Tammy Smittle, Group CEO at SCA Health

Summary

Becker’s Healthcare Podcast: In-Depth Summary of Episode Featuring Tammy Smittel, Group CEO at SCA Health

Podcast Information:

• Title: Becker’s Healthcare Podcast
• Host: Grace Lynn Keller
• Guest: Tammy Smittel, Group CEO at SCA Health
• Release Date: July 5, 2025

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Introduction

In this episode of the Becker’s Healthcare Podcast, host Grace Lynn Keller engages in a compelling discussion with Tammy Smittel, the Group CEO at SCA Health. Recorded live at the 22nd Annual Spine, Orthopedic, and Pain Management-Driven ASC and the Future of Spine Conference, the conversation delves into current industry trends, workforce challenges, the evolving role of outpatient care, and innovative initiatives shaping the future of healthcare.

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Guest Introduction

Tammy Smittel begins by introducing herself and her role:

"Hi, I'm Tammy Smittel. By trade, I'm a nurse. I'm almost 30 years of being a nurse. Proud of that. I'll always be a nurse."
— Tammy Smittel [00:59]

She oversees Stonegate Surgery Center and Northwest Hill Surgical Hospital in Austin, Texas, managing a team of 14 ORs focused primarily on orthopedic and spine procedures.

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Key Industry Trends

When asked about the most significant trends in the healthcare industry, Tammy highlights the increasing higher acuity cases in Ambulatory Surgery Centers (ASCs) and surgical hospitals:

"We're seeing higher ASA levels... sicker patients... being treated well and safely in our surgery center."
— Tammy Smittel [01:39]

She emphasizes the delicate balance leaders must maintain between embracing higher acuity cases and ensuring patient safety. Collaborations with competent anesthesia groups and skilled surgeons are crucial in navigating this balance. Tammy also notes the shift of procedures to ASCs, observing improved patient outcomes without elevated infection rates.

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Staffing and Workforce Challenges

Addressing the persistent issue of staffing in healthcare, Tammy shares her organizational strategies:

"Building culture and my two facilities, the culture is totally different at both of them... creating this family and taking care of patients as a team."
— Tammy Smittel [02:48]

Tammy advocates for cultivating a strong, positive workplace culture over simply offering the highest pay. By fostering an environment where teamwork is paramount and responsibilities are shared ("We mop floors, everyone mops floors"), her facilities have successfully retained staff without facing significant staffing shortages. This approach ensures that employees are motivated by more than just financial incentives, leading to a committed and cohesive team.

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Evolution of Orthopedic and Spine ASCs

The conversation shifts to the growing role of outpatient care within orthopedics and spine specialties:

"The very first orthopedic surgeon to perform a peripheral nerve stem on a patient post total knee... patient outcomes have been great."
— Tammy Smittel [04:17]

Tammy highlights the innovative procedures being adopted within ASCs, such as peripheral nerve stems for managing chronic pain in orthopedic patients. She observes that as technology advances, traditional orthopedists are expanding their repertoire to include non-traditional procedures, resulting in enhanced patient outcomes. The willingness to embrace new technologies and procedures is pivotal for continued growth and success in outpatient settings.

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Innovations and Initiatives

Discussing innovations that improve efficiency and outcomes, Tammy shares insights into strategic partnerships and care models:

"My two facilities have teamed up with a large hospital system... it's a win-win for both the surgery centers and the hospital system."
— Tammy Smittel [05:35]

SCA Health’s collaboration with a major hospital system provides mutual benefits: ASCs gain reliable patient referrals, while hospitals have diversified outlets as more procedures move to outpatient settings. Despite challenges like patient allocation and physician alignment between entities, Tammy anticipates continued growth in such partnerships as the landscape of surgical care evolves.

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Conclusion

As the conversation wraps up, Tammy reiterates her appreciation for the discussion:

"No, I think that's it. Thank you guys for having me." — Tammy Smittel [06:38]

Grace Lynn Keller concludes by acknowledging the live recording at the conference, underscoring the relevance and immediacy of the topics discussed.

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Key Takeaways

1. Higher Acuity in ASCs: There's a noticeable trend of more complex cases being handled in ambulatory settings, necessitating robust collaborations and safety protocols.

2. Culture Over Compensation: Building a strong organizational culture can effectively mitigate staffing challenges, leading to better employee retention and patient care.

3. Technological Advancements: Embracing innovative procedures and technologies within orthopedics and spine care can significantly enhance patient outcomes and operational efficiency.

4. Strategic Partnerships: Collaborations between ASCs and large hospital systems are becoming increasingly vital, offering mutual benefits and facilitating the shift towards outpatient care models.

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This episode provides valuable insights for healthcare leaders aiming to navigate the complexities of modern healthcare environments. Tammy Smittel’s experiences and strategies offer a blueprint for fostering successful, patient-centered care in an evolving industry landscape.

