Private Equity In Healthcare Works Only When Culture Comes First

The fight over where orthopedic surgery happens is really a fight over who holds the power. Ryan Van Puffelen joins us to explain how ambulatory surgery centers (ASCs) moved from “lower acuity” options to the center of modern ASC strategy, shifting control away from the hospital and toward surgeons, administrators, and new financial players.

We unpack the KOL to DOL transition, from key opinion leaders on conference stages to digital opinion leaders shaping what people believe on LinkedIn. Ryan shares what changed, why it matters, and how he built a consistent voice by picking specific lanes: surgeon autonomy, private equity in healthcare, infusion of operational support, and the messy intersection where all of it meets. If you care about healthcare leadership, orthopedic innovation, or building a personal brand that actually opens doors, this conversation gets practical fast.

Private equity gets the honest treatment too. We talk about when PE can help an ASC stay independent, fund upgrades, and professionalize operations, and when culture gets discounted and deals go sideways. We also call out the biggest online mistake we see in healthcare marketing: executives defaulting to corporate reposts that only get love from coworkers instead of creating trust with real people.

Subscribe, share this with a colleague in orthopedics or ASC leadership, and leave a review if it helped. What is one lane you want to own this year?

Transcript

Why Corporate Reposts Fail

SPEAKER_00 0:00

What they try to do is is they start out with just corporate reposts and corporate shares. It drives me absolutely baddie, right? Is you know, we have a product product post, we have a a corporate post, and and then you see if you actually dig into who's who's liked it, who's commented, who's reshared it, right? It is is gonna be nothing but same people in the company, same sales rep, same sales team. And and so that's probably the number one thing that I see, at least from a healthcare executive uh perspective, is they're not putting their voice out there. It is uh they're relying upon kind of a social media team that is um fairly watered down.

SPEAKER_02 0:38

All

Meet Ryan And The ASC Power Shift

SPEAKER_02 0:39

right, we have a special guest today on the Content Crib Podcast, don't we ever, Eric? Yes. And like podcasts are always better when we have guests. They do perform much better, and uh, we've been talking about having guests back on for I don't know, three or four months. And we're so blessed to have an amazing guest here today. We have Ryan Van Pufflin, who for 25 years watched orthopedics quietly change hands. Not the surgery, the control. Where the cases happen, who owns the economics, and who gets to decide what comes next. He has spent a career completely inside that shift from the hospital floor to the ambulatory surgery center, and he has come away with a clear point of view. The ASC movement is not about a cheaper place to operate, it is about power. Today, Ryan will walk through ASC strategy, surgeon autonomy, the real role of private equity, and how he turned a LinkedIn account into actual influence in a field that usually rewards staying quiet. He helps healthcare leaders build a voice, create value, and stop barring other people's stages. Ryan, welcome to the Content Crib Podcast.

SPEAKER_00 1:45

You bet. Chris, uh Eric, thanks for having me on.

SPEAKER_01 1:49

Yeah, I was gonna say that's uh that's an awesome introduction. So we're gonna let you start from when you were a child. No, I'm kidding. We're gonna take this into an intro about you and what you're doing, and and uh and thank you so much again for coming on.

SPEAKER_00 2:04

Yeah, you bet.

