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.