In the last two years, spine and orthopedic leaders made key changes to their work that have paid dividends from moving services in-house to implementing new technologies.
The 23 leaders featured in this article are speaking at Becker’s 22nd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, set for June 18-21 at the Swissotel Chicago.
If you would like to join the event as a speaker, please contact Carly Behm at cbehm@beckershealthcare.com.
As part of an ongoing series, Becker’s is connecting with healthcare leaders who will speak at the event to get their insight on thought-provoking questions within the industry. The following are answers from event speakers, lightly edited for clarity.
Question: What is the most impactful change you made in the last two years, and what were the results?
Caleb Ashmore, PT, DPT. Orthopedic rehabilitation services supervisor at Harris Health System (Bellaire, Texas): In the past two years, I have worked diligently to build stronger relationships with people that I work with. This has paid dividends with the team that reports to me, as well as other departments within our hospital system. I’ve made many more connections by networking across other fields and disciplines, and this has helped me to be much more efficient when working on projects that require contacts within other departments. I find this to be incredibly beneficial, especially in a large hospital system like Harris Health. I have also met many more people through LinkedIn within my own organization, and have actually run across several people that I had not met in person who had been enjoying the things that I post on my LinkedIn feed.
John Brown. Administrative Director at the Musculoskeletal Institute of AdventHealth (Fort Worth): The most impactful strategic move in the past two years has definitely been bringing in a second spine surgeon on an income guarantee (A little risky and not cheap). We worked hard in year one to make his OR experience great and to develop rapport with the physician as a valued partner. He has become our highest producer (133 surgeries in 2024) and helped us to grow spine surgeries 47% from 2023 to 2024.
Janet Carlson, MSN, RN. Vice president of ASC operations at Commonwealth Pain & Spine (Louisville, Ky.): Hiring experienced clinical nurse executive leadership into my ASCs has been the most important and impactful change I have made in the past two years. I believe there is room for many professionals with diverse backgrounds working in the ambulatory spaces to collaborate for maximum efficiency and excellent reproducible patient outcomes. However, I strongly believe that having nurse leadership at the helm of my ASCs has been extremely successful and impactful in bringing together a winning team. All my nurse administrators have worked in a variety of roles in an ASC prior to assuming the lead role, they are integral to the daily operations to be available to ‘jump in’ to staff wherever needed. We do not cancel cases (with the exceptions for patient safety concerns, of course) if someone on our team has an unplanned emergency, the nurse administrator can fill that void, allowing us to continue clinical operations to provide patient care. Surgeons and the rest of the clinical professionals on my teams respond very favorably to nurses leading in an ASC.
Talha S. Cheema, MHA, BS. Business operations manager for the Marcus Neuroscience Institute at Baptist Health South Florida (Boca Raton): Over the past two years, we’ve placed a stronger focus on financial stewardship, ensuring that every decision supports both our immediate needs and long-term growth. This has allowed us to make thoughtful, financially responsible choices that improve efficiency, maximize resources and strengthen our ability to invest in what truly matters. As a result, we’re not only operating more sustainably today but also building a foundation that will support innovation, program expansion and enhanced patient care for years to come.
Jennifer Danner, BSN, RN. Senior director of Jewett Ambulatory Surgery Centers (Orlando, Fla.): One of the most significant changes we’ve made in the past two years is bringing anesthesia services in-house and establishing an employed model. This shift has provided us with greater flexibility and control over our operating rooms, ensuring that we can efficiently complete our scheduled cases.
Additionally, this change has provided us with transparency into anesthesia financials. Understanding the financials helps in making informed decisions about resource allocation, staffing, and scheduling. This can lead to more efficient operations and better utilization of operating rooms.
Scot Davis. CEO of Arkansas Spine and Pain (Little Rock): Having recently returned to the spine and pain specialty after several years in another field, I was immediately struck by the incredible advancements in technology and treatment options. Innovation is moving at a rapid pace, giving us more tools than ever to improve patient outcomes. But amidst all this progress, one thing hasn’t changed — the importance of investing in the people who make exceptional patient care possible.
Over my first three months at Arkansas Spine and Pain, my most impactful change is taking the time to meet with our employees, listening to their experiences, and understanding both their challenges and what motivates them to come to work every day. These conversations have reinforced a fundamental truth: the success of any practice isn’t just about having the latest technology — it’s about having a team that is engaged, supported, and empowered to provide the highest level of care.
Kate Gillespie, BSN, RN. Vice president of MSK and Neuroscience, Virtua Health (Marlton, N.J.): We negotiated a large ortho group to join Virtua as an employed group. They were close to signing with the capital group. Second, we negotiated an agreement with a large vendor, which mutually benefits both parties. These two changes have dramatically increased our volumes, savings and reputation. This also has resulted in new orthopedic surgeons joining our team.
