How to keep growing when staff turnover is a given | Jeremy Fournier, Director of Operations, Advanced Orthopedics New England | Ep. 12

How to keep growing when staff turnover is a given | Jeremy Fournier, Director of Operations, Advanced Orthopedics New England | Ep. 12

This episode looks at a problem every mid-size specialty group knows: when you don't own the surgery center and don't have physical therapy under your roof, your growth depends on referral relationships you don't fully control. Joe Zboch [https://www.linkedin.com/in/joezboch/], Director of Marketing at Hatch [https://hatchcare.com/], sits down with Jeremy Fournier [https://www.linkedin.com/in/jeremy-fournier-50420a188/], Director of Operations at Advanced Orthopedics New England. Jeremy walks through how a clinical background shapes the way he runs operations, why he took over referral-source communication himself, how his team turned durable medical equipment leakage into an in-house program, and what they track every Wednesday to find the places they're hurting. It's a grounded conversation about diversifying referral streams and keeping patients from getting bounced around. ㅤ 👤 Guest Bio Jeremy Fournier [https://www.linkedin.com/in/jeremy-fournier-50420a188/] is Director of Operations at Advanced Orthopedics New England, a physician-owned orthopedic group in Connecticut. He has spent 19 years with the practice, starting on the clinical side as an X-ray tech casting fractures and bracing patients before moving into operations. That hands-on history shapes how he thinks about staffing, training, and the day-to-day reality his teams carry. ㅤ 📌 What We Cover * Why Jeremy plans for turnover instead of fighting it, when a third of his medical assistants are on track to med school or PA school * Taking over the referral-source communication piece personally, so PT groups can shadow a surgeon and learn what to do for a SLAP tear and what to avoid * The physician access hotline: a private number, given only to referral sources, that rings straight to a scheduling manager * Running an orthopedic urgent care that bills as a specialist visit, not as urgent care * Spotting leakage in the DME program and building it in-house, then applying the same lens to pain management and physiatry * The one-stop-shop goal: keeping patients from being referred across town twice * Tracking patient volume, no-show rates, call volume, and third next available since 2016, reviewed every Wednesday by a leadership team where each person owns a metric ㅤ 🔗 Resources Mentioned * Hatch [https://hatchcare.com/], referral management software for specialty care (sponsor) * Brian Hayes, Executive Director, Advanced Orthopedics New England * The practice's private EMR and self-scheduling registration system (named generically in the episode)

Keeping referrals flowing during an EHR migration | Ken Takenaka, Director of Operations, Orthopedic + Fracture Specialists | Ep. 11

Switching electronic health record systems is one of the riskiest projects a growing specialty practice will take on, and the danger isn't always where teams expect it. On this episode of Scaling Specialty Growth, Joe Zboch [https://www.linkedin.com/in/joezboch/] sits down with Ken Takenaka [https://www.linkedin.com/in/ken-takenaka-m-ed-atc-otc-bcs-o-82190349/], Director of Operations at Orthopedic + Fracture Specialists, a 32-provider physician-owned ortho practice in Portland, Oregon. Ken came up through the clinical side, more than a decade as a certified athletic trainer and a first assistant in the operating room, before moving into operations leadership. They get into what it took to run an EHR conversion this year without losing referral volume, how Ken decides when to move fast and when to hit the brakes, and why honesty beats optimism when you're asking a whole organization to work in two systems at once. If you're scaling referral operations while keeping the day-to-day running, this conversation is for you. Hatch [https://hatchcare.com/] sponsors the show. ㅤ 👤 Guest Bio Ken Takenaka [https://www.linkedin.com/in/ken-takenaka-m-ed-atc-otc-bcs-o-82190349/] is Director of Operations at Orthopedic + Fracture Specialists, a physician-owned orthopedic practice serving the Portland, Oregon metro since 1933. He spent more than a decade as a certified athletic trainer and a first assistant in the operating room before moving into operations leadership, which gives him a clinical fluency most operators don't have. Today he oversees operations for a roughly 32-provider practice that runs its own ambulatory surgery center and in-house MRI, and he helped lead the practice's recent EHR conversion. ㅤ 📌 What We Cover * How a clinical background changes the way you read operations and talk to physician owners * The brakes-on-a-car model for supporting aggressive growth without becoming a blocker * Running an EHR conversion with a team that already trusts each other * Why honesty about a rocky road beats overselling a smooth one * Protecting referral channels when community partners are faxing to old numbers and using old portals * Knowing what to measure, and which dips are direct signals versus indirect ones * Treating your system's data structure as a goldmine your team can actually use * The career advice: growth happens after hours, and complete strangers will help if you ask ㅤ 🔗 Resources Mentioned * Hatch [https://hatchcare.com/] — referral operations software, sponsor of Scaling Specialty Growth * Ken Takenaka on LinkedIn [https://www.linkedin.com/in/ken-takenaka-m-ed-atc-otc-bcs-o-82190349/]

