The Operator | Healthcare Business

AI promises to give clinicians their time back. But who gets to decide what happens to that time?

AI scribes are being marketed as a solution to one of healthcare's most persistent problems: the administrative burden that takes clinicians away from patients and contributes to burnout.

The promise sounds straightforward. Less documentation. More efficiency. Better productivity. Maybe even a technology investment that pays for itself.

But what happens when you actually examine the numbers?

In this episode of The Operator, Jimmy McKay and Larry Benz explore the economics behind AI scribes and challenge healthcare leaders to think beyond vendor promises.

Larry examines research on AI documentation costs, adoption rates, reimbursement, and time savings. The conversation raises an uncomfortable possibility: healthcare organizations may be capturing the financial benefits of automation without meaningfully improving clinicians' working lives.

And when technology creates more capacity, the schedule often finds a way to fill it.

Key Ideas From This Episode

• Free doesn't mean free. AI documentation tools operate within pricing models that can create costs beyond the advertised subscription.
• ROI requires more than a projection. Operators need to understand the full cost per clinician, measured financial returns, coding changes, editing time, and actual utilization.
• Not every clinician uses AI on every visit. Adoption rates and real-world usage matter when evaluating the value of an enterprise-wide investment.
• Documentation savings aren't the same as workload reduction. Time saved during clinical hours doesn't necessarily translate into less work after hours.
• Reimbursement isn't guaranteed. Financial returns driven by coding changes may be vulnerable to payer scrutiny and future reimbursement adjustments.
• Someone must own the saved time. Without deliberate decisions about scheduling, additional efficiency can simply become additional work.
• Clinician retention may be the more meaningful return. A technology investment that helps experienced clinicians remain in practice may create value beyond immediate revenue or productivity gains.
• Measure results after the excitement fades. Larry explains why operators should evaluate implementation outcomes at six months rather than relying exclusively on early enthusiasm.

The Bigger Question

If a technology investment makes clinicians more efficient but doesn't improve their experience, what problem have we actually solved?

For healthcare operators, this episode offers a framework for evaluating AI that goes beyond software features and financial projections.

Because the real measure of technology isn't simply what it automates.

It's what the organization chooses to do with the capacity it creates.

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Growth is easy to measure. Building an organization that gets better as it grows is much harder.

Healthcare leaders spend enormous amounts of time thinking about expansion, performance, efficiency, and profitability. But what happens when an organization grows faster than its culture can support?

Bob Fontana has spent nearly three decades confronting that question.

Starting as an office manager in a dental practice, Bob went on to found Aspen Dental and build one of the largest dental organizations in the country. Today, as Chairman and CEO of The Aspen Group, he leads an organization supporting more than 1,400 healthcare locations.

In this episode of The Operator, Larry Benz sits down with Bob to explore the leadership philosophy behind that growth.

Their conversation begins with a simple observation: traditional dentistry was saying no to millions of patients.

No to their insurance. No to evening appointments. No to convenient access. No to transparent pricing.

Bob saw an opportunity to build an organization that approached those patients differently.

But as Aspen expanded, he discovered that removing barriers for patients was only part of the equation. Sustaining that mission required investing in the people responsible for delivering the care.

Larry and Bob examine why culture becomes more important as organizations grow, how provider ownership changes the relationship between clinicians and their work, and why employee development should be treated as an operating investment rather than an HR expense.

They also explore the connection between autonomy and burnout, the importance of community in healthcare, and the role technology should play in making clinicians more effective without making care less human.

• Growth doesn't guarantee success. Culture determines whether expansion strengthens an organization or exposes its weaknesses.
• The patient experience starts with the team. Organizations cannot consistently deliver exceptional care without supporting the people responsible for providing it.
• Access begins with understanding the patient. Aspen Dental's approach grew from recognizing the practical and emotional barriers preventing underserved populations from receiving care.
• Training must produce results. Learning and development should improve clinical capability, communication, leadership, and ultimately patient outcomes.
• Clinical excellence alone isn't enough. Providers must also build trust, navigate difficult conversations, and help patients feel comfortable accepting care.
• Ownership creates connection. Giving clinicians a pathway to ownership can strengthen autonomy, accountability, engagement, and long-term commitment.
• Burnout is more complicated than workload. Control, community, purpose, and meaningful relationships all influence how healthcare professionals experience their work.
• Technology should make care more human. The right tools reduce administrative friction and create more opportunities for meaningful patient interactions.
• Meaning matters. Giving healthcare teams opportunities to serve their communities can reconnect them with the purpose behind their work.