Sean Gipson. Division CEO and president at Remedy Surgery Centers (Fort Worth): The ambulatory surgery center market has been an ever-changing area in medicine for many years. One of the more prolific changes that I had to make was embracing technology. Let’s face it, no one likes change, however, there comes a time when operators must make hard decisions. This was one of them for me.
In the last two years I’ve learned to embrace technology like implementing an EMR system. The conversion was the pits, however once completed the lights started to turn on. Our patient data management was much easier to use, data mine and trend.
We were able to streamline communications between healthcare providers and improve patient care coordination. This overall led to enhanced operational efficiency and reduced paperwork.
Another area that helped improve the ASC was within scheduling and workflow. Automated systems helped to reduce wait times and improve patient flow; ultimately leading to better utilization of resources.
Regulatory, compliance and safety regulations have also all been integrated into our system to help extract, record and report quality, safety data metrics required by and to the different agencies. Simple software integration allows us to collect and report patient satisfaction and quality data in a fraction of the time.
Embracing the technological change was a positive one for us with making the decision to use technology. It has allowed us to transform the ASC by enhancing efficiency, reducing costs, and improving patient care. We are doing our part to lead a growing preference for outpatient surgical procedures among patients, their families and healthcare providers alike.
Alexandra Hogue. Director of operations at Orbis Surgery Center (Houston): The last two years have been met with a lot of changes since I came on board in 2022. The most impactful would have been implementing a new EMR system. This allowed us to automate many of our processes and streamline our workflows to be more efficient. Our new EMR has freed up time for our team to manage other more important tasks.
Sebastian Ksionski, MD. Centra Health (Lynchburg, Va.): Coming out of Covid, I think we as providers and as people, had a real change in terms of priorities and what it means to be “successful”. I know our department over the last two to three years has placed a strong focus on family and our community during these years. You hear of it in an organization’s mission statement, but often financial solvency overshadows this goal.
However, in the last few years this focus on taking care of patients and their families and truly being a center of regional excellence for patients with pain has in turn led to a positive patient driven momentum for us. So much that tertiary and university pain clinics are referring patients to us given that we are able to offer unique and cutting- edge therapies in an integrated approach. When you put the patient first you are able to do this versus being limited to what is or is not approved by the patient’s insurance.
This focus and reputation has led to more and more referrals and increased profitability for us to the point that we are a featured pain center in the region. I think this with the hunger to continue to grow and learn newer and more effective integrative pain therapies has led to our success with patients and other clinics in the region.
Les Jebson. Regional administrator at Prisma Health (Greenville, S.C.): Organizing and implementing the infrastructure for outpatient joint replacements has been the most impactful change. A robust ambulatory robotic joint replacement program covering shoulders, knees and hips is proving to be a big hit with our patients and providers.
Andrew H. Lovewell. CEO of Columbia (Mo.) Orthopaedic Group: In the last two years, our organization’s most impactful change was starting an orthopaedic urgent care hub. We have improved access in our region to high-quality orthopaedic care at a very convenient and affordable price point. Our goal is to offer an unparalleled patient experience. That is why our organization is comprised of several ancillary services (durable medical equipment, pharmacy, radiology, lab, ASC and urgent care).
Cheraire Lyons, PhD. Vice president for revenue cycle at Alliance Spine and Pain Centers (Augusta, Ga.): Leveraging more technology has been the most impactful change within our organization. Enabling patient portals, e-payments, e-statements, and prior authorization automation has made the organization more efficient. In healthcare, we are consistently looking for ways to improve patient care with better patient satisfaction. Giving patients more access through the use of automation can provide better transparency and allow them to be more aware and active in their patient care.
Brett Maxfield, CRNA. Director of Anesthesia and Surgical Services at Teton Valley Health Care (Driggs, Idaho): The most impactful change that I have made in my surgery center is to make a conscious effort to empower my staff to showcase their individual strengths. In doing so we have had great results and discovered hidden talents that have contributed to the overall success of and growth of our center and an increase in employee job satisfaction. Giving general guidance while being available for advice and support but making a conscious effort to avoid micromanagement has had powerful results.
Olga Medowska. Director of operations at ANR Clinic (Tampa, Fla.): Over the past two years, the most impactful change we made was focusing on new technologies and integrating AI and automation into our workflows. By automating clerical tasks, we reduced administrative burdens and improved efficiency. AI-assisted documentation and data analysis have helped reduce human errors and enhance clinical decision-making. These impactful changes have freed up our staff’s and providers’ time, allowing for more direct patient interactions. As a result, we’ve seen increased productivity, improved staff satisfaction, and a smoother patient experience. This shift has enabled everyone — from the management team to administrative and medical staff — to focus on what truly matters: delivering high-quality, individualized patient care while also improving efficiency and strengthening the bottom line.
