The Business Of Better Orthopaedics with Aaron M. Chamberlain, MD, MBA, MSc, FAOA

The next wave in orthopaedic surgery isn’t just surgical technique it’s how care gets organized, measured, and paid for. We sit down with Dr. Aaron Chamberlain, senior medical director for Intermountain’s musculoskeletal clinical program, to unpack why vertically integrated healthcare systems can be a powerful engine for value-based care and what that means for surgeons who want to lead, not just react.

We talk candidly about “risk” and why taking on financial accountability can actually unlock better medicine: clearer incentives, tighter alignment with payers, and a sharper focus on outcomes across the full episode of care. Aaron shares how Intermountain uses deep data infrastructure, enterprise dashboards, and careful patient cohorting to reduce unwarranted variation and make cost and quality visible to clinicians. If you’ve ever wondered how an Epic-era analytics platform can change real-world practice patterns, you’ll hear the nuts and bolts.

You’ll also get a concrete care redesign example: shifting appropriate hand procedures from the hospital or surgery center into the clinic, then using shared savings to reward the extra work required to make the change safe and scalable. We connect that playbook to broader trends like bundled payments and the CMS TEAM model, and we close with leadership lessons that translate anywhere: keep physicians involved, stay close to the bedside, and “fall in love with the problem” before you pitch a solution.

If you found this useful, subscribe to the AOA Lessons in Leadership Podcast series, share the episode with a colleague, and leave a review with the value-based care question you’re wrestling with right now.

Transcript

Welcome And Guest Background

SPEAKER_01 0:23

Welcome to the AOA Future in Orthopedic Surgery Podcast Series. This AOA podcast series will focus on the future in orthopedic surgery and the impact on leaders in our profession. These podcasts will focus on the vast spectrum of change that will occur as the future reveals itself. We will consider changes as they occur in the domains of culture, employment, technology, scope of practice, compensation, and other areas. My name is Doug Lundy, host for this podcast series. Joining us today is Dr. Aaron Chamberlain. Dr. Chamberlain is a board-certified orthopedic surgeon with Intermountain Orthopedic Specialty Group. He's the senior medical director of the musculoskeletal clinical program at Intermountain. His clinical interests include shoulder and elbow problems as well as innovative arthroscopic and open reconstructive surgical techniques. Dr. Chamberlain is passionate about advancing and innovating surgical care on the shoulder and elbow. He went to medical school at the University of California, San Francisco, graduating in 2006, did his residency at the University of Washington, his fellowship at the Washington University School of Medicine and Shoulder and Elbow Surgery, and then got his Master's of Clinical Investigation and his Master's of Business from the Washi School of Medicine. So, Dr. Chamberlain, welcome to the podcast, sir. Thank you, Doug.

SPEAKER_00 1:54

Thanks. It's great to be with you.

SPEAKER_01 1:56

All right, Aaron. So we are, as you know, we're talking about the future in orthopedic surgery. And you have the distinct honor at working

What Makes Intermountain Different

SPEAKER_01 2:05

at one of the largest and most integrated healthcare networks that I'm aware of at Intermountain Health. So, and you've obviously become quite integral in that with getting your master's degrees in both clinical investigation and your MBA. Tell us a little bit about Intermountain and what brought you out that way and why you like working there.

SPEAKER_00 2:26

Great. Yeah, Intermountain Health is a large vertically integrated health system that's been around for the better part of 50 years or so. The goal is to become a model health system where we take care of our community nonprofit managed by a local board up until a couple of years ago was primarily housed in Utah and southern Idaho. And then over the past, you know, handful of years, we've expanded into the Las Vegas market, as well as we've now merged with a health system called SCL based primarily in Colorado and Montana. So recently, Intermountain Health has become larger. So we're in several states, about 33 hospitals and around 20 JV'd surgery centers that we operate in. We have over 60,000 caregivers. And the other thing that's unique about Intermountain is we have a health plan that's called Select Health. And so it's our own health plan. This is an important part of our business strategy. But we're a little different than Kaiser in that Kaiser is fully integrated. You know, all care they provide is within their umbrella and their health plan and insured lives within Intermountain with about 40%, 30 to 40% of our book of business is through our own health plan or Select Health, but we also contract with other health plans as well. So we walk this tightrope at Intermountain between both the fee for service, traditional fee for service line of business, as well as our at-risk or value-based business as well. So we're trying to navigate both worlds at the same time.

