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Beyond the Stethoscope: Vital Conversations with SHP
Beyond the Stethoscope: Vital Conversations with SHP
Revisit: Mastering Private Practice in a Post-Pandemic World: Insights & Strategies from Coastal Vascular and Vein Center's CEO Craig Kilgore Part 2
What happens when you mix the expertise of Coastal Vascular and Vein Center's CEO Craig Kilgore with the turbulence of the post-pandemic private practice landscape? You get a dynamic and insightful exploration of the challenges and opportunities facing private practices in this transformative era. From the consolidation of payer landscapes to the evolution of volume levels, and the constant struggle with staffing, Craig offers his perspective, grounded in his extensive experience across IT, finance, and executive administration.
Craig goes beyond just identifying the problems: he offers tangible strategies for fostering growth, harnessing innovation, and engaging physicians and staff within a practice. Drawing from his own experience, he outlines the merits of owning property and diversifying business strategies to build a resilient and successful private practice. But it's not all rosy – Craig also shares his concerns about the declining interest among physicians in private practice and the ongoing struggle with staff retention. This episode is more than a conversation; it's a masterclass in navigating the choppy waters of private practice in a post-pandemic world. So, ready to get some invaluable insights? Of course, you are! Let the conversation begin.
Craig M. Kilgore, CEO - Coastal Vascular & Vein Center
(e) craig.kilgore@coastalvvc.com
(p) 843-577-4551
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Welcome to Beyond the Stethoscope Vital Conversations with SHP. As we take a summer break to prepare for Season 5, we're revisiting some of our most insightful episodes. In this episode, we dive into the post-pandemic private practice landscape with Craig Kilgore, the CEO of Coastal Vascular and Vein Center. Ceo of Coastal Vascular and Vein Center, craig shares with us his extensive experience in IT, finance and executive administration to explore the challenges and opportunities that face private practices today. Craig discussed the consolidation of payer landscapes, shifting volume levels and ongoing staffing challenges. He offers practical strategies for fostering growth, embracing innovation and engaging physicians and staff. Additionally, craig highlights the benefits of owning property and diversifying business strategies, while addressing concerns about declining interest in private practice and staff retention. If you liked this episode, please be sure to rate and share the podcast in your favorite podcast app. It really helps us reach more listeners. Share the podcast in your favorite podcast app. It really helps us reach more listeners.
Jason Crosby:Thank you for tuning in and let's dive into this vital conversation with Craig Kilgore. Kind of piggyback previous points, because you've hit on this, the point of you've got payer consolidation. You've got consolidation in the private practice market in terms of going the employed route, in particular because of COVID in these last few years, and then volume slowly trickling back to some levels that are, you know, back to where they were. And then you get staffing, still a concern. So you got these variables out there that still present this challenge to the group. As you mentioned, you've transitioned recently from an ENT to a vascular group, but still a specialty private practice setting that all each experienced those same variables and challenges. What sort of staffing initiatives, way that you've engaged your staff members or the physicians to kind of keep the morale, the culture in a positive, moving fashion, whether it's a benefits thing or a team function or even a strategic initiative that, guys, we need to keep this practice moving forward and here's a kind of a strategic objective we're going to work collectively to attain.
Craig Kilgore:Well, it's kind of my opinion is that you know people like to be part of an organization that is moving forward. You know they don't like to be stuck in a stagnant organization. So I think you know, by demonstrating that the, you know the physicians are interested in growing, interested in innovation. You know, like innovation, whether it's ancillaries, you know growth, so you know that's a big part of any practice success. Private practice success is making sure that you have, you know, the appropriate ancillaries and that you are, you know, supporting them legally. You know, not illegal but appropriately, and that's always the first thing.
Craig Kilgore:But then, you know, actually looking at diversifying a little bit. So do they own their property, do they own their real estate. That's a business strategy and so that was a very successful one, you know, in my Charles and me and T days. So you know it got to the point where you know they now own all their locations and even some, you know, commercial and even some commercial properties. So they went beyond just the practice of real estate but into commercial. So that's a success story in itself. The vascular surgery group is looking to do similar things, maybe not so much in the commercial area but in the practice-owned properties, and so they just recently completed, before I joined, a new office with an ambulatory surgery center in Somerville. It's a development called Nexton, and so I see those kind of things as people like to be part of something that has purpose or something that's growing. And you know, a lot of times I get it the risk associated with growth to some physicians, depending on their career, their stage in their career, are they?
