Group Practice with Neal Goldstein

Beyond CPAP: How ENT Dr. Len Covello Is Rethinking Sleep Apnea Care

39 min · 12 de may de 2026
Portada del episodio Beyond CPAP: How ENT Dr. Len Covello Is Rethinking Sleep Apnea Care

Descripción

Most sleep specialists are just CPAP purveyors. If the mask fails you, they often have no next step. Dr. Len Covello is changing that narrative. Neal Goldstein sits down with Dr. Len Covello, an otolaryngologist and sleep surgery innovator who developed the sleep surgical program at Powers Health. This episode cracks open the “system failure” in sleep medicine and provides a holistic roadmap for those failing traditional treatments. What you will learn ● Why the “CPAP or bust” mentality creates a massive blind spot in modern sleep medicine ● The mechanics of Hypoglossal Nerve Stimulation and why it’s a game-changer for moderate to severe apnea ● How common medications like acetazolamide can “trick” the brain into fixing central sleep apnea ● The surprising link between GLP-1 weight loss medications and surgical eligibility for sleep patients ● Why screening in hospitals often leads to “order drift” and how to ensure patients actually get treated ● The “Quarterback” model: why you need a single clinician to own the entire holistic sleep journey ● How to navigate restrictive insurance criteria (BMI and AHI) to get the life-changing surgery you need Timestamps 00:00 — Introduction: Dr. Len Covello’s 30-year journey in ENT 03:31 — The evolution from traditional ENT to sleep surgery specialist 05:40 — Why the UPPP throat surgery was “justifiably discredited” 07:03 — Hypoglossal Nerve Stimulation: How stimulating the tongue nerve works 11:22 — The CPAP blind spot: why 50% of patients are falling through the cracks 15:54 — Creating a high-quality alternative to the CPAP mask 21:50 — Using GLP-1s and weight management as a bridge to sleep surgery 24:32 — Fixing Central Sleep Apnea with acetazolamide 28:45 — The STOP BANG screening method and why it often fails in hospitals 32:20 — The Sleep Counselor: Why patient navigation is the missing link 34:34 — The financial argument for payers: preventing AFib and heart failure Guest bio and links Dr. Len Covello is a board-certified otolaryngologist at Community Hospital in Munster, Indiana (Powers Health). He is a pioneer in sleep surgery and developed a comprehensive program focusing on neurostimulation and holistic airway management. Dr. Covello also consults for financial and medical institutions on the future of sleep technology. Website: https://www.powershealth.org LinkedIn: Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice.

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21 episodios

Portada del episodio Peter Cunningham of Evolve Healthcare Marketing: Adding Science to the Art of Medical Group Marketing

Peter Cunningham of Evolve Healthcare Marketing: Adding Science to the Art of Medical Group Marketing

Half of all advertising spend is wasted—and in healthcare, your front desk intake might be the biggest leak destroying your patient growth. Peter Cunningham is a three-time entrepreneur and the founder of Evolve Healthcare Marketing, a digital agency specializing in private physician groups and provider organizations. In this conversation with host Neal Goldstein, Peter reveals why traditional medical marketing fails, how recent Google health ad policy crackdowns impact patient acquisition, and how independent practices can thrive against hospital systems. This episode is essential for practice administrators, private equity investors, and independent physicians looking to scale measurable, reliable patient growth. What you will learn: ● Why marketing a medical practice like a standard retail or home services business leads to compliance failures and wasted ad spend ● The “Three Legs of the Stool” framework: how performance marketing, intake operations, and decision support must work together for patient growth ● Why front-desk intake operations and unanswered inquiries represent the single biggest financial leak in healthcare marketing ● How integrating marketing dashboards with EMR and financial systems allows practices to track ROI down to the exact insurance copay collected ● The “Poet vs. The Engineer” philosophy: why mid-market healthcare groups must prioritize quantitative performance and “butts in seats” over creative brand awards ● How retired physicians using peer-to-peer cold calling achieve a staggering 96% appointment booking rate with practice decision-makers ● Why hospital consolidation and post-COVID restrictions have permanently killed traditional “bagel drop” physician referral networks ● Why independent practices have a major tactical advantage over hospital-employed groups because patients actively avoid “big box medicine” Timestamps: 00:00 — Healthcare Digital Marketing and Agency Accountability 01:33 — Why Medical Marketing Is Different: HIPAA and Health Ad Policies 06:27 — Evolve’s Three-Legged Stool: Performance, Intake, and Data 07:35 — Why Front-Desk Intake Is the Biggest Marketing Leak 08:07 — Revenue IQ: Tracking ROI from Ad Click to EMR Billing 14:11 — B2B Telemarketing: Why Retired Physicians Achieve 96% Booking Rates 16:47 — The Poet vs. The Engineer: Brand Marketing vs. Performance Marketing 23:05 — Competing With Hospitals: The Future of Independent Medical Practice 27:36 — Why Traditional Physician Referral Networks Are Dead 30:19 — Why Patients Avoid “Big Box Medicine” and Choose Private Practices Peter Cunningham is a three-time business owner and the founder of Evolve Healthcare Marketing, a specialized digital agency that helps mid-market and enterprise-level provider organizations grow. Combining deep healthcare compliance expertise with predictive data analytics, his agency acts as an outsourced chief marketing officer for private practices and private equity-backed healthcare businesses. He is dedicated to replacing agency guesswork with transparent, quantitative decision support that tracks patient acquisition from initial click to final billing. Website: ehmresults.com LinkedIn: /in/evolvehealthcaremarketingpsc Facebook: evolvehealthcaremarketing Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice. #HealthcareMarketing #MedicalPractice #DigitalMarketing #PracticeManagement #PhysicianGroup #PrivatePractice #HealthcareROI #MedicalAdvertising #EvolveHealthcare #GroupPracticePodcast

