. Keith has been a public relations consultant since 2010, and he’s got more than 26 years of experience as a news anchor, news reporter and public affairs show host, which he uses to implement innovative public relations strategies for medical practice clients. All right, let’s turn it over to Keith and Dr. Clegg and let’s hear about Dr. Clegg’s experience breaking away from his hospital system.
Hey, before I turn it over to Keith, I want to say a special thanks to our sponsors Ortho Live. Ortho Live is the only telemedicine platform created for orthopedic practices by an orthopedic surgeon. So make sure you check out ortholive.com if you’re looking for a telemedicine solution for your busy practice. Let’s go ahead and get started.
Keith Landry: Hello everyone, and thanks for listening in. We’re going to give you some tips on how to grow a successful orthopedic practice. My guest today is Dr. Travis Clegg. He is a hip and knee replacement specialist with the American Health network. So great to have you with us today.
Dr. Travis Cleg…: Thanks for having me on.
Keith Landry: Tell us about the passion you have for doing hip and knee replacements. You’ve done many of these minimally invasive surgeries over your career. Why do you have a passion for this?
Dr. Travis Cleg…: I think, as we go through residency training in orthopedics, you get exposed to a lot of what I thought were very awesome fields, but hip and knee replacement was really attractive in that the patients are better almost immediately after the surgery. And it’s just almost life changing for patients who’ve suffered for some time with this debilitating arthritis and to be able to change that for them, with a procedure that allows them to go home the same day and really get back to doing the things they love, it’s just an awesome way to spend your career. And so that’s drawn me further and further down that pathway.
Keith Landry: That is fantastic. So, I think, one of the key insights you’re going to provide for our listeners today is this experience that you had with moving away from hospital system and the insight you’ve gained, and continued to gain, along that journey. So you worked in a hospital system for about seven years and in January you moved out of that hospital system into a system that gives you more flexibility in your practice. First of all, describe for us what that system is so that folks have some context.
Dr. Travis Cleg…: Yeah. So now I am with a large group of doctors, including some primary care, some specialists, who are not hospital employed. It’s called American Health Network. It’s based here in the Midwest. I’m in Indiana, but we have a base here in this region. And really it’s a hybrid model between an employed hospital position and a true private practice, in the sense that we have some support, but also have the autonomy to develop and take our patients to what we find to be the most appropriate level of care, keeping costs, as a part of the equation, as well.
Keith Landry: And why did you decide to move away from the hospital system? What was that thought process when you finally said, “Yep, this is what I’m going to do.”
Dr. Travis Cleg…: In evaluating where medicine is headed, for me, you start to see these trends of the payers coming to the insured person and saying, “Hey, I don’t think that that’s the best place for you to have your knee surgery done because they charge more money or it costs more.” And patients are really starting to educate themselves. And they don’t just have a loyalty to a specific hospital network as much anymore, because patients are getting on the internet and they’re really researching things. And so I think being able to provide not only the highest quality possible, but also being able to provide that at an affordable cost to the payers is really kind of where the future is headed, in my opinion. And so this opportunity allows me to do both, provide great care, but also, form strategic partnerships with the payers and the patients, as well.
Keith Landry: That sounds great. And it’s interesting, because the trend across America is for these large hospital systems to buy up private practices. We’ve been seeing that trend accelerating in recent years, and yet you’re going in the opposite direction. What are your thoughts on that?
Dr. Travis Cleg…: Yeah. I think, coming out of residency, the draw of joining a hospital, because you just have that comfort of knowing there’s going to be some patients automatically referred to within the system and you have, usually, a guaranteed salary that’s attractive. I think it makes sense for some people, but I think, for me, having done this long enough, I think number one, you figure out that the patients really, their loyalty is more with their provider and their doctor than it is a particular system, anyway. And I think just being able to have a little more control over the patient experience and the culture of your practice is very valuable in terms of just the job satisfaction, but also in controlling the outcomes for your patient.