Craig Kilgore:within 10 years of retirement or are they at 40 and going to work for another 20 plus years? I mean, a lot of that impacts their interest in growth and expansion. But that's what I like to do. I don't like to have to sit behind a desk and count nickels. I like to be active and growing and it's been pretty successful, I think over my career. But I think if you look at other successful independent groups, they've done the same thing.
Jason Crosby:Yeah, that's some great points. What I gathered there, hearing your response, was the practice itself is one thing, but you don't have to get timid with growth because of the practice. You still and in your case you've got an ASC potential to grow via that path. You've got real estate as a potential opportunity to help. So looking at the total financial overall picture is more than just simply visits in your practice.
Craig Kilgore:Correct.
Jason Crosby:Are you seeing that a lot more? You're really active in the administrator type networks, as you mentioned, and your experience, what you're seeing in South Carolina in particular Are you seeing that quite a bit.
Craig Kilgore:It's kind of a mixed bag, you know. It's kind of. Again, I think a lot of it has to do with the career cycle of where physician owners are. The big things are you have to have a core group that's going to support a growth plan. But I would say yes, and I think it's actually, you know, going to, you know, expand, you know, because of the CON loss that changed in South Carolina and so, you know, we can now go and open an ambulatory surgery center without having to go through the regulatory CON process. Now you still have the financial constraints. You better, you know, get those serious concerns, but you have to be able to, you know, demonstrate that you can meet your debts. But I think that most groups are finding that they can, and so, yeah, I think that's you're gonna see more of that in South Carolina just because of the elimination of the CON laws.
Aaron C Higgins:That sounds like a really positive change for South Carolina. And here in Georgia we still have CON laws. There's a lot of discussion around how should those change or evolve or go away? So it'll be interesting to see with our neighbor to the north how successful that's been for you all, because I think our markets are fairly similar in a lot of our key cities. So it'll be fascinating to watch and obviously that's, I think, a positive thing. So let's go negative. Nelly, here for a second. From your perspective, where you're sitting as CEO, what do you feel like your challenges are going to be for the next I don't know three, five, 10 years?
Craig Kilgore:Yeah Well, we've already touched on staff, so that's obviously going to be the number, probably the highest or the greatest concern.
Craig Kilgore:The other issue that we're seeing and again I touched on a little bit but the number of physicians actually coming out wanting to go into private practice, and so we're already seeing trends that you know fewer and fewer want to be part of a private practice, more and more want to be in an employed setting. So it's going to really, you know, limit the number of physicians for the specialists. More so I think it's very much a factor for specialists, more so than the primary care. I just know in ENT, my recent experience there's, I think, maybe hold me to this number, but I think there's 350,. You know fellows that come out annually and third of those are looking to do a subspecialty fellowship. A third of those are looking to do go to work for somebody and like a hospital system, and so you basically have 120, you know ENTs coming out that are potentially looking at private practice for the entire country. So that's a real challenge.
Craig Kilgore:I'm not sure of this vascular numbers yet, but I don't think they're that much different, maybe even fewer, because a lot of the vascular surgery training programs that are the more technology advanced and innovative ones are probably fairly limited to. So, yeah, it's going to be, you know, staff and staff retention and training. And then it's going to be providers physicians we have plenty, I think we have enough your PAs coming out, nurse practitioners and certainly, you know, with their expansion of their scope of practice, you know, I think that's going to meet the needs for a lot of the primary care practices and communities. But you know this, specialists are going to be really in high demand and there's not enough supply coming out.
Aaron C Higgins:Yeah, and I think you're right. Coming from my own background, in private practice and in the specialties I was in I was in vascular and in cardiology we couldn't replace our retiring providers fast enough. We would get someone fresh out of medical school with, you know, half a million dollars in school debt and, yeah, we couldn't replace them fast enough because the difficulty was they had so much debt they couldn't go hang a shingle on their own. So it's certainly a challenge everywhere. So, in a happier ending sort of question, looking back and even looking forward here, where would you define success? Where would, as a CEO and even as a private practice, what does success look like for you?