One of the most important lessons from Bob's experience is that healthcare organizations have two groups whose needs must be understood: patients and providers.

Ignoring either creates operational problems.

Supporting both creates the conditions for better care and sustainable performance.

For healthcare executives, dental practice owners, physical therapy leaders, and anyone responsible for building clinical organizations, this conversation offers a practical challenge:

Are you simply growing your organization, or are you building something people want to be part of?

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You Don't Need More Patients. You Need to Stop Losing Them.

What if your healthcare organization doesn't have a patient acquisition problem? What if it has a patient experience problem?

Healthcare organizations invest heavily in marketing, lead generation, and patient acquisition. But what happens when someone finally picks up the phone?

In this episode of The Operator, Larry Benz sits down with Amol, founder and CEO of Patient Prism, to explore one of healthcare's most overlooked growth opportunities: the conversations that happen before a patient ever walks through the door.

Drawing on insights from millions of patient conversations, Amol explains why missed calls, scheduling barriers, financial anxiety, and inconsistent front-desk experiences can undermine even the best marketing strategy.

Together, Larry and Amol explore how behavioral psychology, employee coaching, and AI can help healthcare organizations build trust, improve access, and create better patient experiences without losing the human connection.

They also tackle a question every healthcare operator should be asking: Should AI replace the person answering the phone, or help that person become better?

The conversation closes with a broader leadership lesson from Larry on navigating uncertainty, developing people, and returning to operational fundamentals when the market gets difficult.

• Why healthcare's biggest growth opportunity may already be calling your practice.
• How empathy, affordability, and appointment availability influence patient decisions.
• Why the front desk should be treated as a critical part of patient care, not just an administrative function.
• How AI-driven feedback can help employees improve without creating a culture of surveillance.
• What behavioral psychology reveals about the beginning and end of patient conversations.
• Why better scheduling can improve access to care and practice productivity.
• Where AI voice agents can help today—and why human connection still matters.
• Three operational behaviors that distinguish stronger healthcare organizations.
• Larry's approach to leading healthcare organizations through economic uncertainty.

Are we using technology to replace human interaction, or to make human interaction better?

For healthcare leaders, that distinction may determine what sustainable growth looks like.

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Healthcare AI promises to give clinicians their time back. But what should they actually get back?

Less documentation? Earlier evenings? More time with patients? A better experience delivering care?

Recorded live at Titans of Private Practice, Jimmy McKay sits down with Pedro Teixeira of Prompt Health for The Operator with Larry Benz to explore what happens when healthcare technology moves beyond the promise and into daily clinical practice.

Pedro has been working with machine learning since 2009. His perspective is that successful AI adoption isn't about the sophistication of the technology. It's about whether that technology makes a meaningful difference in people's lives.

For physical therapists, that often means having more time to connect with patients and focus on the work that brought them into the profession.

But practice owners need more than positive feedback or impressive software demonstrations. They need to know whether the tools they're implementing are actually working.

Key ideas from the episode:

• Time back for what? Why the value of AI isn't simply saving minutes, but what clinicians can do with those minutes.
• Measure the actual impact: How documentation sign-off times, after-hours work, and compliance metrics can help evaluate technology.
• Adoption is part of the story: Why a tool can't deliver value if clinicians never get around to using it.
• Listen when something isn't working: How user feedback and measurable results help identify problems and improve the experience.
• Protect the human connection: Why technology should support the clinician-patient relationship rather than replace it.
• Choice matters: How giving therapists control over whether they use a tool can support meaningful adoption.
• Solve today's problems: Why demonstrating something that works now can be more valuable than promising future capabilities.

The central challenge for healthcare operators is to stop evaluating technology based solely on what it can do and start evaluating it based on what it gives people back.

Because the goal isn't more AI in healthcare.

It's better healthcare.

Prompt Health: https://www.prompthealth.com/

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What if the biggest obstacle to growing your physical therapy practice is the identity that made you successful in the first place?

Physical therapists are trained to care, solve problems, and take responsibility for their patients. But those same strengths can become limitations when a clinician becomes a business owner.

Recorded live at the Titans of Private Practice conference, Jimmy McKay hosts Jamey Schrier of Practice Freedom U for The Operator with Larry Benz.