SPEAKER_01 3:53

Man, there's a lot we can unpack here. So this is really great. Give us an idea if you could, if you know, how many orthopedic surgeons work at Intermountain Health?

SPEAKER_00 4:03

We have employed surgeons. I would say we're in around 80 or so, maybe a little over 80. And then more than that, we have affiliated surgeons that work with us. So we're over 200 surgical providers across all of our sites. Again, most of which are affiliates with us and closely aligned partners. And then there's a healthy number of employed docs within our

The Musculoskeletal Program Mission

SPEAKER_00 4:25

system.

SPEAKER_01 4:26

Very good. And what is your role as senior medical director? What do you do?

SPEAKER_00 4:30

I lead the musculoskeletal clinical program. And what that means at Intermountain is it's an enterprise-wide party organization where we have enterprise-wide visibility, where we try to develop and align practices around clinical best practice, evidence-based practice, as well as innovative care delivery models. So we want to make sure that our patients are getting the best quality of care, whatever site they end up coming to to see us across our system. And so that's our goal is that orthopedics is delivered at a high quality everywhere our patients are. And at the same time, the clinical program is asked to look at kind of value-based care initiatives and innovative care design. So we function a little bit as kind of an internal consulting portion of the organization where we're asked to kind of look ahead and around the corner what's coming and how do we best position ourselves to be successful in the future.

SPEAKER_01 5:21

And you started there right after your fellowship in 12, is that right?

SPEAKER_00 5:26

I started at Intermountain in 2023. So I finished my fellowship at Washington St. Louis in 2012 and then stayed on faculty there until January of 2023 when I came to Intermountain. Yeah. Okay, great.

SPEAKER_01 5:39

All right. So you've been there since 23. Tell us what, if you were gonna tell

Why He Left Academia For Innovation

SPEAKER_01 5:45

us what brought you to Intermountain and what's the advantage of being there? Why? I mean, WashU, my gosh, what a great system that is, and some incredible people there. So you had to leave there for a good reason. What brought you to Inner Mountain?

SPEAKER_00 6:01

Yeah, no, WashU is a fantastic place. We had a great experience there, great partners. Could not have asked for a better experience as a academic shoulder surgeon. My research interests led toward a path of an interest around healthcare delivery, innovation, health economics, and kind of recognizing the problems that we all see and practicing in our current landscape in healthcare in the United States and having a desire to try to understand the problems better, but then find solutions at some of these large-scale problems that we see fundamentally with our system. And so that led me to get the MBA to try to understand better the language of business. And after doing that, I engaged a lot with Washu and the hospital partner, BJC Healthcare, around initiatives on improving efficiencies, cost of care, and working along those lines. What I came to realize is the next level of innovation in healthcare delivery or some value-based care initiatives really requires a unique relationship with health plans or payers. And around that time was when Intermountain's former senior medical director for the Muscular Skell Clinical Program called and said, I think we have similar interests and would love to have you join the team. And so we chatted for a while and it became clear to me that uh the best lab to do some of this research is in a lab where you have a lot of, you have your own health plan or a lot of financial risk that you can then try to organize around to organize your care delivery system to be successful. I think it became evident that some of the most innovative things I think we can do next in healthcare is partner between payers and provider groups and healthcare delivery systems and start thinking outside the box that way. And so Intermountain presented a uniquely strong opportunity as a lab, so to speak, for value-based care initiatives and some of the care delivery innovation that I'm more interested in.

SPEAKER_01 7:50

That is really cool. And we're gonna want to get into that in a minute. But before we do,

Vertically Integrated Care And Risk

SPEAKER_01 7:55

this is about the future in orthopedic surgery. Can you make the apologetic of why the large vertically integrated healthcare system is the way to go in the future? Is this the future of medicine in the United States? Is this the future of orthopedic surgery? And if so, why is that?