Why manual referral tracking scales a practice backward | Misty Sullivan, Care Center Administrator, Proliance Rainier Orthopedic Institute | Ep. 10

Referrals are how an independent specialty practice grows, and right now most of that work still runs on spreadsheets, paper, and someone's memory. This episode looks at what happens when a practice gets serious about the referral process and treats it as a growth driver instead of a cost of doing business. Joe Zboch [https://www.linkedin.com/in/joezboch/] sits down with Misty Sullivan [https://www.linkedin.com/in/misty-sullivan-mba-a7664a246/], care center administrator at Proliance Rainier Orthopedic Institute, to talk through balancing aggressive growth goals with operational excellence. They get into why customer service has to come first, why access to care is part of the growth conversation, and why manual tracking quietly scales a practice backward. Misty also explains the visibility gap that keeps her up at night, the metrics she wishes she could track, and where an operations leader should actually start. The episode is brought to you by Hatch [https://hatchcare.com/]. ㅤ 👤 Guest Bio Misty Sullivan [https://www.linkedin.com/in/misty-sullivan-mba-a7664a246/] is care center administrator at Proliance Rainier Orthopedic Institute and the Surgery Center at Rainier, a seven-physician orthopedic private practice in the Pacific Northwest and part of the larger Proliance Surgeons group. She oversees roughly 70 employees across a clinic, MRI, X-ray, a four-room surgery center, and a satellite location. She has spent years improving the referral process inside the broader Proliance organization and has also helped primary care clinics learn to process referrals. ㅤ 📌 What We Cover * Why customer service and access to care sit at the front of every growth decision, and why promising referrals you can't see for three months breaks both ㅤ * How manual tracking on Excel and paper stops working as a practice grows, and why it costs time, manpower, and money ㅤ * The visibility gap leadership often can't see: no single view of how many referrals came in, where they came from, or who worked them ㅤ * Why SharePoint and Teams aren't built for processing referrals, including no keyword customization and no way to flag urgency ㅤ * The four metrics Misty tracks: referrals received, receipt to first attempt to contact, receipt to schedule, and the reason a patient couldn't be scheduled ㅤ * How a process map and training documentation help a lean team onboard, cross-train, and promote from within ㅤ * Where to start when getting serious about referral operations: staffing first, then process, then technology ㅤ 🔗 Resources Mentioned * Hatch [https://hatchcare.com/] referral database * Qlik (data and reporting) * Microsoft SharePoint and Microsoft Teams * Excel * Puyallup Sumner Chamber of Commerce * SWOT analysis * Contact Misty: m.sullivan@proliancesurgeons.com [m.sullivan@proliancesurgeons.com]

Not all growth is good growth | Michelle Winfield-Hanrahan, Chief Clinical Access Officer, UAMS | Ep. 9

