Dr. Earl Kilbride, Orthopedic Surgeon, Austin Orthopedic Institute

Summary

Becker’s Healthcare Podcast: In-Depth Summary of Dr. Earl Kilbride’s Insights

Podcast Information:

• Title: Becker’s Healthcare Podcast
• Host: Grace Lynn Keller
• Guest: Dr. Earl Kilbride, Orthopedic Surgeon, Austin Orthopedic Institute
• Release Date: August 2, 2025
• Event: 22nd Annual Spine Orthopedic and Pain Management Conference

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Introduction

In this episode of the Becker’s Healthcare Podcast, host Grace Lynn Keller engages in a detailed discussion with Dr. Earl Kilbride, an esteemed orthopedic surgeon from the Austin Orthopedic Institute. Recorded live at the 22nd Annual Spine Orthopedic and Pain Management Conference, the conversation delves into current trends, workforce challenges, the evolving role of orthopedics in outpatient care, and innovations shaping the future of healthcare.

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Dr. Earl Kilbride’s Background and Role

Dr. Kilbride begins by introducing himself and providing an overview of his professional background.

Key Points:

• Experience: Orthopedic surgeon in Austin, Texas since 2000.
• Specialization: Fellowship-trained in sports medicine.
• Practice Breakdown:
  • One-third trauma cases handled in a hospital setting.
  • One-third total joint replacements.
  • One-third sports medicine procedures, primarily conducted at Ambulatory Surgery Centers (ASCs) or surgical hospitals.

Quote:
"My practice consists of about a third trauma which I do in a hospital, a third total joints, and a third sports medicine." ([00:56])

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Industry Trends and Shifts

Grace asks Dr. Kilbride about significant trends or shifts in the orthopedic field that industry leaders should monitor.

Key Points:

• Employed Model: Dr. Kilbride observes the rise of the employed model, whether through private equity or hospital employment structures. He notes the competitive pressure this model places on smaller groups.
• Practice Dynamics: Transitioning from a larger group to a smaller one of five, emphasizing the importance of maintaining patient volume and contract stability.
• Marketing and Primary Care: Larger hospital systems allocate more resources to marketing and cultivating relationships with primary care physicians, posing challenges for smaller practices to compete effectively.

Quote:
"The hospitals tend to be able to put more money to marketing, put more money to primary care physicians. And so that's been something that really we keep in the radar." ([01:26])

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Staffing and Workforce Challenges

The conversation shifts to the ongoing staffing and workforce issues affecting healthcare sectors, with Grace probing into strategies to navigate these pressures.

Key Points:

• Reduced Reimbursements: Declining reimbursements limit the ability to increase salaries as a solution to staffing shortages.
• Organizational Culture: Emphasis on creating a positive workplace culture to enhance employee retention.
• Flexible Work Policies: Implementing policies such as not working Friday afternoons to provide better work-life balance.
• Retention Over Financial Incentives: Prioritizing non-monetary benefits to keep staff engaged and committed.

Quote:
"You have to create culture and create stickiness in your organization. You have to treat people right." ([02:11])

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The Evolving Role of Orthopedics in Outpatient Care

Grace inquires about the future role of orthopedics within the expanding outpatient care landscape.

Key Points:

• Growth of ASCs: Ambulatory Surgery Centers are becoming integral and are unlikely to diminish in importance.
• Healthcare System Integration: Larger health systems are acquiring ASCs to complement inpatient services.
• Shift in Procedures: Increasing number of procedures, such as total shoulder replacements, transitioning from inpatient to outpatient settings due to changes in Medicare coding.

Quote:
"I think ASCs are not going to go anywhere... it's going to complement the inpatient care very well." ([02:52])

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Innovations and Initiatives in Healthcare

The discussion concludes with a focus on innovative technologies, partnerships, and care models that enhance efficiency and patient outcomes.

Key Points:

• Patient-Reported Outcomes: Implementing initiatives to track patient-reported outcomes in total knee replacements to provide objective data.
• Strategic Partnerships: Collaborating directly with businesses like Whole Foods and Concentra's work comp system to streamline operations and reduce reliance on insurance intermediaries.
• Case Mix in ASCs: Noting a shift toward higher acuity levels and the inclusion of specialized procedures such as peripheral neuromodulation and spinal cord stimulation, which are more feasible in ASCs due to reimbursement structures.

Quote:
"We try to go one on one with certain businesses... to really try to work to get a partnership with them and keep things streamlined." ([03:36])

Additional Insight:
"The case mix is changing. The acuity levels are getting higher... these procedures aren't really reimbursed, even above cost, in a hospital setting. And so they have to come to the ASC." ([04:09])

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Conclusion

Dr. Kilbride provides a comprehensive perspective on the challenges and opportunities within the orthopedic field, emphasizing the importance of adaptability, strategic partnerships, and fostering a supportive work environment. His insights are invaluable for healthcare leaders aiming to navigate the complexities of modern healthcare delivery.