Transcript

[A]

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[B]

Is Grace Lynn Keller with the Becker's Healthcare Podcast and we are recording live at the 22nd annual Spine, Orthopedic and Pain Management driven ASC and the future of Spine Conference. I am joined right now by Tammy Smittel, who is the Group CEO at SCA Health. So Tammy, thanks so much for being here. Let's start off by having you introduce yourself and telling us a little bit more about your role and your organization.

[C]

Okay. Hi, I'm Tammy Smittel. I by trade I'm a nurse. I'm almost 30 years of being a nurse. Proud of that. I'll always be a nurse. I am group CEO in Austin, Texas. I have a surgery center called Stonegate Surgery center and a surgical hospital called Northwest Hill Surgical Hospital. So I run up and down the highway most days maintaining both of these facilities. So I have 14 ors in all and we do mostly Ortho and spine.

[B]

Wonderful. Well, thank you for joining me today. And let's start off with what trends or shifts you're currently seeing right now in the industry that you think are the most important for industry leaders to pay attention to.

[C]

Yeah, I think it's the same thing that we've been seeing the last few years is just it's been interesting seeing the higher acuity cases hitting the ASCs and even the surgical hospital. So we're seeing higher ASA levels also. So we're kind of seeing some sicker patients go through the doors and being treated well and safely in our surgery center. So that's been a fun trend to watch. I think that leaders are having to learn to walk a tightrope in between what's pushing the envelope on higher ASA and higher acuity and what can safely be performed in the asc. And I think a lot of times until you do it that first time, you don't know. And so you have to team up with a great anesthesia group and great surgeons. Obviously that can help you teeter that tightrope But I think that's what I'm watching, and it's been really cool to see and been a nurse for so long is how much has been moved to the ASC and how patients are performing great and they're having good outcomes without any infections.

[B]

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

[C]

Well, so obviously staffing is always going to be an issue and I'm all about building culture and my two facilities, the culture is totally different at both of them. It's works perfectly for the facility that it's in. My South Austin facility is a little bit kookier than my North Austin facility and that's how life should be. So I, I think that you have to build a culture and a team and a family that works for that environment. Of course, like everyone's leaving or wanting to leave and it's interesting for higher pay, but then all those people end up coming back to you. Because I don't want to be the highest paying employee employer out there because then you're just getting these staff that's there for the money and not there for the, for the right reasons of, you know, creating this family and taking care of patients as a team. I want to create a culture where we're a team and that we all work together and it's never someone's not my job to do something. We all work together. I mop floors, everyone mops floors. And so I think that it's, if you focus on building culture, then the rest of it kind of falls into place. And I've not had staffing challenges at my two facilities because I think that us focusing on culture and not necessarily focusing on the highest pay has really made it a positive environment for people to want to come and work.

[B]

And as outpatient care continues to grow, how do you see the role of orthopedics, spine, ASCs, all those things evolving within the border or the broader healthcare ecosystem?

[C]

That's been fun to watch. So I have I, I told you, I do mostly ortho and spine in my facilities. And ASC has done some neat things recently. I had the very first orthopedic surgeon to perform a peripheral nerve stem on a patient post total knee for having chronic pain after a total knee. So it's been interesting watching traditional orthopedists evolve into these non traditional procedures and seeing the patient outcomes have been great. And yet it just takes, you know, you have to have that catalyst it takes the one guy to start doing these procedures. And then now I have a, a whole group of orthopedists that are doing these procedures. And one of them is traveling around the world doing papers and talking about how peripheral nerve stems work great in orthopedic population for orthopedists to perform these. So it's been, it's been fun to watch. And then I think that, I think that as the technology improves, like we're just going to have to continue to be open to have new technology in your door.

[B]

Absolutely. And as we wrap up our conversation, many organizations are exploring new technologies, partnerships or care models to improve efficiency and outcomes. So are there any innovations or initiatives you found particularly promising?

[C]

Yeah, I mean, that's always a good question with care models and trying to find the right mix of taking good care of patients and then still making money. And a facility. My facilities are physician owned. My two facilities have teamed up with a large hospital system that has helped us tremendously. And I think it's a win win for both the surgery centers and the surgical hospitals as well as the, the hospital system because then that gives them like they have outlets because everything's moving to the ASCs and these hospitals see it. So when they team up with us, they actually can be like, hey, we're part of this. So it's been a good win. I think there's going to be struggles and we' struggling through it like who gets what patient. And there's still those fights and it's interesting how the doctors get pulled in between them. But I think that that will continue. I think we'll continue to see a bigger growth of ASCs pairing up with these big hospital systems.

[B]

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

[C]

No, I think that's it. Thank you guys for having me.

[B]

Awesome, Tammy, thank you so much. Again, we are recording live at the Becker's 22nd Annual Spine, Orthopedic and Pain Management Conference.