Robert Norton, MD, founding partner and spine surgeon at Boca Raton, Fla.-based Florida Spine Associates, said the practice’s growth from a single office to six facilities across Palm Beach and Broward counties came down to one decision: giving up control.
Twelve years after the practice opened, Florida Spine Associates now houses orthopedic spine surgeons, interventional pain management physicians, physical therapists and physician assistants under one roof, offering care ranging from injections to surgery. But scaling that model required Dr. Norton to step back from running daily operations himself and hand that work to dedicated managers — a shift he said was central to the practice’s ability to grow.
“The days of being a solo surgeon or provider in a practice, caring for your patients and simultaneously being the boss of everyone and running the organization are pretty much over,” Dr. Norton said during an interview with the Becker’s Healthcare Podcast at the 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC Conference. “It’s very difficult to do that nowadays.”
Dr. Norton said he put his energy into recruiting management personnel to run the business under his and his partners’ oversight, a move that gave those leaders room to grow into their roles.
“I put all my energy into finding the key management personnel to run the company with oversight from my partners and I, of course,” he said. “This has really allowed the key personnel to flourish, building their confidence, being able to execute while doing what they do particularly best.”
That philosophy extended to physician hiring as well, he said, pointing to one piece of advice that has stuck with him since early in his career.
“Never be afraid or feel threatened to hire someone who’s better than you,” Dr. Norton said.
But solving the leadership layer hasn’t resolved every staffing challenge facing the practice. Dr. Norton said inflation and rising costs of goods have squeezed the practice’s finances since the COVID-19 pandemic, at the same time employee expectations have shifted. That pressure has landed hardest on front-line clinical roles, he said.
“It’s really been a dwindling pool of the workforce, specifically in key areas of medicine, such as physical therapists and X-ray technicians,” he said.
Layered on top of that shortage is a newer concern among staff: fear that AI and automation could eliminate their jobs altogether, according to Dr. Norton.
“The most recent issue is this scare that employees have: Are they going to have a job with automation and AI taking over?” he said.
Dr. Norton said the combination has forced him to reexamine what he wants from the practice and has tested his resolve as a leader.
“It’s been marked by inflation, increased cost of goods. Employee expectations have changed,” he said. “So I would say it’s a hard time to test one’s convictions. So either throw in the towel or you’re gonna fight harder to get what you want.”
For Dr. Norton, that means continuing to invest in the practice’s team-based model even as the labor market for allied health roles remains tight. He said one advantage private practices hold over larger health systems is the ability to move quickly without layers of bureaucracy, but he cautioned that speed alone isn’t a strategy — practices still need long-term plans and the right people in place to support growth.
“I also think you can’t grow a medical practice without having the appropriate team and personnel in place, so it’s important to get your house in order, so to speak, before you extend yourself,” he said.
Listen to the entire podcast here.
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