Building An ASC Education Ecosystem

SPEAKER_00 2:05

Um, so yeah, as Chris said, uh I'm a longtime ortho guy, uh 25 plus years in the industry, um, a variety of different roles from product development to marketing to professional education. And um, you know, just as a little bit of backstory, so um I was heading up our professional education team about eight, nine years ago, maybe nine, 10 years ago, and uh we did our first ASC national course. Um time of year, just kind of teaching surgeons how to transition higher acuity cases to lower acuity sites of care or the or the the ASC. And I went to our director at the time and I said, take everything else off my plate. The only thing I want to do is talk about this shift. You know, just let me let me own it from soup to nuts. And and thankfully they agreed with that. And so we kind of um what started out is like one time, one national course a year, turned into uh four national courses, um, eight regional education courses over the across the country. We did dinner meetings, we did um you know cadaver labs, and we built out a whole ecosystem of education and visitation sites across the United States. So um, so did that for about four years and and then um about four years ago transitioned it back into the commercial side of the house, a marketing role where I really lead all of our ASC, what I call strategic thought leadership. So, how do we uh think about the ASC space? How do we talk to surgeons and administrators and uh all the all the influencers that are in this side of care and bring productive solutions uh to help them support their practices and their business? So uh once again, appreciate uh you guys having me on.

SPEAKER_02 3:51

Yeah, absolutely. And one question I wanted to ask you because you I mean what you're doing is is incredible and so needed for the space. So uh thank you for doing that. And I think that you really are your clarity on the KOL to the DOL shift is so on point. And I wanted to kick off like the first question on this, because I think that you absolutely nail this. So for people who don't live in this world and that may not, you know, the people that listen to this podcast are mostly in healthcare, but some we have some listeners that aren't. But they do understand the value of what we talk about and you know, personal brand building and and being revelant relevant online and creating your

KOL Versus Digital Opinion Leaders

SPEAKER_02 4:31

voice. But for people who don't live in this world, break down KOL versus DOL. What actually has changed?

SPEAKER_00 4:36

Sure, yeah. So um so KOL is what's what what we term in healthcare key opinion leader. So it's it's some of those more influential, uh, typically surgeons, um, orthopedic surgeons who kind of have a an outsized voice in in orthopedics. So they tend to be the surgeons that are um consulting surgeons, uh, they are leveraged for professional education. Um, you know, they're invited to conferences and speak on behalf of organizations. Um they host groups into their into their operating rooms and and provide education there. Um, they're the ones that are you know speaking from the podiums. That's your historical kind of KOL. And then eventually a lot of them kind of uh work with orthopedic companies on the you know the royalty side or new product development side of things. Um what I have seen really over the past, I'd say, I'd say four to five years, is the shift from from that concept KOL to DOL, which which is a digital opinion leader. And you see it really across all of our industry. Um several of the folks that are on this podcast probably know of of surgeons that I you know you can find on LinkedIn. It's it's your your Dr. Corey Callendines, it's your Dr. Ryan Molly's, it's your uh Chris McClellan, it's your Scott Sigman, um, it's your Dominic Merino. You just go down the list. Yeah, yeah. Uh Charlie DeCook, right? You you're very familiar with these names. And um there has been a rise in in some of these DOLs to to to really kind of change the narrative of what we talk about in orthopedics. And so I I kind of saw that coming early on and and really have leaned into that from my own LinkedIn journey and and kind of have enjoyed finding my own voice, frankly, over the past um you know, four, five, six months and and enjoying the space quite a bit.

SPEAKER_02 6:31

Well, take

LinkedIn Consistency And Picking Lanes

SPEAKER_02 6:32

take us through that, actually, you know, let's pivot a little bit here and take us take us into your your journey or maybe where it started or where it is today. What what were you doing that really started working, or when did it kind of click for you?