SPEAKER_00 8:15

Well, in the sense that it provides an opportunity to organize around how healthcare is paid for, and then organize that along with how healthcare is delivered. I think you can make a very strong case for that, which is why I think working for Intermountain Health makes a lot of sense. I think there's, like I said, the future in my mind in cutting out some of the fat that we see in healthcare is a better, more strategic relationship with health plans. I think historically health plans and health insurers have been viewed in an adversarial way with providers. And I think there's a lot of reason for that, and it's valid. I think there's a lot of opportunity to improve on that. But I also see that if we can share risk, financial risk between the providers and those who pay for care, I think that provides a lot of opportunity to really scrutinize how we spend dollars, get providers more aligned, and have more say and involvement in how those dollars are spent. And I think that can only provide some more harmony and alignment with the health plan. So I think in the sense that vertically integrated systems have financial risk and they involve their providers and how to best use that financial risk, I think that's a good thing.

SPEAKER_01 9:22

I hear your MBA coming out through this entire discussion. I love it. And I really appreciate that. When I was at Resurgence in Atlanta, we embraced risk. We went out and looked for it because risk is where the sweet spot is for well-integrated and organized groups. And you brought up that word multiple times so far. Can you explain to our listeners why risk is the avenue to do something cool, to come up with something cool and innovative? Risk is where the sweet spot of that is, right? So how does that all work together?

SPEAKER_00 9:56

Yeah. So I think for us at least, it's how to best describe it, but when you hold the financial risk, those delivering the care or designing the care that's being delivered have a more direct line of sight on the dollars being spent. And by holding risk, you're also holding yourself accountable to outcomes. When you hold the risk, you understand as the patients do better and are healthier, you do better financially. So it aligns that the business aspect and the financial performance with the clinical performance of the lives you're taking care of. When there's too many degrees removed from the financial risk and those that are spending the dollars or those of us that are making clinical decisions, then I think it becomes the clinician becomes a little blinded, or at least the effects of their decisions become obscured in that they're just like, this is what I think is best. And I really don't know the ramifications of those, some of those decisions as far as costs are concerned. And so uh with that, I think risk just aligns and approximates those that are making the clinical decisions and the costs associated with those, with the financial ramifications of those decisions. It's also, we've, and I'll

Data Platforms That Make Value Work

SPEAKER_00 11:05

tell everybody this, I think it's a very data-heavy lift. So to do this well, you need to have really good data. And historically, health plans have had a lot of good actuarial data at large scale, et cetera. In some regards, hospitals have had data, but I would say it's more of a rare occurrence where health systems or clinicians at the bedside have a clear line of sight of data, both clinical outcomes data as well as financial data that helps them inform some of their decisions. And Inner Mountain has a long, rich history of data, understanding where there's variation in care, how do we minimize variation in care that's unwarranted variation, I should say. And then in addition to that, understanding the costs of our choices. And so Inner Mountain presents a nice kind of landscape to do some of this work. But I would say to anyone considering more risk, it's important to dovetail that drive for risk with a drive for data and building those data platforms.

SPEAKER_01 11:58

And by embracing risk, you're able to incentivize the patients and your physicians to all have exactly the same motivation and work toward that, right?

SPEAKER_00 12:12

Yeah. So we so one one kind of use case that we, I think highlights this well, and what we've been able to do is when we have the risk, so our select health payer is a close partner and a good strategic partner for us to design some of these care models. I'll say, for example, our hand surgery practice. So we identified an opportunity clinically where there's there is a wide range of clinically appropriate hand surgeries or procedures that can be done in the office setting. And so we went to our medical groups and the operational side to understand better what the needs would be to execute safely and perform hand procedures in procedure rooms that have been nicely designed,