7 de jul de 202634 min
Portada del episodio Competing with the Hospital Employed Group

Competing with the Hospital Employed Group

The report of the private medical practice’s death has been greatly exaggerated. Here is exactly how independent doctors are beating hospital systems. Neal Goldstein draws on over 30 years of experience to reveal why private medical practices still hold the upper hand against well-capitalized hospital-employed groups. This episode is a strategic playbook for independent physicians looking to stop playing defense and start leveraging their true competitive advantages. What you will learn: ● Why the massive bureaucracy of hospital scheduling creates a patient access advantage for independent clinics. ● How private practices can use ancillary profit-sharing to compete with inflated hospital compensation offers. ● The hidden reason why high-deductible insurance plans are driving patients away from hospitals and toward independent doctors. ● Why hospital brands suffer from “dilution” while focused private practices build stronger, localized authority. ● How to pitch independent practice solutions directly to the hospital C-suite to solve problems their employed groups cannot Timestamps: 00:00 — The Demise of Private Practice is Exaggerated 00:52 — Advantages of Private Practice vs. Hospitals 03:40 — How Hospitals Control Primary Care Referrals 04:23 — Winning on Patient Access and Experience 08:44 — Competing with Hospital Physician Compensation 12:59 — Hospital Bureaucracy vs. Private Practice Agility 17:53 — Why Less Expensive Private Care Wins Patients 21:40 — Hospital Marketing Budgets vs. Focused Branding 25:57 — Playing Offense: Partnering with the Hospital Neal Goldstein is an experienced healthcare attorney, legal strategist, and board member specializing in medical practice structures. He served as the structural engineer for the founding of the Illinois Bone and Joint Institute and has provided guidance on healthcare governance through his work on hospital system boards. His work focuses on navigating the Stark Law, corporate practice of medicine doctrines, and professional risk management Website: https://www.pfs-law.com/ Website: https://www.goldsteingrouppractice.com/ Website: https://nealtgoldstein.com/ LinkedIn: https://www.linkedin.com/in/neal-t-goldstein-841aa652/ Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice. #PrivatePractice #MedicalBusiness #HealthcareAdministration #PhysicianOwned #HospitalSystem #MedicalGroup #PracticeManagement #GroupPractice

30 de jun de 202633 min
Portada del episodio Buy-In of Partner:  Admission of an employed doctor to partner.

Buy-In of Partner:  Admission of an employed doctor to partner.

A massive partnership buy-in might make founders rich today, but it could permanently destroy the medical practice’s future growth. Neal Goldstein breaks down the financial realities and mechanics of admitting an employed doctor as a partner into a medical group. This episode explores how medical groups structure partnership buy-ins, the components of a fair deal, and why traditional valuation models often fail in the healthcare space. Whether you are a founder looking to expand or a young doctor navigating a partnership offer, this outlines exactly how the money should work. What you will learn: ● The exact differences between hard asset, accounts receivable, and goodwill buy-ins. ● Why requiring new doctors to buy into their own generated receivables is financially fair but psychologically controversial. ● How to shift accounts receivable buy-ins into pre-tax income to save new partners money over a two-to-three-year period. ● Why using private equity EBITDA multiples to value traditional physician groups usually fails. ● The Path to Parity model that scales an employed doctor’s profit share incrementally over five years. ● Why the concept of a standard buy-in formula for your specific region or specialty is usually a complete myth. ● How one Midwest medical group used a shockingly low $20,000 buy-in to drive massive practice growth and recruit top talent. Timestamps: 00:00 — The Financial Aspects of Medical Partnership Buy-Ins 01:00 — How to Value Hard Assets and Equipment 03:14 — Buying Into Your Own Accounts Receivable 05:58 — Paying for Organizational Costs and Goodwill 08:17 — Structuring Buy-In Payments (Pre-tax vs. After-tax) 14:32 — Why EBITDA Valuation Fails for Medical Practices 18:52 — The Capital Contribution Model for Medical Groups 21:29 — The Path to Parity Buy-In Model Explained 23:18 — Is Your Partnership Buy-In Set Too High or Low? Neal Goldstein is an experienced healthcare attorney, legal strategist, and board member specializing in medical practice structures. He served as the structural engineer for the founding of the Illinois Bone and Joint Institute and has provided guidance on healthcare governance through his work on hospital system boards. His work focuses on navigating the Stark Law, corporate practice of medicine doctrines, and professional risk management Website: https://www.pfs-law.com/ Website: https://www.goldsteingrouppractice.com/ Website: https://nealtgoldstein.com/ LinkedIn: https://www.linkedin.com/in/neal-t-goldstein-841aa652/ Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice. #MedicalPractice #HealthcareBusiness #PhysicianPartnership #MedicalGroup #PracticeManagement #DoctorLife #MedicalBusiness #HealthcareFinance #PartnershipBuyIn #GroupPractice