SPEAKER_00 6:45

Um yeah, so I I posted about this, I don't know, probably last week or so. But um my my journey or experience on LinkedIn was always um you know haphazard, right? Like I'd I'd be at a conference and and post about it, and maybe you tag a few people and throw a couple hashtags on there, and um then you you you go radio silent for for the next three months and then you post something else, or you go on a business trip and and maybe you you know you write something up about it. But um March 1st of this year, I decided to get much more um serious about it and much more focused on it. And um that led to kind of me thinking a lot more about how I want to position myself and and frankly the call it the RVP brand on on LinkedIn. And so it's just it's more consistent posting. It's it's really uh thinking a lot about the lanes that I want to be talking consistently about. So that's ASCs, it's private equity, uh, infusion, and and kind of the PE dynamics of healthcare, um, the concept of surgeon control, and specifically the the intersection of surgeon control, private equity, um, and asc's all coming together. And then I like to sprinkle in, you know, a little bit of flavor, right? Like the world would be way too boring if if it was, you know, you didn't have a little bit of salt and and spice in there. So uh I'll talk about everything from my my Yorkie to playing Magic the Gathering to coin collecting to whatever hobby I pick up for this week that drives my wife insane. You know, like you have to kind of flavor it a little bit and let people know who you are on LinkedIn. And um, you know, since since March, I mean, for me, I kind of track the metrics a little bit as much as LinkedIn gives them to me. Um, you know, 100,000 impressions, just kind of being consistent with with posting in those lanes and um talking about things that are are of interest to me and hopefully interest to others.

SPEAKER_02 8:46

I want to, you know, I know Eric is dying to jump in here, but sorry, I want to just pass one question. Well, you jump in in a second. Uh you had a great post about the picking the lanes, and I think this is this is like golden material right here. I had this conversation the other day actually with my brother, who's a listener to the podcast, Robbie. So if you're painting your house and listening, what's up? Uh he was trying to understand you know uh you know, he's in this space that you know he's in current he's currently successful. He doesn't know if he's gonna be in it forever, but you know, he's gonna he he pictures himself at the company and he's like, where do I you know I don't want to pigeonhole myself into this? And I went through a little bit. We were at his one of his son's birthday parties, so we couldn't get into too much. I ended up making him a little bit of a playbook that he can kind of you know rack his brain and see where he can take it, but I think it's so important because you posted about how you picked your lanes, and it's really important because of that big A-word that everyone tries to be an expert on, but nobody is. Um but it is relevant to how the algorithm is reading and how people are being becoming more successful, and it actually really coincides with a lot of the ways that we found to be successful years ago, and now it's more important than ever. Can you talk a little bit about that?

SPEAKER_00 10:05

Yeah, um you know you can you could have success on LinkedIn um by by posting generic things that are gonna um do very well, right? Like it's the what the posts that go viral, right, are those that here's the here's my top 10 list on how to use Claude, right, for for LinkedIn, you know, traffic, you know, driving or for uh modernizing my day or what it happens to be, or leadership tips and pearls, or um whatever high level, right? Um and as as you as you both probably know, uh I think about it differently. I I I think there's you know riches in the niches, so to speak. And and I think that you're gonna have more productive, more fruitful, frankly, more um more advantageous for yourself, you know, conversations when you when you define the lanes that you want to speak in and play about. Those are the ones that open up doors for you. Those are the ones that allow you to kind of you know be invited to an advisory board conversation or speak at a conference or you know, join you two, right? As uh as we are right now, and um and kind of opening up those conversations that if I was just posting about you know my my journey from chat GPT to Claude, you know, it might get a lot of views, but I don't know how impactful that's gonna be at the end of the day.

SPEAKER_01 11:28

Yeah, I can tell you there never has been a consultant who's gotten a call for you to share your top ten treat the top ten things about Claude to anybody. So yeah, no, I totally agree. Well, I can tell you one of your lanes that I I I read your post and I read a lot about, and I'm gonna put you on the spot here.

Private Equity And Surgeon Autonomy

SPEAKER_00 11:45

Okay.

SPEAKER_01 11:46

Two letters in healthcare now that either drives people absolutely nuts or they go, I'm on board 100%. And those letters are P private equity. What do you where do you because I'll give you my opinion about it? Private equity, and since Chris has turned me on to this the PE guy on on Instagram and everything else, I don't know if you've ever seen this guy. He's hilarious. Anyway, but but you have to he's a comedian and he's hilarious. Um but he could he makes fun of all the PE guys, the way they dress, the way they talk. It's really hilarious. But all that being said is he he makes uh at one point they was like the goal of PE is to buy something, enhance it in their minds, make it better, and then sell it. That's the antithesis of what healthcare is about. What healthcare is all about. Let's grow together, let's build, let's you know, heal people, let's save lives. It's it's a very interesting dichotomy right now with that. And I, you know, it's it's and there is I feel the pendulum swinging to I hate this thing. This is dumb that this is in the business. What are your thoughts?