Keith Landry: So our listeners are looking for those key tips on ways to successfully build that orthopedic practice. And this is interesting, because you had to make some conscious decisions when you left the hospital and set up your practice. What were some of the intentional changes that you made in saying, “Okay, this is how I will run my practice.”
Dr. Travis Cleg…: Yeah. I mean, a lot of the day to day is similar between a private practice or this model that I’m in and a hospital practice, but there are certainly some intentional differences as you mentioned. And one of those is just really when we started we worked with our team and said, “Listen, patient experience is going to be our center focus. And if you have a question, the answer is, does it improve the patient experience? If yes, then you know the answer already.” And so really focusing there and making the patient the central key has been where we started.
And then bringing in things to the equation of cost transparency, giving patients the option… A Lot of patients now, have [inaudible] plans where they’re paying for most of their care. And so talking to them about where they get their MRI done or where their surgery’s performed and what that means from a financial standpoint, with something that really, in the hospital model, you don’t have much flexibility at all in doing that. And now you can. And the patients are starting to seek that out. And so are the payers. And so we’ve been able to form partnerships with payers directly by having a fixed cost, a transparent price, that’s very competitive while still showing the same quality measures that we’ve always had. And so by doing those two things, it’s really been able to build our practice successfully.
Keith Landry: I think that is awesome. And here comes the nugget. This is the nugget in the interview that you’re about to give. What is the advice that you would give to doctors who are thinking about leaving a healthcare system to either go into private practice or into a setup like what you’ve got?
Dr. Travis Cleg…: I think as doctors, and orthopedic surgeons, one of the things that you don’t really get taught anything in residency much about is just how to market yourself or how to share what is unique that you bring to the table with the population that’s seeking care. And I think you can’t be afraid to really be proud of what you’ve developed and your skillset, and be able to market that to people. And sometimes that means thinking outside the box, like doing webinars or going and giving talks to people. And I think if you’re willing to do that, and you’re honest with yourself that I am willing to do some of these extra things that maybe the hospital was doing for me or that I didn’t need to do in the hospital, then I think you can be really successful with it.
Keith Landry: Dr. Clegg, tell us a couple of things that you just never would have thought of in running your practice until you actually left the hospital system and had the experience.
Dr. Travis Cleg…: I mean, probably the one that jumps out the most is, embarrassingly, I don’t think I understood the pricing differences between location of care that existed. And I had started to hear from patients and say, “My insurance company doesn’t want me to have my MRI done here.” And so to find out, excuse me, that the same MRI costs twice as much in one setting versus another is really astounding to me. And the same goes for surgery. A knee replacement at a one hospital may cost twice as much as it costs to do the exact same surgery down the road at a surgery center. And I think starting to realize that really changed my mindset on things tremendously. And trying to develop practices that allow for outpatient surgery when it’s appropriate for your patients. And really considering those things has been a real game changer for us.
Keith Landry: And I imagine the aha moment you had when you said you didn’t realize this until you left the hospital system, but when you did realize this, that you’re offering care at a more affordable price point, what was the light bulb that went off at that point?
Dr. Travis Cleg…: Well, I mean, when you’re doing this, you don’t necessarily think you need to think of the hospital as your competition, but you’re out there and you’re practicing and you’re trying to grow your volume to the level that you want, and I think this is a huge strategic advantage for somebody who has the ability to choose the best venue based on price and quality. And so this then opened the door to allow us to really develop some pricing strategies and relationships with the payers directly that now helps to increase the total number of patients we’re able to take care of.
Jennifer: Today’s episode is presented by Ortho Live. Designed by an orthopedic surgeon for orthopedic practices, Ortho live is a comprehensive telemedicine platform that puts the features you need front and center, increasing practice revenue without adding to your already full plate, like consent forms and patient readiness indicators that visually guide patients to fill out the necessary legal consent forms before an appointment can begin and then automatically save them, so you don’t have to. When a patient is ready for their appointment, you’ll see a green indicator light. If there’s no light, that means your providers can focus on other patients on their schedule until the icon turns green. For more on how Ortho Live can increase efficiency, practice revenue, and patient satisfaction, visit ortholive.com today. Ortho Live, the world’s leading orthopedic specific telemedicine platform.