Moving Hand Surgery Into The Office

SPEAKER_00 12:50

clean, good sterilization process, and a whole team built around that. But as we started to approach hand surgeon providers, it was like, well, it's work to shift. You know, I've got block time at the surgery center or the hospital. It's a different thing for me to manage a team, to do more procedures, get sterilization equipment. In some cases, it's hard for people to figure out or be comfortable having an awake patient all the time. And it's work for them. So there was a there is an amount of work we were asking our clinicians to do to try to shift that side of care to the clinic in order to save the health plan money. So in exchange, we went to the health plan and say, with this risk, we're we're planning to save you X amount of dollars, which was substantial. It was in the millions of tens of millions of dollars annually if we shift our cases to the clinic. So with that, why don't we take some of that savings and share that back to the providers here doing the work? And we can say, all right, if we're doing a good job, we're getting good outcomes, we're saving the health plan money. Why don't we share that back and appropriately place financial value to the time and effort that the providers are putting forth? And so I think that was a nice harmonized way to say, you know, we're asking something of our providers. It's putting a little more of a load on them. And likewise, we'll we negotiated a professional fee reimbursement premium for those cases that are done in the office. So with that risk, we were able to be creative with the financial model and align the financial model with the care delivery model that we were promoting.

SPEAKER_01 14:17

That's fantastic. And you said this the your insurance program that y'all are part of is about 30 to 40% of your book of business. Is that right?

SPEAKER_00 14:26

Yeah, as a system. And in this, and in some of our markets, it's closer to 50% of our book of business. But yeah.

SPEAKER_01 14:32

Are you able to persuade the other third party payers this is the way to go and get them to jump on this mechanism of delivery care?

SPEAKER_00 14:40

Yeah. So that was the really nice effect. And I think uh what I've learned is there are other health plans are interested in some of these innovative models. It's work though to try to establish a performa and predict how that's going to work. So when we piloted this with our health plan, we could then take that experience and demonstrate to other health plans, say, here's what you can expect if we were to initiate this. And we did then find other health plans following suit and say, okay, that makes sense. We can, we can we can follow that. That makes sense for our business as well. We would like to have that, the savings and claims expense, clearly. And so we were able to work now in contract with other health, multiple health plans to achieve the same end.

Getting Other Payers To Follow

SPEAKER_01 15:20

This is very interesting because I feel like the majority of the push toward value-based care is coming from the federal government. And in most communities, were it not for CJR, BBCI advanced, and now the team model, that many orthopedic surgeons would not be involved in value-based programs at all. Yet it seems like y'all are leading the way, saying, no, no, we forget it, Medicare, we know how to do this. We're setting it up here. This is how we go with it. And then almost dragging federal payers behind you, say, if you just do it this way, it'd be better. Am I putting too much in that or well?

SPEAKER_00 16:00

No, I think you're right. I think we've we view this work as inherent to our business strategy. This is part of our business strategy with the amount of risk we hold as an enterprise. And I think as an enterprise, we're north of a $16 billion by revenue, and it's a large system. And for us to succeed, this is part of our business strategy. We hold that much risk, we need to perform well with that risk. So we view that as part of our strategy. And we need to deliver on that for us to succeed as a system. That said, I think what CMS is doing should be lauded. I think they are creating maybe the impetus of the nudge that people need to be able to say, look, we need to be thinking about this a little bit more. And I don't think people weren't doing it because they didn't see the benefits. I think it was the systems, we all get so entrenched in the day-to-day, how to be successful. And there's always these financial pressures, economic forces, et cetera. The constant view has always been how

CMS TEAM Model And Joint Dashboards

SPEAKER_00 16:55

do we improve on our performance in our current model and our fee-for-service model? So I think what CMS is doing is trying to nudge in that direction to say, we're now going to introduce or kind of force people to think about this a little bit. They've come in with a little bit of a light, light touch. It's getting heavier, and some of the things need refinement. But I think the CMS innovation group should be commended for their efforts and go in moving in that direction. But I think for us at Intermountain, we view ourselves as we need for a business case and our own business strategy, we need to be ahead of that curve. We need to be the tip of the spear on that and hopefully provide data and experience in our pilots that will then inform either CMS or other health plants who want to deliver on that value-based mission as well.

SPEAKER_01 17:39

Very well said. Yeah, that was excellent. So are y'all involved in the team model at all?

SPEAKER_00 17:45

We are. We have four hospitals that are participating.