SPEAKER_00 12:56

Um how much time do we have?

SPEAKER_01 12:58

I think uh I almost said, and you only can use this many minutes. Yeah, no, that's why Eric doesn't make the questions, so yeah, yeah. I know he's not the question. Um started to hit record, so I'm just telling you.

SPEAKER_00 13:14

Yeah. Um, so I think I think Scott Sigmund said it best. So he was on, I think he did was one of his podcasts, and he goes, he goes, PE is like black licorice, right? Either some people love it or you either hate it. Um and um I I tend to split the difference a little bit, uh split it down the middle with this. I think PE can be good um in the right situations, right? But what I think PE often discounts or or doesn't really factor in is is the cultural side of an acquisition, right? That like understanding kind of the dynamics of of surgeon control, making sure that you know surgeons are bought into the process, making sure that um the private equity group is is willing to kind of preserve as much of that culture as as possible. Um and I also go back to I go back to like the the idea of surgeon control, which as you guys know I'm I'm a huge advocate of. Um there are upsides with private equity if um private equity allows kind of that ASC to remain independent. Maybe there's a group of physicians who they just need the capital to maybe purchase a robotic system or or outfit or upgrade their their OR system, or maybe they need some help on the operational side to better negotiate contracts or or work through claims denials or pre-authorizations. Um, you know, maybe they just don't have a good IT system set up because it's it's two surgeons and and they're not really kind of you know that savvy at this point and they need some help. Um so there's there's pluses and minuses, right? For sure. And Eric, you brought up second bite, that that's often the you know, that's often the uh kind of the goal for a lot of these. But if you can align that with the cultural kind of dynamics of where that the those group of physicians want to go and they're kind of bought into the vision, then um it can be a success. So uh talk to a little bit more on the positive side. There's for sure negatives where it does not work, and um, you know, it's yeah, it can it can certainly turn a lot of people off. So you gotta play, um frankly, you got you have to play a little bit of matchmaker, right? Finding the right private equity firm, matching that up with the right um goals and desires and culture of the of the acquirers and and uh hopefully go from there. So um it's not a it's not an either or, I think it's an and.

SPEAKER_01 15:40

Yeah, I can appreciate that. No, I I I understand. And I've uh I've seen a number of instances where it's worked very well, it's helped, it's uh definitely an enhanced what the uh whether the pra whether this is a practice or whatever the entity is trying to do. It's just that weird piece of the puzzle where the goal is to sell it. The goal is not to, you know, hold on to it, nurture it, and make it no, it's the goal is to sell it in the end, and that's where I think I guess if you're the entity being acquired by P and you understand that h wholeheartedly, then you're gonna be fine. But if you think that they're anyway, I'm gonna go down to say this and then I guess if you think that you they're your buddies and everything's gonna be great the whole time and it's just gonna be fantastic, that's just not the case. That's not what happens.

SPEAKER_00 16:31

Yeah, you you have to you have to go into it eyes wide open, right? And you have to understand, right, that there's going to be um, you know, if if you're a surgeon, right, um hopefully if the deal is structured right, like you're still gonna be given clinical autonomy to to do what you want to do, right? And treat patients the way you want to treat them. And in theory, kind of all the the operational, the day-to-day running of an ASC, um, some of the financial mechanisms, the things maybe you don't want to deal with, um, maybe those are are in the hands of a private equity firm that that frankly probably knows how to do that a little bit better than than your standard orthopod. Um so if you kind of go into that eyes wide open, then it can be a success. But I've you know I've seen them go really bad as well. So you just gotta you gotta be careful as you work your way through the deal.

