A Conversation with OrthoArizona
OrthoArizona is a group of multi-specialty orthopedic clinics across the Phoenix metro area. Arizona Physician sat down with OrthoArizona’s Board President, Caleb Behrend, MD, who is also a practicing orthopedic spine surgeon. We discussed OrthoArizona’s continued success as one of Arizona’s premier orthopedic groups.
ARIZONA PHYSICIAN: Share with us a brief history of OrthoArizona.
DR. BEHREND: In January 1994, a group of 21 orthopedic surgeons in Phoenix formed the Orthopedic Surgeons Network of Arizona (OSNA), now known as OrthoArizona. Their main objective was to find the best and most account-able orthopedic surgeons who were willing to participate in a rigorous peer review-based quality assurance process. The nature of the group led them to become pioneers in alternative payment models over time. This eventually included capitation with over 1 million lives under care in the 1990s. Participation in alternative payment models expanded to include direct-to-employer, commercial and government bundled care models. As an organization we participated in HHS BPCI program and BPCI advanced for more than 12 years. Today that culture remains the mainstay of our practice, led by our vice president of Medical Affairs, Dr. James Davidson and our quality committee, we continue to focus on excellence and value for our patients.
AZP: Dr. Behrend, what is your history with OrthoArizona?
DR. BEHREND: I joined the group from an academic practice at Virginia Tech, where I served as an assistant professor in the School of Medicine. It was a large, well-run group, and I was not actively looking for a new job. My friends who had stime of year, I was impressed with the culture and energy of OrthoArizona and, over time, made the decision to make the big move. Aside from marry-ing my high school sweetheart, Keren Isabel De La Cruz, it has been the best decision I ever made.
AZP: What makes OrthoArizona stand out from other orthopedic groups across Arizona?
DR. BEHREND: We are blessed to have a strong medical and surgical community, particularly in Maricopa County. That said, the reason for the group’s genesis does stand out. Most larger groups are formed for business reasons to meet needs related to market demand, contracting, or cost efficiency. For our group, it was shared values and a philosophical approach to care. This is very spe-cial, and I am personally proud to be a part of it.
OrthoArizona by the Numbers:
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Founded in 1994
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79 Physicians
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65 Nurse Practitioners & Physician Assistants
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123 Physical Therapists, Certified Hand Therapists, and Occupational Therapists
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Services & Programs
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Physician Specialties: Foot & Ankle, General Orthopedics, Hand, Wrist and Elbow, Hip, Interventional Pain, Knee, Fracture & Trauma Care, Physical Medicine & Rehabilitation, Podiatry, Shoulder, Spine, Sports Medicine, Total Joint Replacement & Revision, Worker’s Compensation Diagnostic Services, MRI & CT Imaging, Ultrasound, X-ray Rehabilitation Services, Athletic Performance, Physical Therapy, Occupational Therapy/Certified Hand Therapy
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Other Services
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​InstantOrtho™ - OrthoArizona’s Walk-in Clinic for Urgent Orthopedic Care and MedLegal
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28 Locations: ​​
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PArcadia, Avondale, Cave Creek, Chandler, Deer Valley, Fountain Hills, Gilbert, Glendale, Litchfield, Mesa, Peoria, Phoenix, San Tan Valley, Scottsdale, Sun Lakes​
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Connect with OrthoArizona:
Visit orthoarizona.org or call (602) 648-5444
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AZP: Share with us what has changed in orthopedics in the last 10 years.
DR. BEHREND: In orthopedics, in the last two decades, there has been a revolution in care, leading to dramatic cost savings and improved outcomes for patients. A decade ago, outpatient joint replacement surgery or spine surgery would rarely have been performed in an ambulatory setting, and this has become fairly routine today. This not only improves the patient’s experience but also has staggering cost benefits for the US hared residency with me inviting me to visit and golf. Of course, in the cooler seasons. More than the beautiful climate at that healthcare system. This is made possible by continued improvements in surgical technique/technology, anesthesia, and peri-operative approaches to the management of pain. This revolution was paved by sports medicine with improved arthroscopic surgical techniques and hand surgery. Subsequently, total joint replacement and spine surgery followed suit.
AZP: Are there any trends in orthopedics or technology that OrthoArizona is taking advantage of to better help patients while also helping its bottom-line?
DR. BEHREND: We are committed to improving our patients’ experience. Technology that supports reduced workflow complexity and improves our operational efficiency will also improve the work experience for our fantastic team members. Examples include improved online self-scheduling, utilization of AI in revenue cycle management, and call center support. In general, patients are happy with the medical and surgical care, and they want improvements in how phones are answered, appointments and referrals are man-aged, and how long it takes for them to be seen. The field of orthopedic surgery continuously sees exciting technological developments resulting from advances in the fields of materials science, molecular biology, robotics, and engineering. Keeping up and choosing what to offer our patients requires a commitment to lifelong learning and evidence-based medicine. As an organization with 80 physicians, this starts with recruiting fellowship-trained doctors with expertise in the most current and emerging approaches. We are committed to that and support our long-standing expertise in career development. We are proud to offer a growing number of fellowships and training programs within the company as well.