Emeka Nwodim, MD. The Centers for Advanced Orthopaedics (Bethesda, Md.): The most impactful change that I have made in my career in the last two years has been the intentional change to prioritize the balance between the time committed to my clinical practice growth and the business management of my practice. Prior to this change, I was committing more time and energy to optimizing our practice as a business, which ultimately compromised the care and capacity I was able to dedicate to patients. Fortunately, I recognized this early enough in my career and have been able to establish a much better balance. This has proven to be effective and rewarding.
Jessica Oreste. Chief human resources officer at U.S. Orthopaedic Partners (Alphretta, Ga.): Our biggest impact in HR at USOP has been elevating the employee experience while strengthening our talent strategy. In the last year, we’ve overhauled HR operations, improved recruitment with centralized sourcing, and added a dedicated Director of Physician Recruitment. We also launched new wellness initiatives, absorbed rising healthcare costs so employees wouldn’t see an increase in 2025, and are developing a learning management system (LMS) to support continuous professional development. The LMS empowers employees with easy access to training resources, enhancing their skills and career growth. Every move we’ve made is about valuing our team, making USOP a place where people want to build their careers.
Melissa Rice. Administrator at Loyola Ambulatory Surgery Center (Oak Brook Terrace, Ill.): Over the past two years, the most impactful change I led was the implementation of a comprehensive implant and vendor management strategy aimed at reducing supply costs and improving case profitability in our ambulatory surgery center.
We conducted a thorough analysis of implant utilization, vendor contracts, and pricing structures. By standardizing implants where clinically appropriate, renegotiating vendor agreements based on data-driven insights, and implementing tighter controls over consignment inventory, we were able to significantly reduce our implant costs without compromising quality or patient outcomes.
As a result, we achieved an average reduction in implant expenses of 18%, while improving case profitability across multiple service lines, particularly in orthopedics and spine. Additionally, the streamlined vendor relationships enhanced operational efficiency in the operating room, reduced implant-related billing discrepancies, and contributed to a more predictable and sustainable cost structure.
This initiative not only strengthened our financial performance but also fostered stronger partnerships with our surgeons and vendors, ensuring alignment around both clinical and economic goals.
Ken Rich, MD. President of Raleigh (N.C.) Neurosurgical Clinic: We terminated the management contract with the company running the center. They ignored the contract when it suited them. We immediately became profitable and our staff was much happier. In the end, you have the best interests of your ASC as the No. 1 priority.
Nikhil Shetty, MD. COO at Midwest Interventional Spine Specialists (Munster, Ind.): One impactful change we have made as a practice is the optimization and streamlining of all non-clinical paperwork and documentation using AI and LLMs like ChatGPT. Letters of medical necessity and appeal letters are done using these tools, freeing up our providers to handle direct patient-related (clinical) issues and questions. Additionally, the inputting of patient paperwork into our EMR has been outsourced. The streamlining of “scutwork” has allowed our ancillary staff to focus on the patient care experience and soft skills that cannot be replaced. This has been reflected in our patient satisfaction scores.
This has led to another impactful change we made as a practice, which has been holding all individuals accountable in the patient care process. All staff interactions with patients along their continuum of care are tracked and staff are held accountable for the patient care experience along the way. This improves morale and responsibility among staff members and allows us to acknowledge particularly positive interactions. Everyone should feel they are a part of the reason we get patients feeling better.
Brett Shore, MD. Orthopedic surgeon at DISC Sports and Spine Center (Newport Beach, Calif.): The most impactful change that I have made in the last two years was leaving my employment at a major HMO and going into private practice as part of a strong, physician-first provider network. The results of this change have been dramatic, as I have greater freedom to structure my practice as I see fit. Furthermore, I now have the opportunity to earn ancillary income outside of regular medical practice, which was prohibited while I was working for the HMO.
Bryan Warren. President at Lancaster (Pa.) Orthopedic Group: The most impactful “change” was actually a rededication to the fundamentals. Our team is facing new challenges. We need to accelerate our ability to deploy initiatives and solve problems. We cannot be slowed by groups that don’t function as highly collaborative, successful, teams. We went back to working with leaders and managers on how to build effective teams from the front line through senior leaders and physicians.
The results? Substantial improvements in staff engagement, patient experience, patient volume, profitability, and our ability to successfully deploy new processes and technology.
Graham Young. Senior vice president of mergers and acquisitions and business transformation at U.S. Orthopaedic Partners (Alpharetta, Ga.): Among the most significant changes we’ve made is reinforcing what it means to be physician-led. We hired Dr. Steve Holtzclaw as CEO, established a physician board chaired by Dr. Stephen Samelson (Southern Orthopaedic Surgeons), and named Dr. JR Woodall (Mississippi Sports Medicine and Orthopaedic Center) as USOP’s board chair. These aren’t just titles — they ensure physicians are driving the decisions that shape our future. The result is an MSO where clinical autonomy, operational efficiency, and patient care remain the top priorities. When physicians lead, everyone wins.