SPEAKER_02 17:20

Where do you see you know private equity uh in this space of uh building a brand? Like I I I feel like it's just a part of you know, the the things that they don't really care about, bucket. Um yeah. How do you have you seen some forward-thinking uh people that put at the top of the list of you know the marketing or prioritize it? Are you just seeing, you know, it's too archaic? They're too archaic in a slow.

SPEAKER_00 17:51

I see the potential for it. Have I actually seen it in practice? No. No. I mean, I I have seen um like a lot of times, you know, if you if you have a a PE firm coming in, they're looking to they're they're gonna look at ancillaries, right? So what are you doing with imaging? What are you doing with your your physical therapy? Are there other you know kind of you know portions of of the practice that you can bring underneath the umbrella, so to speak? Um but and they're also looking at you know surgeon retention, surgeon recruitment, those kinds of things. They obviously want those folks to to stick around. But I think I have not seen, at least to the scale that I think there could be um infusion into like making your good surgeons busier, right? Which is a lot of which is a lot of what you talk about, Chris, the kind of the marketing behind them and and establishing their brand. And um, that's relatively untapped space. So um, while in theory, I think it makes a lot of sense, I haven't seen it done practically.

SPEAKER_02 18:48

Do you think there's an opportunity, and maybe this is part of what you're uh thinking about of being that kind of ASC you know surgeon ninja helps bolster them? I don't know. I mean to me it's right. I mean, we all know that surgeons bring in the revenue for the hospitals and different entities, ASCs and whatnot, right? So where where do you make them under how do you get them to understand that building trust at the core of the revenue machine is the fix and not the ancillary, I guess. Maybe this is a question that can't be answered today, but just kind of where my brain is going.

SPEAKER_00 19:25

Yeah, I mean I it makes a lot of sense. I think you have to um it in my mind it kind of goes back to the to the culture thing. Like you have to have a PE firm that understands the importance of a surgeon that's wanting to do that for for themselves, right? And and being able to um again kind of go back to the the idea of surgic control. Like if that if that surgeon is wanting to grow, then you need to have a PE firm that is aligned with their growth objectives. And if they're part of that growth objective is is developing your own digital voice, then um then they better be pretty flexible to kind of support them along the way. But again, practically speaking, I haven't seen a lot of people do it. So it, I mean, it's a it's a space I'm actively kind of having conversations in and trying to help people out as best I can, um, just knowing a little bit of what I know on the on the PE side and ASC side. Um, but yeah, it it's relatively untapped ground.

SPEAKER_02 20:22

Yeah, the reason why I bring it up, and Eric, maybe bail me out a little bit if I'm going down a bad path, but you know, PE is like the antitrust, right? I mean a lot of people don't know PE's like it's going on unless you ask people that work there directly. Right. But it's like, you know, how how do we make P a good thing? You know, that to me that you know it could be a good thing, but how do we make sure it's a good thing? That's kind of what I'm thinking of like, you know.

SPEAKER_00 20:50

Yeah, yeah.

SPEAKER_01 20:51

I mean, they need to have a firm that can really share their I think they need to have a firm that can really share their thought leadership in a extremely um presentable way abolished and compliantly. Yes. That's that's what they need, Eric. You're right. That's what they need, you're right.

SPEAKER_02 21:08

No, so while they mess up, while they mess up and don't do that and go down and and find the right people to help with that, what is the biggest mistake you think, Ryan, healthcare leaders make when they try to build a presence online?