Most specialty groups treat growth as the goal and figure the operations will catch up. This episode is about why that order is backwards. Host Joe Zboch [https://www.linkedin.com/in/joezboch/] of Hatch [https://hatchcare.com/] sits down with Michelle Winfield-Hanrahan [https://www.linkedin.com/in/michelle-winfield-hanrahan-msn-mha-bsn-rn-b3b2593b], Chief Clinical Access Officer at the University of Arkansas for Medical Sciences, to work through one idea she opens with and never lets go of: not all growth is good growth. They talk through what it takes to actually support volume, the capacity, the workforce, the financial backing, and the quality of care, before anyone says yes to it. You'll hear how she breaks down a problem when ten people in a room can't agree on what it is, why a referral is a wealth of data most groups ignore, and what changes when you treat the front door as a growth driver instead of the cost of doing business. ㅤ 👤 Guest Bio Michelle Winfield-Hanrahan [https://www.linkedin.com/in/michelle-winfield-hanrahan-msn-mha-bsn-rn-b3b2593b] is Chief Clinical Access Officer and Associate Vice Chancellor for Access at UAMS, Arkansas' only academic medical center and the state's only adult Level 1 trauma center. There she oversees enterprise access, care management, utilization, transfers, clinical command operations, and oncology nursing. She came to the role from a nursing foundation and years as a healthcare access consultant, which is where she watched a lot of the patterns she talks about play out across institutions. ㅤ 📌 What We Cover * Why not all growth is good growth, and the four things volume has to line up with before it counts: capacity, workforce, financial backing, and quality of care. ㅤ * The hidden gap that sinks a rollout: a group opens a new practice but nobody budgeted the two people needed at the registration desk to check patients in. ㅤ * How Michelle triages a problem when a room can't agree, by starting with what most people name rather than jumping straight to the goal. ㅤ * The people, process, technology order she works in, and why technology is sometimes the wrong place to start. ㅤ * The legacy-work test: figure out where a workflow came from, then ask whether it's still relevant today. ㅤ * Why a referral is a wealth of data about what your community and referring providers actually think of you. ㅤ * Her 24-hour rule: every referred patient gets reached out to within a day, and why closing the loop with the referring provider keeps volume coming. ㅤ * The failed phone line: a competitor's payer went out of network, the institution blasted flyers and a dedicated number, then put one person on a line taking 100 calls an hour. ㅤ 🔗 Resources Mentioned * Service Fanatics: How to Build Superior Patient Experience the Cleveland Clinic Way by James Merlino, MD (the book Michelle's team was reading) ㅤ * MyChart, referenced as one of the channels for reaching referred patients ㅤ * Hatch [https://hatchcare.com/], for scaling referral operations to drive growth and efficiency

What ops leaders actually think about AI | Ep. 8

This episode steps back from the guest chair. Joe Zboch [https://www.linkedin.com/in/joezboch/], director of marketing at Hatch [https://hatchcare.com/] and host of Scaling Specialty Growth, recaps what five COOs and operations leaders at scaling practices taught him about the job. The throughline surprised him. ㅤ He expected operators to be mechanical and formula-driven. What he heard instead was that operations is about people and communication, and that the people part really is the operating system. Listeners get the top three takeaways from the first run of episodes: why people come before process and technology, why you can't optimize before you stabilize, and what operations leaders actually think about AI. It's a short reflection on what it takes to be an operations leader, and a read on where the show is headed next. ㅤ 📌 What we cover * Why people and communication, not a secret-sauce framework, turned out to be the real operating system * People first, process second, technology third as the actual order of operations * How a quarterly staff forum at DMOS lets feedback bubble up from the roots of the practice to the top * The start-small rule: a few chords before the whole song, and why you can't optimize before you stabilize * Treating change like a game the team plays together, so tough becomes fun * Setting KPIs and milestones so you can right the ship when a plan goes wayward * What operations leaders actually think about AI: grow with the staff you have, and let it clear the low-value tasks that lead to burnout * Why turnover in coordinator, contact center, and access center roles drops with training and a people-forward approach