Jamey challenges practice owners to examine the beliefs and behaviors keeping them tied to daily operations. From the guilt of leaving the treatment floor to the perfectionism that prevents delegation, he explains why growing a successful practice requires more than systems, spreadsheets, and standard operating procedures.

It requires an identity shift.

Key ideas from the episode:

• The loyal clinician trap: Why your clinical identity can make it difficult to lead a growing business.
• The guilt of stepping away: Why being in the trenches with your team isn't always the best way to support them.
• The real reasons employees leave: How better interview questions can reveal what people actually value.
• The power of decisive leadership: Why avoiding a decision can be more limiting than making a mistake.
• Operational irrelevance: How building a capable, empowered team allows the owner to focus on leadership rather than daily tasks.
• Designing the patient experience: Why great care requires intentional leadership beyond the treatment room.
• Freedom through alignment: What changes when owners trust their teams and build a practice around the life and impact they want.

The takeaway is a challenge to every healthcare operator: caring for patients doesn't require doing everything yourself.

Sometimes the most important thing you can do for your practice is become the leader it needs rather than the clinician it depends on.

Practice Freedom U: https://practicefreedomu.com/

Subscribe to The Operator on Substack: https://benzoperator.substack.com/

What if the next stage of growth for your physical therapy practice doesn't start with more advertising, but with the patients you've already treated?

Physical therapy owners spend enormous amounts of energy trying to attract new patients. Yet many overlook the relationships, trust, and goodwill they've spent years building.

Recorded live at the Titans of Private Practice conference, Jimmy McKay sits down with Chad Madden of Breakthrough for The Operator with Larry Benz to challenge how owners think about marketing, patient relationships, and sustainable practice growth.

Chad explains why delivering excellent care isn't necessarily enough to generate consistent referrals and why owners need to become more intentional about staying connected with their communities.

From handwritten notes to targeted patient outreach, he explores the difference between marketing that creates activity and marketing that produces measurable results.

Key ideas from the episode:

• Your patient list is an asset: Why the people who already know and trust your practice may represent an overlooked growth opportunity.
• The handwritten note advantage: How a simple personal gesture can create meaningful differentiation in an increasingly automated world.
• Not all marketing is the same: Why new practices need different strategies than established clinics with strong community relationships.
• The content creation trap: Why posting consistently doesn't necessarily mean your marketing is working.
• Measure the response: How direct response marketing gives owners a clearer way to evaluate campaigns.
• Meet patients where they are: Why effective marketing accounts for whether someone even recognizes their problem.
• Learn from other operators: Insights from Titans of Private Practice on hiring, partnerships, leadership, and scaling.

Chad also reflects on the value of creating an environment where successful practice owners openly share what's working.

The challenge for healthcare operators is straightforward: don't confuse more marketing activity with better marketing.

Understand the audience. Make a relevant offer. Measure what happens.

And don't overlook the relationships you've already earned.

Breakthrough: https://getbreakthrough.com/?utm_medium=ppc&utm_source=google-ads

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The efficiency isn’t the point.

AI can document faster, process more information, support clinical decisions, and remove work clinicians once had to do manually.

But Larry Benz raises the more important question: What happens to the time technology gives back?

In this episode, Larry talks with Alex Bendersky about the rapidly changing role of AI in physical therapy and rehabilitation. They move beyond the usual conversation about tools and features to examine how AI changes the actual clinical encounter, and why implementation may matter more than the technology itself.

Alex explains why AI is moving from novelty to infrastructure, why clinicians need a meaningful role in shaping these systems, and how ambient documentation and clinical intelligence could expand rather than replace clinical reasoning.

Larry pushes the conversation one step further: if a clinician saves fifteen minutes and leadership immediately fills those fifteen minutes with more productivity, has anything meaningful improved?

Key ideas:

• Why AI is becoming table stakes rather than a novelty
• The difference between optimal and suboptimal AI adoption
• How ambient documentation can capture more than a traditional clinical note
• Why AI could strengthen—or unintentionally weaken—clinical reasoning
• How smart systems can support evidence-guided care
• Why clinicians need to become active participants in healthcare technology
• How AI could reduce documentation burden and burnout
• Why efficiency does not automatically produce better care
• The leadership choice behind every minute AI gives back
• How healthcare can avoid “automating the calcification”

The opportunity isn’t simply to make clinicians faster. It’s to decide what becomes possible when clinicians finally have some capacity back.