Keith Landry: So take me back down memory lane for a moment. You left the hospital system, you made the decision to open your practice in a more flexible system. You had to do a lot of preparation for that day. And now it’s the day when you’re about to open the doors for your new practice for the first time. And you’re sitting there, maybe in your office, maybe in your lobby, whatever it might be, and you’re about to open the doors for your new practice the first time. What’s going through your mind at that point?
Dr. Travis Cleg…: I think, in preparing for that first day and all the meetings with… Number one, just developing your team and deciding who’s going to be on the team and how you choose who gets hired. For me, again, we come back to it’s like, I want to be able to say, at the end of the day, we have the best patient experience for hip and knee replacement in the world. The patient experience doesn’t just mean you give them the best surgical procedure. It means what’s the experience like when they call to schedule their appointment, how’s the person talking to them on the phone, what’s the parking situation like, what’s the waiting room environment like, how does the staff interact with the patients. All of these things running through my mind of like, if you really want to control the overall patient experience, you have to be open to the concept that the part that you’re seeing right in front of you is only a small portion of that.
And if you can have a vision and build the right team around you, that everyone gets it and they’re all on the same page, then you can move the needle and say, “Oh wow. And this was a lot better than when I’ve went to the doctor in the past because X, Y, and Z. And it was very efficient and it didn’t waste my time and it got me the results I wanted quickly.” And so for me, when we’re getting ready to open, it’s really trying to focus and not get too narrow a vision on just scheduling surgeries and doing what I do, but also how does the patient feel when they leave? And that was sort of our focus and continues to be the focus.
Keith Landry: So you had that big checklist running in the back of your mind. How much of that were you able to let go of and actually outsource that and release it to your practice manager?
Dr. Travis Cleg…: I guess early on… I guess I get better at that as we go. As you get feedback from the patients, “Hey, the receptionist was really nice and she helped me find it and I got lost and when I called her.” And you start to get this feedback that man, all this kind of team building that you’ve been doing is really paying off and the patients are happy and they’re leaving good reviews about the practice. And the ultimate thing is that they’re referring their friends and family to you. And so then you start to realize, all right, we’re moving in the direction that we want.
I think, as surgeons, sometimes we can be a little bit controlling. If you start micromanaging everybody, number one, I don’t think your team’s going to be very happy. But number two, you don’t have any free time, because you’re constantly trying to worry about everything involved. And the key there is set a good example, but just hire the right people. Take the time to interview everyone yourself. Be a part of that process and put great people around you and then they make you better.
Keith Landry: And so tell us just a little bit more about that first month, in terms of getting feedback and meeting with the team and really stressing communication and making sure they didn’t forget to paint the lines out in the parking lot, things like that. Like how that evolved for you in the first month of opening the practice.
Dr. Travis Cleg…: I think coming into it and having learned from past maybe failures is that communication with everyone is key. I mean, one of the biggest keys on job satisfaction is, I think, autonomy, working with people you like, but then really knowing what’s expected of you. And so being clear with everyone, these are your specific responsibilities and I’m not going to oversee that this is done correctly every day. It’s really up to you. And so I think doing that and then giving feedback and accepting feedback from the staff. I don’t, certainly, have all the answers, and many times they see things differently and better than I do. And so if your staff is telling you, “Hey, I really think you should consider trying this.” You should be open to it and understand that you’re constantly evolving. And just because this was the way we did it for five years, that might not be the way you should do it going forward. And you got to be willing to be flexible and change sometimes.
