Dr. Earl Kilbride, orthopedic surgeon at Austin Orthopedic Institute

Summary

Podcast Summary: Dr. Earl Kilbride, Orthopedic Surgeon at Austin Orthopedic Institute

Podcast: Becker’s Healthcare Podcast
Host: Francesca Matthews (Becker's ASC Review)
Guest: Dr. Earl Kilbride, Orthopedic Surgeon
Date: November 8, 2025
Episode Length (content): ~5 min 20 sec

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Episode Overview

This episode features Dr. Earl Kilbride, a seasoned orthopedic surgeon at Austin Orthopedic Institute. Dr. Kilbride shares firsthand insights on the most pressing trends affecting ambulatory surgery centers (ASCs) and independent physician groups, including industry consolidation, reimbursement challenges, and the integration of AI in healthcare. He discusses the excitement around expanding ASC procedures, strategies for organic practice growth, and innovative techniques like peripheral nerve stimulation. The conversation is marked by practicality, optimism about new technology, and a commitment to patient-centered care.

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Key Discussion Points & Insights

1. Introduction & Background

• Dr. Kilbride’s Credentials and Experience
  • Over 23 years practicing orthopedics in Austin, Texas
  • Trained in Dallas; fellowship in shoulder arthroscopy and reconstruction at SCOE in Los Angeles
  • Member of a six-man independently owned private practice
  • (01:03)

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2. Top Three Healthcare Trends Impacting ASCs

• a. Industry Consolidation
  • Major threat to independent private practices
  • Rising pressure from private equity and employed physician models
  • “One of the biggest threats to our survival is consolidation, whether that be with private equity or under the employed model.” (01:33)
• b. Reimbursement Concerns
  • Physician livelihood tied to Medicare rates
  • Commercial contracts often follow Medicare downward trends
  • “Whenever Medicare goes down, a lot of the commercial contracts are tied to some sort of Medicare factor. And so certainly that threatens the livelihood long term of any physician, much less a small private practice group.” (01:54)
• c. Artificial Intelligence (AI) Adoption
  • Opportunity for efficiency and smarter workflows
  • Importance of vetting AI information, especially within EMRs and patient education
  • “We have to make sure that we vet a lot of the information that's coming through in the AI platforms. And how do you incorporate that into…patient education and things of that sort?” (02:31)

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3. Excitement About ASC Growth & Shifting Procedures

• Expansion of ASC Services
  • Increasing payer support for procedures at ASCs due to long-term savings
  • Recent removal of procedures (e.g., total shoulder replacements) from the inpatient-only list
  • DC legislative chatter about eliminating the inpatient-only list to drive ASC volume
  • Emphasis on patient safety, efficiency, reduced paperwork, and lower patient costs
  • “The bottom line is patients are doing at least as good as, and quite honestly, when they're paying 20% of an overall bill, it's probably cheaper for them in their pockets.” (03:39)
• Literature supports safety and efficiency of moving more procedures to ASCs
  • (03:09-03:43)

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4. Approach to Practice Growth (12-Month Perspective)

• Organic, Community-based Growth
  • Focused on availability, trustworthy care, communication, and patient reviews
  • “I personally believe in organic growth. Getting out there, shaking hands of private practice guys, giving talks at local community events, really encouraging patients to do patient reviews.” (04:17)
• Challenges from Market Forces
  • Growth more difficult due to private equity and hospital employment competition
  • Targeted marketing of unique procedures and ASC capabilities
  • “It gets harder and harder to do that...maybe advertising that we do minimally invasive surgery in an ASC.” (04:32)
• Innovation in Procedures—Peripheral Nerve Stimulation
  • Dr. Kilbride is the first in Texas to perform this
  • Invests time teaching other orthopedic groups
  • “I was the first orthopedist in Texas to do it, is I do peripheral nerve stimulation… giving many talks throughout the year.” (04:46-05:04)
• Openness to New Avenues for Practice Growth
  • (05:09)

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5. Notable Quotes & Memorable Moments

• “One of the biggest threats to our survival is consolidation, whether that be with private equity or under the employed model.” – Dr. Earl Kilbride (01:33)
• “We have to make sure that we vet a lot of the information that's coming through in the AI platforms. And how do you incorporate that into, say, your EMR? How do you incorporate that into, say, patient education and things of that sort?” – Dr. Kilbride (02:31)
• “Just a couple of years ago, many procedures, such as total shoulder replacements got taken off this inpatient only list. And there's even some chatter…to get rid of the inpatient only list, which would then push more patients to the ASC.” – Dr. Kilbride (03:13)
• “I personally believe in organic growth...really encouraging patients to do patient reviews, et cetera.” – Dr. Kilbride (04:17)

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Segment Timestamps

• [00:57-01:24] – Dr. Kilbride’s background and specialty
• [01:31-02:38] – Top three trends: consolidation, reimbursement, AI
• [02:55-04:02] – Excitement around ASCs and expanding procedures
• [04:11-05:23] – Practice growth strategies, highlighting peripheral nerve stimulation and community-based growth

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Final Thoughts

Dr. Kilbride’s conversation underscores the resilience and ongoing innovation within small independent practices despite immense pressures from corporate consolidation and shifting reimbursement. He highlights how embracing new technology (both clinical, like nerve stimulation, and operational, like AI) and deepening community ties can foster practice growth and patient benefit.
The episode provides a compact but informative look into the evolving landscape of orthopedic outpatient care, directly from the perspective of a physician leader navigating these changes day-to-day.

