In this episode, Dr. Mencias and I dive into various topics, from Covid-19 challenges to nurse shortages, scheduling, what it's like to run a private practice, reimbursements, and the difference between employed and entrepreneurial physicians. We talk about what is working and what is not and Dr. Mencias' desire to put the focus back on the patient.

Since I did not mention it during the intro, I have put a full list of Dr. Mencias' education and papers at the end of the show notes.

Based on some final edits, the time stamps for each topic may be a few seconds off and will probably start a few seconds before the times posted below.

And you can watch the episode on YouTube at https://youtu.be/R1Jyd6-L7DA

0:00 - 0:55 - Show Intro

0:55 - 1:55 - AJ Intro and Bio

2:20 - 4:25 - AJ's beverage of choice and book/purchase recommendations (Basil Haydens, No Easy Day - By Mark Owns, and Oofas Footwear)

4:25 - 7:27 - AJ's role and an overview of his practice, South Bend Orthopedics

7:53 - 11:10 - Covid Challenges

11:10 - 12:23 - Nurse Shortages and Scheduling

12:24 - 15:31 - Private Equity Investors buying practices

15:32 - 17:40 - Surgeons being CEOs, leaders of the business, and role of Private Equity

17:41 - 22:40 - What is it like running a private practice (hoops to jump through, peer-to-peer review, EMRs, employees, Insurance codes, answering the phones, etc.)

22:40 - 27:00 - Are insurance companies "the issue"

27:01 - 30:30 - Reimbursements

30:31 - 33:10 - The cost of healthcare

33:10 - 34:45 - What is working in healthcare

34:45 - 36:55 - Lack of doctors/loss of respect?

36:56 - 40:55 - Employed vs. Entrepreneurial physicians and physician-owned facilities/outcomes

40:56 - 48:30 - Technology with robotics, treatments, space utilization, and telemedicine, and call centers

48:31 - 51:29 - Health system financial commentary

51:30 - 52:05 - Retailization of healthcare

52:10 - 53:05 - Commentary on primary care and touching on the root of the pandemic of unhealthy people in the US

53:10 - Closing remarks and AJ's wish to see the focus back on the patients and providers

DR. AJ MENCIAS

Employment and Education, Other Elected Positions

**President, South Bend Orthopaedics and Sports Medicine, 2021-PRESENT

 Partner-Board of Directors, South Bend Orthopaedics and Sports Medicine (SBO), a division of

Ascendant Orthopaedic Alliance, South Bend, Indiana, 2004-current

           Executive Committee Member for SBO/Ascendant, current

           Secretary, Ascendant Orthopaedic Alliance, previous

           Chief of Orthopaedics, Memorial Hospital of South Bend, 2017-2019

                      Level II Trauma Center

           Vice-Chief of Orthopaedics, Memorial Hospital of South Bend, 2019-2020

 **Director, Hand/Wrist/Elbow Surgery, University of Notre Dame, 2016-current

 President of Medical Executive Committee and Board Member, Unity Physicians Hospital, 2022, 2023-current

**Vice-President Medical Staff, Unity Physicians Hospital, Mishawaka IN, 2020-2021

**Medical Executive Committee, Unity Physicians Hospital, 2020-2021

Select Health Network, Board of Directors, 2019-current

MedCraft Healthcare Real Estate, Medical Advisory Board, 2023-

Allied Physicians Surgery Center, Board of Directors, 2020-current

Fellowship, The Indiana Hand to Shoulder Center, 2003-2004

           Upper Extremity Surgery and Microsurgery

Residency, Indiana University Department of Orthopaedic Surgery, 1999-2003

Internship, Indiana University Department of Surgery, 1998-1999

Education and Honors

Indiana University School of Medicine, 1994-1998

           Doctor of Medicine (M.D.)

                      Alpha Omega Alpha (AOA)

                      Class Vice President (1994-1996)

The University of Notre Dame, Undergraduate (1990-1994)

           Bachelor of Science (B.S.)

