The On-the-Job MBA: A Surgeon Decodes Healthcare's Money
episode
ChalkTalkJim: Breaking Down the Game - A Guide to the Future of Healthcare
44 min
1 speaker
6 chapters
transcribed 1 month ago
Transcript
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Transcript generated automatically by AI and may contain errors.
How did Dr. Erica Urquhart’s private practice experience become her on‑the‑job MBA?
My guest today is Dr. Erica Urquhart. She's an orthopedic surgeon and a partner at Urhhart Orthopedic Associates. She also holds an executive MBA, recently authored a book on her experience inside the business of medicine. She's also become one of the clearer voices on what physicians, patients, and policymakers actually see from the front lines of reimbursement. Erica calls her path to healthcare economics, an on-the-job MBA. earned year by year as she grew in a private practice with her husband, and started asking questions most physicians never get the time to ask. Something important to me in this conversation we decode why the talent in medicine receives the smallest share of healthcare dollars, how algorithmic denials and delays quietly became a business strategy, and why prior authorization rules vary insurer to insurer for no defensible reason, and what patients and practices can do about it right now.
So Erica, tell me in the audience a little bit more about your journey.
Well, it's a pleasure to be excited about this podcast interview. My name is Dr. Erica Rowe Urkhart. I'm an orthopedic surgeon and partner at Urquhart Orthopedic Associates. I got here because I'm inquisitive and I like to understand sort of the mechanics of what's happening around me. And I am one of those people that pays attention from A to Z. And as I started in private practice with my husband, my husband had started our orthopedic surgery practice when I was in residency, and I chose to join him. When I started in practice, I began noticing lots of things that just didn't make sense to me on the business side of the practice. And I feel that I really earned like an on the job MBA before I finally decided to go to business school and obtain the executive MBA.
As I began exploring all of the issues that continued to arise and became more and more frequent the longer we practiced, I became somewhat frustrated as many physicians do, and really decided to pay close attention and begin to investigate some of the factors and then decided to speak out about it.
That's sort of the physician's learning of the U U S reimbursement system and paperwork system, right?
Absolutely. And this is not without the opportunity for education and information. As you know, we physicians, we do the four years of undergraduate, we do four years of medical school, then we do residency. So we're talking over a decade of education. And within that context, certainly after the number of years that we've been practicing modern medicine, we could educate physicians about the business of medicine. medicine and that impacts academic physicians as well as those who are entrepreneurial and in private practice. So the opportunity is there. But the exposure for whatever reason is like a black box and that is not I think without intention. by stakeholder in this industry.
So you said ten years, but I want to step back a little bit because I I I don't think What people appreciate. An average physician that goes into a specialty by the time they start practicing and making more than minimum wage from their fellowship. They're generally what thirty-five to forty depending on your specialty.
Depending. I would say early thirties. Definitely on the primary care side. You could be thirty ish and in practice. So early thirties, but if a surgical specialist mid to late thirties.
Can you tell the audience a little bit about that?
I love the way that you unfold that because one of the things I've gone through the process in the last year of writing a book about my experience. And one of the things that became apparent to me as I explored the writing process, talking to editors and agents and different players who have nothing to do with medicine, as we're talking about the core things. theme of what I'm writing. it became very apparent to me that there is this perception of physicians that is not necessarily the most positive out in society. When we're interacting with individual patients, uh generally speaking, I think we do feel appreciated by most people.
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Chapters
6 chapters
1
How did Dr. Erica Urquhart’s private practice experience become her on‑the‑job MBA?
0:00–6:12
2
What early red‑flags did Erica notice about reimbursement and business in orthopedics?
6:12–14:17
3
Why are algorithmic denials and prior‑authorization rules reshaping physicians’ income?
14:17–22:39
4
How do algorithmic denials delay or block high‑complexity orthopedic codes?
22:39–32:54
5
What can patients do to follow the money and understand their insurance benefits?
32:54–40:18
6
How could national standards for prior authorizations reduce waste and variability?
40:18–44:50