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What if one of healthcare’s most accepted ideas about burnout is backwards?

Clinicians are often taught, formally or informally, that caring too deeply creates vulnerability. Keep some distance. Don't get too attached. Protect yourself.

In this episode, Heidi Jannenga joins Larry Benz for a much broader conversation about what actually keeps people in healthcare.

Heidi is the founder of WebPT and the Rizing Tide Foundation, an organization supporting future physical therapists through scholarships, education, networking, and mentorship. Her work offers a unique view into the barriers facing first-generation and underrepresented DPT students—not only getting into the profession, but building sustainable careers once they arrive.

The conversation moves from representation and student debt to mentorship, workforce retention, administrative burden, AI, burnout, and the role human connection still plays in a technology-heavy healthcare system.

The central idea: getting people into healthcare is only the beginning. Keeping them requires human infrastructure.

Key ideas:

• Why financial support solves only part of the access problem

• How representation creates an aspirational path into physical therapy

• Why first-generation clinicians may carry family obligations alongside student debt

• Why good mentorship includes both clinical development and life navigation

• How employers can accidentally reduce someone to the reason they were recruited

• Why recruiting more clinicians cannot compensate indefinitely for poor retention

• What twenty years of healthcare technology have—and haven't—fixed

• Why AI should remove administrative noise and return attention to the patient

• The difference between healthy boundaries and emotional detachment

• Why deeply engaged clinicians may actually build more sustainable careers

• How trust in a clinician can strengthen a patient's belief in their own recovery

• Why the people around you can sometimes believe in your potential before you do

The revised edition of "Called to Care" expands Larry's work around burnout, AI, virtual care, positive psychology, empathy, and the human factors that influence clinical outcomes.

Proceeds from the new edition support the Rizing Tide Foundation.

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Most healthcare organizations can tell you exactly how much they spend acquiring a patient. Far fewer can tell you how many patients arrive because someone already trusts them.

That difference may reveal more about the strength of a healthcare business than another marketing dashboard ever will.

In this episode of The Operator, Jimmy McKay and Larry Benz examine a deceptively simple metric: the percentage of new patients who come from friends, family, or former patients.

Larry explains why digital attribution often gives credit to the final click instead of the relationship that caused it, why he views 35–40% referral-driven patient acquisition as an important benchmark, and why organizations can appear to be growing while quietly becoming more dependent on paid acquisition.

They also introduce the idea of relationship density, the number and strength of trust-carrying connections surrounding a patient, and explore how those relationships eventually show up in the P&L.

Key ideas from the episode:

• Why most healthcare systems measure transactions better than relationships
• The difference between growth you purchase and growth you earn
• Why referral share may reveal the durability of your growth
• How a practice can increase production while weakening relationally
• What Larry means by “relationship density”
• Why hygienists may be an underestimated growth engine in dentistry
• How trust affects acquisition cost, case acceptance, lifetime value, and payer mix
• Why patient reactivation campaigns cannot replace genuine relationships
• The one question front-desk teams can begin asking immediately: “Who can we thank for sending you in?”

A growth number tells you that the business grew.

This metric may tell you why.

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What if healthcare's prescription for clinician burnout has been partly backwards?

For years, clinicians have been warned about compassion fatigue and encouraged to create emotional distance from their patients.

Larry Benz says newer research complicates that story.

In this special conversation, longtime friend and collaborator Tim Flynn joins Larry to explore the ideas behind the newly updated edition of Called to Care.

Their conversation begins with more than four decades of shared history, from the military and the early days of Evidence In Motion, before moving into some of the biggest changes Larry made to the book.

They discuss the distinction between burnout and moral injury, why Larry says “you can't yoga your way out of” a broken system, and research suggesting that the right kind of empathy may actually protect clinicians instead of exhausting them.

Larry describes that approach as exquisite empathy:

Highly present. Deeply attuned. Well-boundaried.

They also revisit Larry and Tim's work around placebo and nocebo, why language can change the patient's experience of care, the growing impact of payer pressure on clinical conversations, and why Larry believes healthcare has increasingly outsourced one of its most important interventions: the conversation itself.

Along the way, Larry offers perhaps the simplest expression of the entire episode:

The new edition of Called to Care asks what it means to preserve that connection in a healthcare environment increasingly shaped by burnout, technology, AI, payer pressure and transactional care.

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