                      Phi Beta Kappa

                      Magna Cum Laude

                      Notre Dame Scholar

 Roncalli High School, Indianapolis Indiana

           Valedictorian, Class of 1990 

Presentations, Research, Design Experience, and Consulting Experience

•      Design Consultant, Speaker’s Bureau, Skeletal Dynamics, 2022-current

•      **Consulting, Education, and Design Surgeon, Arthrex, 2018-current o Instructor, multiple educational courses, Naples, FL

§ 2018 ASSH Las Vegas, NV: NanoScope Presentation o NanoScope project, consulting surgeon

• FiberLock Thumb Suspensionplasty project, consulting and design surgeon, current
• Radiofrequency/Thermal Probe project, consulting and design surgeon, current

•      Consulting Surgeon, Stryker Orthopaedics, 2011-2018

•      Stryker Orthopaedics, Hand and Wrist Implants, Core Design Team, 2014-current o Wrist set o Mini-fragment set

•      2016 ASSH Annual Meeting Presentation, Challenging Cases and Case Controversies in Upper Extremity Surgery, Austin, Texas (On Behalf of Stryker)

•      2015 ASSH Annual Meeting Presentation, Care of Elite Athletes, Seattle, Washington

•      2015 ASSH Annual Meeting Presentation, Challenging Cases and Case Controversies in Upper Extremity Surgery (On Behalf of Stryker)

•      ASSH Commercial Support Committee, previous

•      Multiple presentations at Stryker Orthopaedics Resident and Fellow Courses, 2011current

•      Grand Rounds and Resident and Fellow Dissection Course, University of Kansas, Plastic Surgery Program (Sponsored by Stryker)

•      Keynote Speaker, Kansas City Hand Society, Orthopaedics and Plastic Surgery (Sponsored by Stryker)

•      Low Intensity Pulsed Ultrasound Bone Stimulation (LIPUS), Presented to University of Illinois Chicago Department of Orthopaedic Surgery, April 2010 (On Behalf of Smith& Nephew Orthopaedics)

•      Surgical Procedure Demonstration, Ascension Nu-Grip Prosthesis, Annual Miami Hand Surgery Meeting, March 2010 (On Behalf of Ascension Orthopaedics)

•      Lead Faculty, Ascension Orthopaedics Upper Extremity Workshop, Atlanta, Georgia, January 2010

•      LIPUS Presentation, Sacramento Hand Society, 2010 (On Behalf of Smith&Nephew)

•      Guest Lecturer, Puerto Rican Orthopaedic Society Meeting,  Fall 2010 (On Behalf of Ascension Orthopaedics)

•      Guest Lecturer, Elbow Anatomy, Indiana University School of Medicine at Notre Dame, 2004-2008

•      Research, Indiana University Department of Dermatology, 1995

•      Research, National Institutes of Health, 1993

 Professional Memberships and Board Certifications

•      American Board of Orthopaedic Surgeons (ABOS), Board Certified, General Orthopaedic Surgery, Current

•      Certificate of Added Qualification in Hand Surgery (CAQ-HS), Board Certified, Hand Surgery, Current

•      Fellow and active member, American Academy of Orthopaedic Surgeons (AAOS)

•      Fellow and active member, American Society for Surgery of the Hand (ASSH)

•      **Director, Hand/Wrist/Elbow Surgery, University of Notre Dame, Current

•      Former Consulting Physician, Integra/Ascension Orthopaedics

•      Former Consulting Physician, Smith&Nephew Orthopaedics

Board of Director Seats

•      Unity Physicians Hospital

•      **Select Health Network Insurance Company, Board of Directors, 2014-2017, 2019-current

•      **Allied Physicians Surgery Center, Board of Directors, 2018-current

Licenses

•      Indiana State Physician’s License

•      Indiana State CSR license

•      Federal DEA license