SPEAKER_01 17:48

Okay. Are you how are y'all able to tell us about how your experience with value-based models has helped you in that engaging team? Because team is relatively new. It's only what less than a year old, right?

SPEAKER_00 18:00

Yeah, it's new. And in fact, I think it just started January 1st as far as the you know tracking data. Prior to team, we've had I think many of us have had experience with CJR and other CMS-related bundles. We've had over the past three years, we've had experience a little bit with some similar, I guess it's somewhat similar. We call it our scorecard. So for our total joint reconstruction surgeons, we've had data tracking for eight years or so, a very well-established and well-developed dashboard on complications, readmissions, non-home discharges, supply costs per case, all of that. So we've built that into our culture over a long period of time. What we've had over the last two to three years now is we've added a financial incentive that is funded by claims expense savings. So the claims to the health plan. And so we worked with our health plan to say, all right, we did this in hand. We're going to start dipping our toe in the water in the reconstruction space. And if our surgeons can perform at these benchmarks, and they're fairly aggressive benchmarks as far as very low complication rates. And as a system, we're in the low 1% as far as complication rates. So we've got a lot of people's attention on how to keep those complications low and really work to be cost efficient with our decisions, our choices, our implants, and supplies in general. But over the last two or three years, we've built in this financial incentive that's funded by the health plan. And so that's just increased engagement and provider alignment. And so, team, the team initiative is now started and it's already well aligned with our existing practices as far as tracking metrics, looking at claims expense savings over an episode rather than just the surgical procedural episode. We're looking at the episode of care over a longer period of time. And that's what one of the things the team is looking at as well. So it's aligned very well. Interestingly, the the hospitals that were mandated or required to participate in Team for Us are hot, three of the four are new to our system. And so this has aligned the timing of team has aligned with us also introducing our existing scorecard that we've had for our legacy intermountain system. And so it's an interesting, fortuitous timing that those all coming together at the same time.

SPEAKER_01 20:04

Yeah, that did kind of work out well, didn't it? So I imagine speaking of your data, do you mind telling us what system collects your data?

SPEAKER_00 20:13

What do you mean, which system?

SPEAKER_01 20:15

Do you use Red Cap or how do you collect your data there?

SPEAKER_00 20:18

So we have an enterprise-wide data platform, the EDP we call it. It's been around for quite some time. It was extracting data from our electronic medical record. It was a Cerner EMR prior to last year. Last year we transitioned to Epic. And one of the biggest areas of focus for our transition to Epic was just how do we continue to gather and feed our data platform with data from the EMR. So uh we have our own internal data platform. We have an extremely talented, large fleet of data analysts and architects. And that's just something that Intermountain has invested in over a long period of time. And we meet with them weekly to go over data and what types of data we need, how accurate are the data, et cetera. And I think that data and being able to have a clear line of sight of that data, but also cohorting that data. So cohorting is an area that we've focused on with our data architects, where when we deliver data to surgeons or any provider, the first response is always, is this accurate data? What's being lumped into this data? So we want to make sure we're comparing apples to apples in these data. And when you're tying a financial

The Surprising Metric That Predicts Performance

SPEAKER_00 21:20

incentive to that data, you've got to be really sure that you've got an apples to apples comparison. And so a lot of the work that our data teams have worked on over many years is cohorting appropriately and make sure when we deliver a cohort of data around primary total knee replacement, that's all that's in that data set. And we're comparing apples to apples across surgeons. So our data platform is central to a lot of what we do as far as how we exercise our ability to perform with value based care strategies.

SPEAKER_01 21:48

So in Jim Collins' book, Good to Great, he talks about a single economic indicator that his companies that excel that he they say they look at is they would look at one specific. Specific thing. They would look at all the data, they look at the entire dashboard, but there was one thing they always kept their eyes on as a barometer to see how well the company is doing. Do y'all have a single indicator, quality indicator, a productivity indicator, a value indicator, whatever you want to call it? Is there one thing that Aaron looks at at the dashboard month after month to see how well the enterprise is doing?