AZP: OrthoArizona has grown in the last 5 years. You are now at 73 MDs and Dos. How did you get here?
DR. BEHREND: We are 80 physicians. This happened organically over many years as like-minded groups affiliated themselves with OSNA. Some came and went over time due to economics or cultural fit.
AZP: All your current locations are within Maricopa County, are there any thoughts on expanding across the state?
DR. BEHREND: We have offices in Maricopa and Pinal County. Currently, our offices are within reasonable physical proximity to 76% of the state’s population. In addition, we see many patients from surrounding counties who travel from smaller communities. We continue to offer expanded services to patients through telemedicine visits, expanded 24-hour service, and walk-in clinics for urgent orthopedic care. Improving technology and a population that is adapting to different ways of delivering care has allowed us to consistently provide care for patients who see us from other states and as far away as Europe and Canada while maintaining quality.
AZP: Do you see any opportunities that will allow you to get bigger?
DR. BEHREND: There are always opportunities for growth, but it needs to be strategic based on our shared vision and culture, or it will not be sustainable. We are committed to excellence in all areas of musculoskeletal care and, as a result, continue to expand our non-surgical services through physical therapy and the addition of service lines to provide expanded hours, as well as improved access to care through technology. Regionally, the issue is complex. Seventy-five percent of the state’s residents live within a reasonable distance of our offices. We currently provide care for thousands of patients from other areas of the state each year. We do have a strategic plan to offer our style of medical and surgical care to the entire state. This ideally involves a natural organic alignment of excellent doctors working in other communities rather than an invasion for business reasons. That will require the development of a community of like-minded physicians across the state just as our organization did here in Maricopa and Pinal Counties.
AZP: What do you see the largest obstacles in running a large group practice today?
DR. BEHREND: Today, we have nearly 1200 amazing team members working at OrthoArizona. We are proud and grateful to everyone on our team. We could not provide excellent care without them. The challenges in sustainably running a larger group medical practice require effective, attentive, and informed leadership. Meeting the needs of our patients and creating a satisfying work environment for employees requires a constant focus on operational efficiency, quality, and cost efficiency. Like most medical and surgical practices, we have worked hard following the pandemic to address challenges from staffing shortages, changes in the work environment, inflation-related costs, as well as threats from increasing liability or cybersecurity attacks. The cost of providing care has increased in the face of declining financial support for physicians by government payers. Action from the state and federal government supporting physicians through increased protection from cybersecurity attacks on healthcare institutions, reasonable tort reform, and a rational plan to support physicians fight against inflationary cost increases would allow doctors to keep the focus on our patients without disruptions, as it should be.
AZP: How many other types of healthcare professionals are working at OrthoArizona?
DR. BEHREND: We have non-operative sports medicine, physical therapy, hand therapy, interventional pain medicine, a talented podiatry group, and physical medicine and rehabilitation practitioners.
AZP: You provide 17 specialty services, which are the most popular with patients?
DR. BEHREND: Physical therapy, medical imaging (MRI/CT/US and X-Ray) are very popular. The mainstays in the surgical divisions remain our sports medicine surgeons, total joints surgeons, hand surgery, and foot and ankle surgery. Demand for spine surgery and specialized shoulder surgeons continue to push recruiting in these areas to meet the need over time.
AZP: What does the future hold for OrthoArizona?
DR. BEHREND: Currently the future is bright. If the last five years have taught us anything, it is that things can change quickly. We anticipate that changes in technology and policy will provide the biggest threat and opportunity to how we practice and manage our business today. We intend to adapt early with the objective of further improving quality and patient satisfaction. We face the same challenges any medical group does, large or small, and are working internally to strengthen our management team and operations to avoid the issues that press many groups into corporate or employed models. Over the next few years, we will continue to build our outpatient surgery programs in collaboration with our regional healthcare systems and will build stronger ties through continued participation in co-management and the growing care networks. I would like to see increasing involvement of our physicians in state and local medical societies. Advocacy for patients and physicians by being present to share their views with our policymakers is essential for the long-term sustainability of our medical community. We are committed to excellence in all areas of musculoskeletal care and, as a result, continue to expand access to our services through physical therapy and the addition of service lines, to provide expanded hours, and improved access to care through technology. Regionally, further organic growth will occur by the natural alignment of excellent doctors working in other communities over time. â–