Keith Landry: Great advice. I want to switch gears just a little bit. A lot of times when the doctor breaks away from a hospital system, one of the challenges he, or she, might face immediately is getting patient referrals, because the hospital system is pretty good at keeping those referrals internally. And so what are some of the observations of what you went through in the first few months after you left that hospital system and you’re trying to build the patient referral network? What did you learn along the way?
Dr. Travis Cleg…: I’ve learned a lot and I’m still earning. I think, the one thing, it’s challenging to get in front of some of the docs that are employed by the hospital, for me, is just how do you get their attention and talk to them? Because I think ultimately most primary care physicians want their patients to see the best. Whoever’s providing the best experience, best surgeries. And they also want their patients to be happy, because any doc will tell you, if you make a referral to somebody and the patient’s unhappy, they always make sure you know they didn’t like that experience.
And so I think if you can do your best to communicate, and then when you get the opportunity to take care of someone’s patient, go above and beyond. Pick up the phone and call them and say, “Hey, I saw Nancy today. This is the game plan. Thanks for letting me take care of her. If there’s anything you need from me in the future, this is my cell phone number. Call me directly. Happy to help you.” I think if you do that, that really sets you apart and helps you to start to develop those relationships with your referring providers.
But the other big thing is, I think, the statistics would be that maybe 25 to 30% of your referrals come from primary care physicians now. Whereas before, that number might’ve been 75, 80. I think for me, what I’ve found is the number one referral I have is happy patients who tell their friends and family, or they get on Facebook and they start talking about the services we’ve provided. And I think cultivating that relationship is huge. Physical therapists, there’s a lot of private physical therapy practices, they refer patients a lot of times. For spine guys, maybe the chiropractic office, that isn’t hospital employed, is a great referral source. And so thinking outside the box of what some other sources are, has been key to our success and our growth.
Keith Landry: Good ideas. So it’s been less than a year since you left the hospital system. What are you doing to scale your practice?
Dr. Travis Cleg…: A lot of the things that we’ve talked about going out and educating, I think developing an online presence, that’s something that essentially I had nothing prior to this venture. Didn’t really have a great website. I wasn’t putting out any content. And I think that’s the future. People want to go on and read about their doctor. They want to read about what new procedure you’re offering. And so, really taking the time and forming strategic partnerships to help cultivate that information that’s out there about you is key. And I think if you want to grow, the number one thing for growth, as always, just take the best possible care of your patients. Okay? And, keep the patient experience first. But then also doing those things we talked about, some marketing strategy things is really going to help you.
Keith Landry: Great points. And what are you doing in terms of making a conscious decision every month to pay attention to how the practice of orthopedic medicine is changing and how you need to be nimble and roll with it? Is that something that’s always in the back of your mind?
Dr. Travis Cleg…: Yeah, I think, for me, that means carving out some dedicated time to stay up to date with the absolute latest in research that’s available. Again, being willing to accept that I did this procedure this way for many years, but this might be a little better if I tweak it or change. And so being willing to change and make the experience better has to happen on a weekly or monthly basis. You can’t just get so busy taking care of patients that you’re not staying up to date. I think, in similar fashion, you form partnerships with a marketing team, or a practice manager, who helps say, “Hey, this platform, this social media platform, is really taking off and maybe you should consider putting something out or doing something here.” That’s really another way that you can help grow.
Keith Landry: Dr. Clegg, if folks want to find out more about you or your practice, or the advanced surgeries that you offer, what’s the best way for them to connect with you?
Dr. Travis Cleg…: They can go on my website at www.drclegg.com. That can give links to everything with my practice, what we’re doing, some of the content we’re putting out. We’re also on Facebook and Instagram. And then, they can reach out to me directly. I’m always happy to talk about this stuff. I kind of have a passion for helping other people develop their practice, as well. And so, they can email me, which is on the website as another opportunity or call us directly.
Keith Landry: Dr. Travis Clegg, hip and knee replacement specialist with the American Health Network. Thank you so much for sharing your insights today with us.
Dr. Travis Cleg…: Hey, thanks for having me. This was fun.
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