The Biggest Mistake Leaders Make Online

SPEAKER_00 21:21

Um yeah, well, well, number one, I I what they pro what they try to do is is they start out with just corporate reposts and corporate shares. Um drives it drives me absolutely baddie, right? Is um, you know, we have a product product post, we have a corporate post, um, and and then you see if you actually de dig into who's who's liked it, who's commented, who's reshared it, right? It is is going to be nothing but same people in the company, same sales reps, same sales team. And and so that's probably the number one thing that I see, at least from a healthcare executive uh perspective, is They're not putting their voice out there. It is uh they're relying upon kind of a social media team that is um uh fairly watered down, and and they're just not um having an independent, authentic, relatable, credible voice that people can relate to and and start to open up conversations with. So, number one, far and away, that's probably what what I see the the absolute most. Um, you know, that at least it drives me drives me nuts. Eric, what are what are you seeing?

SPEAKER_01 22:29

Oh, you hit the nail on the head, Ryan. I mean, that's what they do, and uh I get the biggest kick out of what we're gonna do is we're gonna make a bigger picture of the implant and we're going to put it online again on LinkedIn. It's bigger, it's gonna be better. And you're right, it's the same exact people. And you know, Chris and I preach it, and obviously you get it wholeheartedly. Is if you're sharing value, people are gonna listen. If you're sharing your stupid borrow sorry, I shouldn't say stupid. If you're sharing a photograph of something new that you're about to sell no newsletter, nobody cares. They don't care. And and they just for whatever reason, somebody's telling them they do care. And I think it's the you know VP of marketing from 1986 that's telling them that. I I you know, and I don't I hate to be I don't want to be rude, but it's just I'm like, nobody nobody cares about that anymore. And it's the most mysterious department in all of medical devices, the orthopedics marketing department. I I I'm like I say this to I said this to a buddy of mine who's a VP of marketing the other day. I'm like, dude, you know you can shut down your department and nobody would know or care. Of course, he told me 30 reasons why I was wrong. Some of them were valid. I mean, I was just trying to be a little bit hyperbolic and you know, kind of give them a jab, but I don't know. It's I think the ones who start to get it, you mean obviously like you and others that I mean it would be a whole new landscape, but man, truly a benefit to being in the high margin, uh high margin medical device space because you can be really bad at things and it's still okay.

SPEAKER_00 24:04

Yeah, and you have to, I mean, obviously there's you know, there's rules about um what you can post about and what you can't post about, and it's gotta be on label, it's gotta be, you know, you can't be off color, you know, those kinds of

Better Ortho Marketing Starts With Patients

SPEAKER_00 24:16

things. But um there's much more creative ways, I think, that um all of orthopedic marketing can can be a little bit more engaging because um you know these are these are actually if you if you boil it down, these are kind of very real problems that people who have orthopedic joint pain are are struggling with, right? And um frankly, it's opportunities missed because people are people are hesitant to go to doctors, people aren't sure about whether they're you know they have enough money to to pay for what their deductible is, um what their experience is going to be. Uh, I talk a lot about that, kind of the concierge experience you can get in an ASC relative to the hospital. There's so many different avenues, right, that that we could be talking about that are that are actually real problems for both our customers, customers being surgeons, ASC owners, administrators, and patients, um, beyond kind of the traditional marketing. That um that's what gets me fired up is I I enjoy those, you know, those ancillary conversations, those conversations around the fringes, um, the I concepts like surgeon control and getting you know getting autonomy back to to those who are delivering the best care for patients. And um that's where I think uh ultimately this is gonna go.

SPEAKER_01 25:34

Well, on this podcast, we've solved PE, the uh marketing department of major medical device companies. I mean, I think we've got a lot of progress here, guys. We've done a lot, no, but thank you. I want

Final Takeaways And Where To Follow

SPEAKER_01 25:45

to thank you, Ryan, for coming on. I really appreciate your perspective. And uh, for those of you who are listening, make sure to follow Ryan on LinkedIn. He uh shares value every day, every day that he posts.

SPEAKER_00 25:58

I appreciate it. Thanks for having me. Thank you, Ryan. Yeah, thanks for having me on, Eric and Chris. It's been fun.

SPEAKER_01 26:03

Absolutely. Take care.

SPEAKER_00 26:05

Okay, bye bye.