Transcript

[A]

@ Athenahealth, we know your ambulatory practice wants healthier a healthier business, healthier care teams, and healthier patients. But the complexities of modern healthcare tech make it hard for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom Practicing medicine is complex, but running a practice can be that much simpler. With Athenahealth, see how simpler is [e-mail].

[B]

Hello, this is Francesca Matthews with the Becker's ASC Review Podcast. I'm thrilled to be joined today by Dr. Earl Kilbride, an orthopedic surgeon at Austin Orthopedic Institute. Earl, thank you so much for being here today.

[C]

You're welcome. Thank you.

[B]

Yeah, just to start us off, could you please introduce yourself and tell us a little bit about your background?

[C]

Sure. My name is Earl Kilbride. I'm an orthopedic surgeon here in Austin, Texas. I did my training in Dallas way back when I did a fellowship out in Los Angeles with Steve Snyder at SCOE in shoulder arthroscopy and reconstruction. I've been here in Austin now as a practice in orthopedics for about 23 years.

[B]

Hey, excellent. And what are the top three trends that you're following in healthcare and ASCS today?

[C]

Yeah, so I think the biggest thing that I'm following is consolidation. I'm in a six man, small, independently owned private practice group. And so one of the biggest threats to our survival is consolidation, whether that be with private equity or under the employed model. So that's certainly a trend we're following. Obviously, reimbursement is another trend that we're following. Whenever Medicare goes down, a lot of the commercial contracts are tied to some sort of Medicare factor. And so certainly that threatens the livelihood long term of any physician, much less a small private practice group. And then lastly, it's exciting, but is AI, how do we use AI in medicine? Is there a way that can make us more efficient and work smarter, not harder? We have to make sure that we vet a lot of the information that's coming through in the AI platforms. And how do you incorporate that into, say, your emr? How do you incorporate that into, say, patient education and things of that sort?

[B]

Absolutely. That definitely just echoes the conversations that I've been having over here at Becker's. Just a lot this year, especially consolidation Reimbursement, AI. Major themes there. You mentioned you were excited about AI, but what else are you most excited about right now?

[C]

One of the biggest things that excites us, especially as a small independent group, is moving everything to the asc. Right. Some of the payers have got on board with it, and the professional fees for a single physician are higher in the ASC than they would be in the hospital because they see the long term savings. Just a couple of years ago, many procedures, such as total shoulder replacements got taken off this inpatient only list. And there's even some chatter amongst the politicians in Washington, D.C. to get rid of the inpatient only list, which would then push more patients to the asc. I think the literature shows that it can be done safely. The literature shows that it's definitely more efficient. There's less hours in terms of patient rounding, having to discharge patients, paperwork, all those things associated with an asc. And the bottom line is patients are doing at least as good as, and quite honestly, when they're paying 20% of an overall bill, it's probably cheaper for them in their pockets.

[B]

Mm, absolutely. Definitely. Another trend that we've been following closely at Becker's. How are you thinking about growth over the next 12 months?

[C]

As a physician, I always think if you're available, you provide good care, you provide good honest treatments, you communicate with the patients that you're going to grow. And so I personally believe in organic growth. Getting out there, shaking hands of private practice guys, giving, giving talks at local community events, really encouraging patients to do patient reviews, et cetera. But a lot of times, especially with big business coming in, whether it's private equity or hospital employee models, it gets harder and harder to do that. And so I think some of the growth that we'll see will be directed growth. For instance, maybe advertising that we do minimally invasive surgery in an asc, for instance, like we just spoke about. The other thing is figuring out some different procedures that is just not common. One of the things I personally do, and I was the first orthopedist in Texas to do it, is I do peripheral nerve stimulation. I've really incorporated this into my practice. I give many talks throughout the year to different orthopedic groups that are trying to incorporate this. And so I think we just have to be really open to different avenues of growth.

[B]

Absolutely. That that kind of marketing component, I know, is something that's challenging for physicians, but also I think having those strong community connections is something that kind of seems to put people on the other end of the bell curve, you know, that kind of that human element that can't really be replaced. So, yeah, again, just kind of lots of the themes that we talk about here at Becker's. Is there anything else that you wanted to touch on today?

[C]

I think we've covered it all, and I appreciate you guys having me.

[B]

Yeah, of course. And we'll be in touch soon. That's all I have for you today, Earl, but thank you so much for joining us. It's been a pleasure speaking with you, and I look forward to connecting with you again in the future. Perfect.

[C]

Thank you, guys.

[B]

Yeah. Thank you.

[A]

At athenahealth, we know your ambulatory practice wants healthier a healthier business, healthier care teams, and healthier patients. But the complexities of modern healthcare tech make it hard for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions. Reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom lines. Practicing medicine is complex, but running a practice can be that much simpler with Athenahealth. See how simpler is [e-mail].