Leo Spector, MD, Orthopedic Spine Surgeon and CEO of OrthoCarolina

In this episode of the Becker's Healthcare Podcast, Sophie Ades interviews Dr. Leo Spector, CEO of OrthoCarolina and a practicing orthopedic spine surgeon, about the transformative shifts in musculoskeletal (MSK) care. Dr. Spector highlights the industry-wide move from inpatient hospital surgeries to outpatient ambulatory surgery centers (ASCs) as the most significant trend, emphasizing its benefits in lowering costs, improving outcomes, and enhancing patient experience. He discusses OrthoCarolina’s strategic pivot following North Carolina’s elimination of Certificate of Need (CON) regulations, enabling the organization to own and operate its own ASCs, which increases control, flexibility, and patient-centered innovation. The conversation delves into value-based care, defined not just by cost and outcomes but by what patients truly value—access, convenience, and high-quality, affordable care. Concrete examples include direct-to-employer bundled payments and office-based surgeries that eliminate facility fees and streamline patient journeys. Dr. Spector stresses that future success hinges on adaptability, embracing technology like AI as tools—not replacements—and the courage to evolve even when current models are working. He uses the Blockbuster vs. Netflix analogy to underscore the danger of complacency, urging healthcare organizations to innovate proactively. Key takeaways include: 1) The shift to outpatient care is irreversible and should be prioritized for cost, safety, and patient satisfaction; 2) Value-based care must center on patients’ needs—access, affordability, and outcomes—rather than just financial metrics; 3) Organizational success requires embracing change, even when profitable, to avoid disruption; 4) Technology like AI is a powerful enabler but requires investment in training and integration; 5) Owning ASCs post-CON reform allows greater control and alignment with patient-first goals. Dr. Spector’s leadership philosophy centers on sustainability, innovation, and unwavering commitment to patient care, positioning OrthoCarolina as a model for forward-thinking, physician-led orthopedic practices.