Why Listen: An orthopedic surgeon who built and sold a physician-owned surgical hospital explains, in plain language, how practices win on contracts, culture, and capital. If you’re serious about independence, this is your operating manual for the next 12–24 months.
👥 Host: Dutch Rojas – Founder, Rojas Media and Bliksem Health
Guest: Dr. James “Jamie” McAtee – Orthopedic Surgeon, Partner at Orthopaedic & Sports Medicine Center (Manhattan, KS); Co-founder/leader at Manhattan Surgical Hospital; K-State alum and lifelong advocate for physician ownership
Episode Overview
Dutch sits down with Dr. McAtee to unpack how a small college town became a case study in physician leadership. They cover the origin story of Manhattan Surgical Hospital, raising capital (OpCo + PropCo), negotiating payer contracts (and why implants make or break your margins), and the cultural discipline required to keep a practice aligned for decades. McAtee details insurer tactics like retroactive “medical necessity” denials and AI-driven auth games—and how to respond. The conversation closes with strategy: federated models, MSO mechanics, retreats that actually matter, and the political trench war over the physician-owned hospital moratorium.
Notable Quotes
• “You have to have one or two partners willing to carry the workload on strategy.”
• “Insurers say no pre-auth…then deny it retroactively. That’s not fair.”
• “We built OpCo and PropCo—and used local banking that participated in the loan.”
• “Culture is an expectation: if you want to be here, this is how we behave.”
• “Physician-owned hospitals consistently lead on outcomes—and still face a moratorium.”
📚 What You’ll Learn
– How to structure and finance a physician-owned facility (OpCo vs. real estate)
– The payer math: DRGs, implant costs, and why case-level analysis wins contracts
– A practical approach to pre-auths in the age of AI (speak patient vs. legal charting)
– Building durable culture: expectations, accountability, and quarterly deep-dive retreats
– Federated models/MSOs: why “coopetition” beats isolation for independent groups
– Policy reality check: navigating the POH moratorium with creative ownership models
⏱ The Episode (Timestamps)
00:00 – Why Manhattan, KS and the K-State effect on practice growth
06:00 – From OR to boardroom: why McAtee built a surgical hospital
09:45 – Capital stack 101: OpCo, PropCo, and local bank participation
12:00 – Blueprints vs. flow: designing for industrial engineering, not just code
14:35 – Payer reality: DRGs, implants, and uneven reimbursement
15:55 – Retro denials & AI: “bone-on-bone” vs. clinical nomenclature
18:30 – Near-term ops: authorizations, EHR/AI, and squeezing waste
19:45 – Federated MSO vision and why organic physician growth stalled
21:30 – Coopetition mindset: uniting against carrier/system leverage
22:45 – Property & casualty: moving from premiums to contributions and float
26:45 – Leadership cadence: create “productive chaos,” then guide the team
27:50 – Retreats that work: weekly huddles + quarterly deep dives
28:55 – Strategy ownership: two partners carry the torch; others cede control
32:00 – Culture rules: high standards, low drama, long-term alignment
33:20 – Policy: POH moratorium, workarounds, and the path forward
If you want to support these efforts, Buy Dutch a Cigar, connect via socials, or collaborate, visit:
👉 Stan.Store/DutchRojas