SPEAKER_00 22:23

That's a great question. I hadn't thought of that. I'm aware of his quote and his book. I hadn't thought of it in terms of this as a single indicator. But interestingly, one of the indicators and metrics that we track are subspecialty meeting attendance. This may be unexpected to some, but we have every week or every other week on average, you know, subspecialty meetings across the enterprise. So affiliate or employee docs, we meet at 6:30 in the morning on Mondays. Our hip and knee reconstruction surgeons meet on Tuesday mornings. It's our primary care sports group. I'm in the shoulder group on Thursday mornings. So we have these meetings Monday through Thursday before the OR day starts. They're clinically based discussions, journal clubs. Hey, here's an interesting case. Wanted to get everybody's opinion on it. These meetings are probably our single indicator. The indicator that most drives us and where we see aligned surgeons, meaning they're attending at least 50% of the meetings, they're engaged, they're all presenting at the meetings. These are surgeon-led discussions. Uh, where we see our most aligned surgeons, we see the highest performance on the other metrics in the scorecard. Because in these meetings, we share best practices, evidence, and then people become aware of how they can subspecialize in this area. If somebody attends a meeting and they start to feel like I'm just dabbling in shoulder replacements, and it's clear that maybe I'm not up to speed on all this and it's not something I want to focus on. They let the shoulder replacement experts take those shoulder replacement cases. And that subspecialization is kind of a natural progression. The clinical best practices and evidence-based medicine is another kind of common effect. And we date, we share a lot of data at these meetings so people can see where they stand as far as their complication rates and spend and supply expense, how much narcotic they prescribe after certain procedures. We share that data at these meetings. And so just by attending the meetings, the surgeons get a lot of knowledge, understanding, networking, but also data that helps inform their decisions. So I would say for us, meeting attendance has been our main indicator for alignment and performance.

SPEAKER_01 24:26

So, in terms of looking at the future of orthopedic surgery, it seems like y'all have found the golden ring. I mean, I would not want to try to compete against Intermountain and any of the venues that you guys are so dominant in just because everything you're describing is exactly the way that healthcare should go in terms of producing the value-based paradigm that we've been looking for for so long. Is that working out? Are you consolidating in the marketplaces where you seem to be dominant on and you're kind of getting that edge? And people are going, yeah, this is the future of healthcare, or are you getting a lot of pushback?

SPEAKER_00 25:04

Well, I think it's a market-by-market thing. And I appreciate your kind words. And I view Intermountain as being, I'll say, poised to be able to deliver on a lot of these things that we, you know, we're talking about. I don't think we're there yet. I think we still have work to do clearly. But where we've had, where we've been, as far as Intermountain's been for a longer period of time in our, what I'll say, our legacy Intermountain markets, yeah, Intermountain's a pretty dominant presence in those markets. And I think most other we have good relationships with other competing systems and multi-specialty practices. They work with us at our hospitals. And so we have good collegial really, we view that as important. We don't want to be adversarial. But what I think the effect of that is is hopefully we're all boats are rising. We're helping each other out. We're share, we're sharing data with those other

Building Physician Leaders At Scale

SPEAKER_00 25:50

competing groups where they have surgeons working in our hospitals. We share data with those practice administrators. So they see how their docs are doing. And so we we have a very, I hope, collaborative and collegial approach to the markets where we have competitors in the market, but hopefully we're helping everybody improve. We have other markets where we're less well-developed, we're newer to those markets and we're just feeling things out. We're trying to build relationships. Hopefully, we'll have a positive effect in those markets. But I think we're it's still maybe too early to tell.

SPEAKER_01 26:18

So, as you know, the AOA is all about the development of leadership in orthopedic surgery. And you have been dropping leadership pearls since you got on the podcast. But this is this takes a tremendous amount of leadership to get folks away from the conventional fee for service. The more I work, the more I operate, the more RBUs and collections I make, the more incentivize them to do these things. This is an entirely divorced mindset in terms of developing the value-based care. How do y'all develop leaders within Intermountain? Because if we don't develop our folks that follow behind us, I mean, this is just a flash in the pen and it's all gone. How are y'all working to develop the people that come behind?

unknown 27:07

What is that?