23 de jun de 202628 min
Portada del episodio Partner Admission:  Admitting an employed physician into partnership

Partner Admission:  Admitting an employed physician into partnership

Most medical groups assume new partners must buy into the practice’s real estate, but that expectation might be turning away top doctors. Neal Goldstein breaks down the complexities of admitting an employed physician into partnership at a medical group practice. This episode explores the exact timeline, criteria, and ancillary venture rules you need to structure a safe and profitable partner admission. What you will learn: ● The eligibility period for partnership depends heavily on market dynamics and the size of the buy-in amount. ● A doctor’s productivity and clinical quality serve as the baseline business criteria for partnership. ● Treating staff rudely is a massive red flag that must be corrected sternly before an employed doctor is promoted. ● Medical groups should consider carving out real estate ownership so buy-ins remain affordable for new partners. ● Anti-kickback safe harbors strictly prevent a group practice from financing a new partner’s surgery center buy-in. ● The “income partner” model used by law firms can help medical groups retain talent without giving away voting rights. Timestamps: 00:00 — When is an employed physician eligible for partnership? 03:55 — The business criteria for making an employed doctor a partner 07:00 — Why acceptance by patients and staff is critical for promotion 09:47 — Should new practice partners buy into the medical real estate? 11:58 — Anti-kickback safe harbors and surgery center ownership 15:47 — How the income partner model works for medical groups Neal Goldstein is an experienced healthcare attorney, legal strategist, and board member specializing in medical practice structures. He served as the structural engineer for the founding of the Illinois Bone and Joint Institute and has provided guidance on healthcare governance through his work on hospital system boards. His work focuses on navigating the Stark Law, corporate practice of medicine doctrines, and professional risk management Website: https://www.pfs-law.com/ Website: https://www.goldsteingrouppractice.com/ Website: https://nealtgoldstein.com/ LinkedIn: https://www.linkedin.com/in/neal-t-goldstein-841aa652/ Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice. #MedicalPractice #PhysicianPartnership #HealthcareLaw #PracticeManagement #MedicalGroup #SurgeryCenter #NealGoldstein #GroupPractice #IncomePartner #HealthcareBusiness

16 de jun de 202621 min
Portada del episodio How to Survive the Rollercoaster of a Malpractice Lawsuit with Bill Rogers

How to Survive the Rollercoaster of a Malpractice Lawsuit with Bill Rogers

Most doctors think a malpractice lawsuit will ruin their life. But the truth is, you are statistically more likely to win than lose. Bill Rogers is a veteran medical malpractice defense lawyer and partner at Swanson, Martin and Bell in Chicago. In this episode, he breaks down the reality of facing a lawsuit, the emotional toll it takes on physicians, and the strategic secrets to winning in front of a jury. What you will learn: ● Why doctors actually win 65 to 75 percent of medical malpractice jury trials in Cook County. ● The predictable emotional rollercoaster every first-time defendant experiences. ● Why plaintiffs typically win “carpentry plumbing” cases, but lose “question of judgment” cases. ● The reason why highly-paid expert witnesses often cancel each other out in the eyes of a jury. ● How a doctor’s inability to admit a harmless mistake can completely destroy their case. ● Why having mutual respect for opposing plaintiff’s counsel is a strategic advantage, not a weakness. Timestamps: 00:00 — Meet Medical Malpractice Defense Lawyer Bill Rogers 03:00 — The First Conversation With a Sued Doctor 04:00 — Why Doctors Win 65-75% of Jury Trials 05:00 — The Emotional Rollercoaster of a Lawsuit 11:00 — The 3 Categories of Malpractice Cases 20:00 — Why Expert Witnesses Cancel Each Other Out 26:00 — Why You Must Respect the Plaintiff’s Bar 30:00 — The Difference Between A Cause and The Cause Guest bio: Bill Rogers is a partner at Swanson, Martin and Bell in Chicago, specializing in defending doctors against medical malpractice claims for decades. He is a fellow of the American College of Trial Lawyers and the recipient of the JVR Trial Lawyer Excellence Lifetime Achievement Award. He has held leadership positions in the American Board of Trial Advocates and the Society of Trial Lawyers. Website: smbtrials.com/brogers LinkedIn: /in/william-j-rogers-664ba625 Show subscribe and platform links New episodes every week — subscribe so you never miss a conversation on the business of medicine. Spotify | Apple Podcasts | YouTube Disclaimer This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice. #MedicalMalpractice #HealthcareLaw #PhysicianLife #DoctorLawsuit #MedicalDefense #TrialLawyer #GroupPracticePodcast #BillRogers

9 de jun de 202636 min