Final Quote:
"The ASC setting is changing, and we have to adapt to maintain our volume and ensure quality care." ([04:09])

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Closing Remarks

Grace Lynn Keller wraps up the episode by expressing gratitude to Dr. Kilbride for his valuable contributions, reiterating the importance of the discussions held at the Spine Orthopedic and Pain Management Conference.

Quote:
"Dr. Kilbride, thanks so much for joining me today on the Becker's Healthcare Podcast." ([04:42])

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Summary

This episode of Becker’s Healthcare Podcast delivers an in-depth exploration of the orthopedic sector's current landscape through the expertise of Dr. Earl Kilbride. Key discussions highlight the impact of employment models, workforce retention strategies, the pivotal role of ASCs in outpatient care, and innovative approaches to enhancing patient outcomes and operational efficiency. Dr. Kilbride's insights offer actionable perspectives for healthcare professionals and decision-makers aiming to thrive in a rapidly evolving industry.

Transcript

[A]

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[B]

Is Grace Lynn Keller with the Beckers Healthcare Podcast and we are live at the 22nd annual Spine Orthopedic and Pain Management Conference. I'm currently joined by Dr. Earl Kilbride, who is an orthopedic surgeon at the Austin orthopedic institute. So Dr. Kilbride, thanks for being here. Let's start off by having you share a little bit about yourself, your role in your organization.

[C]

Sure. My Name's Earl Kilbride, MD. I've been an orthopedic surgeon in Austin, Texas since 2000. I'm fellowship trained in sports medicine. My practice consists of about a third trauma which I do in a hospital, a third total joints, and a third sports medicine. The latter two I do mainly at an ASC or a surgical hospital.

[B]

Wonderful. Well, thanks for taking the time to be here and let's start our conversation with what trends or shifts you're currently seeing in the industry that you think are most important for industry leaders to pay attention to.

[C]

So one trend that's been in particular that I've watched over the past 20 years or so is the employed model, whether private equity or hospital employment. I'm still in a small group. I was in a big group and we peeled off to form a small group. We currently are five. And in that sense I think we have to really watch to maintain our volume. We have to watch to maintain our contracts. The hospitals tend to be able to put more money to marketing, put more money to primary care physicians. And so that's been something that really we keep in the radar.

[B]

And staffing and workforce challenges also continue to be a concern across healthcare sectors. So how is your organization navigating these pressures and what strategies have you seen work?

[C]

Well, yeah, so it's a difficult scenario, right, because our reimbursements are going down. So we just can't keep throwing money at staffing because that makes them even sort of more fluid in the sense that they'll leave you for a dollar more an hour. And so I think what you have to do is create culture and create stickiness in your organization. You have to treat people right. You have to make sure that they have adequate time to do their job. You let them off. Our employees don't work Friday afternoons. And so it's things like that that we hope to keep them around as opposed to just continuing to throw money at them 100%.

[B]

And as outpatient care continues to grow, how do you see the role of orthopedics evolving within the broader healthcare ecosystem?

[C]

Yeah, I think ASCs are not going to go anywhere. I think a lot of the hospital systems initially thought they would just hopefully go away, but you can see ascension is in the process of buying amp surge. And so that's just evidence that a big healthc system needs an ASC system to go along with it. And so from our standpoint, I think it's going to complement the inpatient care very well. And probably more and more of it's going to move to the outpatient setting, just as Medicare has allowed for some of the inpatient only codes to now become outpatient as well, such as total shoulder replacements.

[B]

And finally, many organizations are exploring new technologies, partnerships and care models to improve efficiency and outcomes. So are there any innovations or initiatives you found particularly promising?

[C]

Well, I think unlike most orthopedists, I actually think there's an initiative that we have to report patient reported outcomes in total knee replacements. I actually think it's a good thing. I think it's going to objectify some of the data. Some of the partnerships that we do is we try to go one on one with certain businesses like Whole Foods or Concentra, the work comp system, and we avoid the middleman, such as the insurance companies, to really try to work to get a partnership with them and keep things streamlined.

[B]

Absolutely. Well, is there anything else you'd like to share that we didn't touch on today?

[C]

Yeah, the only other thing I would say in the ASC setting is in addition to moving more volume over, I think the case mix is changing. The acuity levels are getting higher. But there's also some other procedures that we are pretty much limited to. The asc. I do a lot of peripheral neuromodulation, which is a little bit odd for an orthopedist to do. There's plenty of back surgeons, whether it's neurosurgery or orthopedic surgery that do spinal cord stimulation. And so some of these procedures aren't really reimbursed, even above cost, in a hospital setting. And so they have to come to the asc.

[B]

Well, Dr. Kilbride, thanks so much for joining me today on the Becker's Healthcare Podcast. To share these insights again, we are recording live at the 22nd annual Spine Orthopedic and Pain Management Conference.

[C]

Thank you.