SPEAKER_00 27:08

It's a great question. It's a great question. So I'll start with one thing that I think Intermountain does very well as far as leadership is there's a heavy dose of physician leadership in the system. And with physician leaders, it's asked or required to continue to be clinically active. So those of us in physician leadership roles, we are clinically active. And I think that's important because leaders in healthcare, it's different than leaders in other, maybe other industries or economies, but I think it's important to understand what's happening at the bedside and understand effects of decision, effective decisions at for our patients on the front lines. As far as developing leaders, we have a pretty well-established leadership institute at Intermountain where we have leadership coaching available. So as we identify those who have interest in leadership or aptitude, we will enroll them in coaching along those lines. We have leadership development programs leading through others is one, some other executive leadership programs where we can nominate folks on our teams to go through and have some additional education through some great instruction. And we have very collaborative, very amazing guest lecturers and professors, so to speak, from other well-known institutions, Stanford being one that we have a close partnership with, et cetera. So we have a lot of opportunity inside the organization to identify leaders and help get them additional expertise. And then with as large of an organization as we have, we do we have a lot of opportunities to bring people in to help with the decision making. We're a highly matrixed organization. So the leadership umbrella is broad rather than being too narrow where you got just a few people making decisions. We intentionally broaden that decision-making umbrella and we want more voices, we want more input. And so we'll involve a lot of people in those decisions and in those parts of the organization to a fall sometimes. I think sometimes it causes us to move too slowly, in all honesty. I think a large matrix organization, that's one of the challenges is how do you remain nimble and be able to move quickly when needed? But I think we continue to learn how to navigate that space.

Fall In Love With The Problem

SPEAKER_01 29:24

This was where I was really able to help influence change for the better for the patient care, all because anything that you would give somebody as an advice that you picked up on in the process of doing this.

SPEAKER_00 29:43

This is different. But I think what gives me kind of the professional satisfaction, makes me smile, and the leadership side or the administrative side of my role is honestly understanding the problems to a deeper level, where we as a clinician or as a surgeon, it's easy to see where things get frustrating. You're like, man, this is slow, this is frustrating as a clinician. I can't get this done like I want to get it done. Now that I have a portion of my time set aside to just dig into the problem, I've been able to better understand the problem. And a wise colleague of mine from business school once said, fall in love with the problem before you try to fall in love with your own solution. Once you understand the depths and breadths of a problem, then you can start to pick away at finding a solution. And we've had a handful of opportunities, whether it's on the supply chain side, robotics, or just care delivery integration, where we've been able to say it's been rewarding to go in, really understand the problems. And I think in healthcare, it's important to understand the various stakeholders and understand their incentives. What's incentivizing? And what's great about Intermountain is we have all those stakeholders represented within our one organization. We're all on the same team, technically, and yet we have a healthy tension with hospital presidents wanting more cases in their hospital for the revenue. And yet then we have a surgery center that competes for business. And then we have a health plan who wants to have a different set of considerations from the hospital president. Now, all along we have caregivers who are living their own experience and then have their own considerations. So for me, the rewarding part has been to say, take the time to understand the depth of the problem from the perspective of all those related stakeholders. And once you have that, then you can start putting the pieces together to find where is the opportunity for alignment. And for me, that's been the really really rewarding part to say, how do we get to a win where in the end the patient wins and it's all our measuring stick is does the patient do better? Are we making the patients better, either through both through their health and their outcomes, but also how much they're spending out of their pocket? I want our patients to get the best health care, live the healthiest lives possible, and I want them to spend less on their healthcare premiums over time. And so this is our big arching goal, but being able to piece together and understand the stakeholders and their needs, incentives, et cetera, find the win and be able to organize around that, I think it's been really rewarding.

SPEAKER_01 32:05

That is a great way to wrap this up. Thank you. So it has been an absolute pleasure talking with Dr. Aaron Chamberlain, who is a senior director in the musculoskeletal vision and delivering value-based healthcare at Intermountain Health. And once again, some very great pearls on leadership. Aaron, thank you so much for being on the podcast.

SPEAKER_00 32:26

Thanks, Darren. Happy to be here. Thanks for having me.

SPEAKER_01 32:30

Very good. And y'all look forward to future AOA podcast series on this channel.