Independent spine and orthopedic practices are navigating mounting payer friction, consolidation pressure and patients who increasingly expect to understand what care will cost before it happens.
During a featured session sponsored by CareCredit at Becker’s 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, Pamela Mehta, MD — an orthopedic surgeon who founded Resilience Orthopedics (San Jose, Calif.) and is chief medical officer at The Good Feet Store — offered a practical playbook on building a profitable practice outside the insurance model.
Dr. Mehta walked attendees through the pricing, staffing and patient-financing decisions behind it, in a discussion moderated by Daniel Miller, CareCredit’s vice president and general manager of healthcare specialties.
Below are four takeaways from their conversation.
Note: Quotes have been edited lightly for length and clarity.
1. Transparent, upfront pricing helps build trust
Dr. Mehta runs a cash-pay, menu-based practice, and her staff checks each patient’s insurance in real time so patients can compare what they would owe in network versus out of network before any care begins. She argued that the conventional model — in which costs remain ambiguous until a bill arrives months later — undermines trust from the first encounter.
“There is no other industry like healthcare where the physician has no idea how much he or she is getting paid. The staff has no idea, the patient has no idea,” she said.
2. Hire for service, not a healthcare résumé
When it comes to staffing, Dr. Mehta said she finds communication skills and emotional intelligence — qualities often central to customer service roles — harder to teach than clinical tasks. “The best hires often come from outside of traditional healthcare. I’ve hired baristas, I’ve hired waitresses, people that are very service oriented and know how to give really good customer service,” she said.
She pointed to culture and autonomy as retention tools, including giving front-desk staff $5 Starbucks gift cards to hand out, at their own discretion, to patients frustrated by a wait.
3. Flexible payment options help keep care moving
Because patients rarely plan for an injury, Dr. Mehta offers payment plans, deposits and third-party financing tailored to each case — an approach she said improves patients’ acceptance of treatment.
“Options are so important because then they feel they’re part of the decision-making,” Dr. Mehta said.
Mr. Miller described the CareCredit credit card as one such option: a revolving line of credit patients can use across enrolled providers, with payments spread over time practices reimbursed within two business days, less a fee.
4. Lean operations and reputation sustain independence
Dr. Mehta shared how her practice started without a loan, keeping overhead low by eliminating insurance-related billing. She said she now earns three to four times what she made as an employed surgeon while working far less. She pushed back on the notion that independent practices can’t survive consolidation.
“I think there’s actually a pendulum going the other way. I think people are sick of being treated like cattle and going and getting a 12-minute appointment at a big organization where they’re just a number. I think people really want personalized care,” Dr. Mehta said, crediting word-of-mouth referrals and actively managed online reviews for steady growth.
What it means for independent practices
For spine, orthopedic and pain management leaders weighing whether to stay independent, the session reframed financial transparency and payment flexibility as growth levers rather than back-office chores — and made the case that owning the patient’s cost conversation can strengthen both trust and the bottom line.
This content is subject to change without notice and offered for informational use only. You are urged to consult with your individual advisors with respect to any information presented. Synchrony and any of its affiliates, including CareCredit, (collectively, “Synchrony”) makes no representations or warranties regarding this content and accepts no liability for any loss or harm arising from the use of the information provided. All statements and opinions are the sole opinions of Dr. Pam Mehta. Your receipt of this material constitutes your acceptance of these terms and conditions.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
