What if a health system could be massive and still feel local to every patient it serves? We sit down with Dr. MaCalus Hogan, chair of orthopedic surgery at UPMC, to unpack how a hybrid model—academic, community-employed, and private partners—can deliver scale without sameness. Dr. Hogan shares the leadership habits that shaped his path (mentorship, humility, listening first) and how those habits translate into practical decisions that align surgeons, hospitals, and health plans around value.

We pull back the curtain on horizontal integration—building trust and shared standards across regions—before moving into vertical integration that connects financing, bundles, post-acute care, and data. Dr. Hogan explains how UPMC leveraged CJR-era lessons to create surgeon-built programs for quality and cost, mirrored within a 4M+ member health plan. Expect clear insights on center-of-excellence designations, optimizing post-acute spend, and the realities of TEAMS participation. We also dig into consolidation with eyes wide open: comparing contracts, unlocking economies of scale, and reinvesting savings into community access points like ambulatory surgery centers and subspecialty services where patients actually live.

Looking 15–20 years ahead, Dr. Hogan argues the big will get bigger, but winners will collaborate, not copy-and-paste. Markets differ, payer mixes shift, and culture matters. The future favors systems that listen locally and act decisively—standardizing where it helps, flexing where it counts. If you care about orthopedic leadership, bundles, payer alignment, and how to grow without breaking what works, this conversation offers a grounded playbook.

Enjoy the episode? Follow, share with a colleague, and leave a review with your biggest takeaway—what’s one integration move your market needs next?

A new chair’s first year can feel like drinking from a fire hose—until the patterns emerge. Dr. Doug Lundy speaks with Dr. Jennifer Wolf, Chair of Orthopaedic Surgery and Rehabilitation Medicine at the University of Chicago, to unpack what truly shifts when your role becomes building others: the politics you don’t see until you’re in the seat, the communication cadence that keeps a department aligned, and the quiet decisions that make or break culture.

We also delve into the structural elements of leadership: when to appoint vice chairs, how to select division chiefs fairly and why an application process can reveal motivation more effectively than seniority.

Whether you’re a surgeon aspiring to leadership or a chair refining your playbook, this conversation offers lessons on culture, structure, and strategy—delivered with humility and practical insight. Subscribe, share with a colleague ready to lead, and leave a review noting the one leadership practice you’d adopt tomorrow.

The future of orthopaedic practice won’t be won by the highest offer or the loudest brand—it’ll be won by groups that can bend without breaking. Dr. Doug Lundy sits down with Dr. Alex Vaccaro of Rothman to unpack how a true megagroup navigates shrinking CMS rates, anesthesia shortages, hiring wars, and private equity.

Dr. Doug Lundy sits down with two leaders at the forefront of residency education: Dr. Tessa Balach, past chair of the Council of Orthopaedic Residency Directors (CORD), and Dr. Trent Guthrie, current CORD chair to discuss the future of Orthopaedic Education.

Their conversation explores the shift toward competency-based medical education in orthopaedic surgery. Technology's transformative role in surgical education emerges as another focus of the discussion.

Regardless of your career stage, this discussion provides a crucial perspective on how orthopaedic training is evolving to meet tomorrow's challenges.

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Robotics emerges as another transformative force. While many surgeons remain skeptical, Dr. Chen makes a compelling case for why robotics will eventually become standard.

Perhaps most exciting is the potential to address periprosthetic joint infection (PJI)—what Dr. Chen calls "the holy grail" challenge in joint replacement. From implant coatings that prevent bacterial adhesion to novel technologies that disrupt biofilm formation, the future may include treatments that can eliminate infections without removing well-fixed implants.

What makes a great orthopaedic leader? Dr. Alex Ghanayem, fresh off his term as the 137th President of the American Orthopaedic Association (AOA), shares candid reflections on leadership, legacy, and the future of orthopaedic surgery in this thought-provoking conversation with podcast host, Dr. Doug Lundy.

Dr. Ghanayem brings refreshing humility to his assessment of presidential leadership, emphasizing that the organization's strength lies in its committee members and chairs doing the essential work. His greatest satisfaction came not from personal accomplishment but from identifying emerging leaders who will guide orthopaedics through future challenges.

Hear the advice that resonates far beyond orthopaedics: balance subspecialty expertise with broader engagement, develop interests outside medicine (like Dr. Ghanayem’s own wildlife photography), and recognize that leadership service provides returns far exceeding what you invest.

Listen to discover how orthopaedic leadership principles might transform your own approach to medicine and career development.

Moving beyond typical discussions of value-based care, Dr. Mather reframes the entire conversation. "Value-based care is financial innovation to solve important healthcare problems," he explains. These problems extend far beyond cost control to address clinician burnout, prior authorization burdens, care gaps, declining profitability, and health equity. For surgeons planning their careers, understanding this broader context proves essential.

The discussion dives deep into why procedural bundles like CJR and BPCI have limitations despite their promise. "Bundles are a building block," Mather notes, explaining their volatility problems and how they've made value-based care appear to be a "joints and spine initiative" rather than engaging entire practices. He then explores the complex world of condition-based bundles, global risk, and capitation models, illustrating why the shift from fee-for-service feels like "entering a dark forest" for many surgeons.

Dr. Rick Wright explores the future of orthopaedic sports medicine, focusing on promising developments in cartilage replacement, meniscus substitution, ACL repair, and innovative rotator cuff treatments. His expert insights reveal how these advancements could transform patient care while addressing the economic realities of implementing cutting-edge treatments.