Craig Kilgore:You know it's always been. You know, my goal in working with physicians to see them, to see their success, you know, for them to, you know, thrive in practice growth for them to, at least you know, maintain a good you know income and benefits, but also for them to have a good quality of life, practice, a good balance, you know. So it's things like that that make me happy. You know, at the end of the day it's not easy to obtain, but, you know. But I think that gives me the greatest success.
Craig Kilgore:And you know I wish I could get more young folks interested in private practice. You know, because I think it's been such a great career. It is demanding and I'll say that I mean unfortunately there's way too many night meetings and stuff like that because physicians are working during the day. So it's not attractive to a lot of people. But it is a very rewarding career and I think it's been. I've enjoyed it. You know I like what I do and I want to keep doing some of it. I don't want know that I want to do the day-to-day grind for 10 more years, but I certainly enjoy the development and the growth aspects. That's what I really enjoy.
Jason Crosby:Great feedback, craig, maybe to sort of you, you know. Wrap this loop back to our original question to and to Aaron's last one to you. So we're both located near universities that have health systems, universities that have health administration type programs. Speak to those that might be listening that you know you came in through a different route, the IT and finance path. You know a lot of these folks are getting the MHSAAs or maybe the MBAs. Speak to them, if you will, about okay, you're starting out, you're in this new, challenging environment. Here's a couple of little nuggets from someone that's been there, done that, as to how to have a smooth entry into this.
Craig Kilgore:Yeah, that's great. That's great because at EMT they actually do have an internship program within USC, so they'll take two, three of the students for a semester to come and work. And I'm not as close to that Obviously I'm not there now, but still very familiar with what they were doing. But the biggest thing is you have to get. You have to get your hands dirty, you know, and you have to learn it. You can't.
Craig Kilgore:It's not like there isn't a textbook, you know, for practice management. You know there is there. I say, say that, but you really you got to get your hands dirty. You got to sit at the front desk. You got to schedule a patient, you have to do demographics, you have to watch the revenue cycle, you have to understand the regulatory side. So is more geared to hospital administration than it is private practice. But I'm actually on a committee, advisory committee, you know, with the USC, you know, to help give some exposure, you know, to the private practice world. So you know it's not for everybody, again, you know, but those that are ambitious and are willing to put the effort, the time and the commitment in it can be extremely beneficial, rewarding to them personally and from a career standpoint.
Jason Crosby:Great recommendation. I wish I could have asked you that a couple of decades ago myself. You still got time.
Craig Kilgore:Jason Come on.
Jason Crosby:That's great feedback, craig, and with your background, I think folks will definitely appreciate it. And so well, we've asked a lot. Strategically placed a UT hat right over his shoulder, and so for those like myself in Georgia country, sec country, that's the first thing you see.
Craig Kilgore:It's all in good fun. I love SEC football. I love football, so love SEC football, but kind of have a passion for Tennessee Falls.
Jason Crosby:Hey, there's nothing better than the fall, Nothing better than a good fall Saturday in the south for football. So, yes, most certainly agree with that. Well, Craig, on behalf of Aaron and I, SHP, we really appreciate your time. This was great insight. We'll be sure to include all the information we can in our show notes and we thank you again.
Craig Kilgore:Sure, I hope something was beneficial to someone out there, so I appreciate the opportunity.
Aaron C Higgins:Yeah, thank you for coming, Craig Yep.
Jason Crosby:You've been listening to Beyond the Stethoscope Bottle Conversations with SHB. This has been a production of Strategic Healthcare Partners.
Aaron C Higgins:Your hosts are Jason Crosby and me, Aaron C Higgins. This episode was produced and edited by Nyle Weed. Our social media content producer is Jeremy Miller.
Jason Crosby:The transcriber is Heather McKnight and our executive producers are Mike Scribner and John.
Aaron C Higgins:Curry For more information about SHP, the services we offer, including the back library of episodes, episode transcripts, links to resources that we discussed and much more. Please visit our website at shplccom slash podcasts. Thank you for listening.
