Legent Health's new CMO wants a Starbucks-like level of quality standardization standardization at the ASCs he oversees. (Image by Fabian Holtappels from Pixabay) Todd Albert, M.D., wants to make high-quality care so consistent at Legent Health that visiting one of its orthopedic/spine surgery centers is not unlike going to McDonald’s or Starbucks.
Albert – who is also the surgeon-in-chief emeritus at Hospital for Special Surgery (HSS) – was recently named chief medical officer of Legent, the Texas-based ambulatory surgery center (ASC) operator. Recently, Legent became the platform in which HSS and General Atlantic will grow their national ASC footprint.
According to Albert, standardizing protocols and quality metrics to make Legent’s surgery centers consistently best-in-class is a top priority in his new role. That way, when patients turn to Legent for musculoskeletal care, they know exactly what type of experience they can expect.
Ambulatory Surgery Center News caught up with Albert to learn more about his plans at Legent, his views on broader ASC industry trends and more.
The following conversation has been edited for style, length and clarity.
ASC News: You’ve had an incredible career at organizations like HSS and the Rothman Institute. Looking back, what would you say are one or two leadership experiences that you feel prepared you for this CMO role at Legent Health?
Albert: Probably the No. 1 leadership experience I’ve had that really helped for this was when I was at Rothman. We were a practice that had basically no ancillaries, and when I became the chairman, it was just at a time it was starting. We built around five ASCs and we created two musculoskeletal physician-owned hospitals. Those experiences – leading a group of 15 people to well over 100 – that was very helpful in terms of the skills [and] challenges that came along with that, for this experience as well.
You’re going to be continuing your work as surgeon and chief emeritus while taking on this role. How will those two positions play off one another, and how might one inform the other?
I’m a practicing spine surgeon, and I’ve cut back that role to an extent. Right now, I’m seeing patients on Monday, I operate on Tuesday and … the rest of the week is going to be devoted pretty much to Legent and anything else I’ve got going on academically, and some other businesses. The roles do interface in that HSS is a partner of Legent. And one of the goals between General Atlantic, Legent and HSS was to use best practices and some of the things we’ve learned over time about quality, about how to expand quality and imprint it … in an enterprise model to try and have the same quality at every site.
What about Legent Health in particular excites you; why is this an exciting next step in your career?
I love the leadership team there, and the way they built the company so far is they have a very physician-centric attitude in terms of delivery of care, making the care model such that this is a place physicians want to practice, want to bring their patients – which ultimately leads to better care for the patients and a better experience.
When I initially met with all the folks there, especially Jordan Fowler, the CEO and [Chief Development Officer] Tanner Croley, and others there, they really had the right attitude about the way to build a network and what to put the emphasis on.
What would you say some of your top priorities as CMO will be over the next year to 18 months?
The No. 1 thing is, I really need to gain knowledge. Step 1 is getting to know … all the administration and the practitioners and understand what is our playbook that we have in place presently. Step 2 will be, how can we enhance that and impart all these quality metrics, quality protocols that I know we should have, and start gaining consistency.
There’s chief medical officers at the different sites and different regions, and I want to work very closely with them to hold hands around what our quality programs are going to look like – what we’re going to measure, and how often we’re going to measure it, and how we’re going to bring best practices and consistency to every center. If we can achieve that in the next year, I think we’ll be doing great.
Additionally, [my goal is] to start growing the platform – decide which geographies where we’re going to focus, and then try to get footprints into those geographies through connections we have.
One of the big trends that we report on is this clear migration of complex cases from hospitals and hospital outpatient departments to ASCs. In your role as CMO, what’s your take on this trend?
Definitely [complex] cases are migrating, but one of the reasons cases are migrating is because of new surgical techniques, new anesthetic techniques, new medical techniques that have made it safe and doable to be able to bring those cases. The total joints were the first exit, and now spine, but we have to remain careful in reminding ourselves that, yes, there’s a migration, but not every case can migrate like that. There are certain cases we probably should not be doing in ASCs.
If we make sure that we’re very careful about medical optimization, screening [and] making sure we have the right patients in the right place, the paradigm will work perfectly. But if we start really pushing the limits, we might not be doing ourselves or our patients any favors. I think our capabilities are going to really expand, so that the patient population that can go to an ASC will become broader and broader, but there still probably will remain some that cannot.
From a clinical perspective, what are three things that are critical to making the shift successful and safe for patients?
Preoperative identification, selection and optimization of the patients; [putting] the pre- and intraoperative and postoperative protocols at the center to make sure it’s maximally safe; and then the postoperative surveillance to make sure if there’s any problems, we are well-equipped to take care of those problems.
Are there topics related to what you’re doing at Legent, or topics related to ASCs, that you’re extremely passionate about that you want to dig into a little bit?
The thing I’m most passionate about is … it’s not the best example, but … when you go to a McDonald’s, you can go to a McDonald’s in New York City or a McDonald’s in Chicago, [and] you’re pretty much getting the same hamburger. Or a Starbucks – you go to Starbucks, you’re going to get this similar coffee [every time]. I would like to get our quality, protocols and paradigms so good and so consistent, that we see something similar. That whether you go to a Legent facility in Dallas, you go to a Legent facility in Houston, you go to a Legent facility in Florida – or wherever we end up developing Legent facilities – that the quality is so good that it has a brand [where] everybody knows it is the place to go.
When you’re able to standardize quality and have these proof points, how does that factor into conversations with payers and maybe even value-based care arrangements down the road?
If we have that consistency across all our centers, we [will] deliver a product [that’s] by definition … going to be high quality and lower costs, which obviously equals high value. Many of these insurers have Center of Excellence programs, and you can imagine going at risk. We could ultimately do risk-based contracts, value-based contracts, and that would be a goal.
