By Graham Young, SVP, M&A & Business Transformation, U.S. Orthopaedic Partners
When I first walked into Mississippi Sports Medicine & Orthopaedic Center — our platform’s first practice — my goal was straightforward: acquire great practices, build a repeatable model, and help outstanding surgeons scale exceptional care.
Five years in, that still looks tidy on a whiteboard. The work of getting there, however, was far more complex, and a lot more instructive, than any spreadsheet ever shows.
We’ve built a physician-led MSO that actually acts like one: a Physician Board that decides clinical matters, a business intelligence platform that informs decisions, multiple ASC projects coming online, and a platform-level total-joint agreement that surgeons led and that will free up capital for practices to reinvest locally.
Along the way, I’ve learned a few lessons I wish I’d known on day one. Here are five that matter.
1 — Give physicians real clinical authority, and support them with non-clinical experts
Physician governance can’t be window dressing. At USOP, surgeons lead the clinical decisions — they run product evaluations, test protocols, and sign off on standards. That doesn’t mean physicians do everyone’s job; it means we provide the operational expertise so they can focus on patient care. When physician input is meaningful and operational work is handled by experienced teams, decisions are both clinically defensible and practically executable.
Takeaway: Structure governance so physicians lead on clinical matters, and staff the MSO with experts to handle the non-clinical heavy lifting.
2 — Clean, credible data gets you past debate and into improvement
Surgeons are scientists. They’ll forgive a lot, but not sloppy numbers. Early on, some conversations stalled because there was no single source of truth: data lived in disparate systems, reports didn’t align, and debates started with methodology instead of solutions. So we spent more than a year building a business analytics platform that delivers auditable, reliable analytics. Once that happened, the conversation shifted from parsing inconsistent reports to asking, “how do we improve?” That’s when we moved from talk to action.
Takeaway: Invest aggressively in data quality and governance. Honest, defensible analytics are the grease that speeds change.
3 — Standardize thoughtfully, with clinicians leading the tradeoffs
Standardization can feel like an affront to surgeon preference — unless it’s done right. Our platform-level total-joint agreement was surgeon-led from the outset: head-to-head testing, real-world validation, and outcomes benchmarking. The result: products chosen because they met clinical standards first, and because they allow practices to capture value they can reinvest locally.
Takeaway: Let clinicians lead the selection process, and make every standardization decision defensible with outcomes data and hands-on testing.
4 — Execution is a people problem — invest in routines and relationships
You can buy the best tech, but you can’t buy trust. We created practical routines — regular, in-person on-site sessions, physician panels, and cross-practice working groups — to build relationships and shared muscle memory. Those rituals are what let us move quickly and cleanly when opportunities appear.
Takeaway: Design the cadence of engagement (meetings, site sessions, working groups). Culture and relationships determine whether tech and contracts actually deliver.
5 — Be commercially rigorous, and patient about relationships
Commercial rigor matters: get the economics right, understand how value flows, and protect the upside. But deals that stick are negotiated hard and closed slowly, with clinicians brought into the process until they endorse the outcome. That deliberate patience costs time, but it creates scaled value that lasts.
Takeaway: Combine sharp commercial strategy with disciplined, relationship-focused execution. One without the other yields contracts, not platforms.
What this means for USOP going forward
USOP has momentum, and that momentum will stick because it’s built on governance, data, and execution. Practices will see benefits through strengthened ASCs and the ability to reinvest in services for their communities. Our platform initiatives — business intelligence, physician governance, and strategic vendor agreements — create durable advantages for partners and practices alike.
Looking back, these five years have been defined by steady, practical work — the long meetings, the site visits, the tests, and the honest conversations that turned hard choices into durable wins. Looking forward, we’re taking that same discipline into the next phase: scaling ASCs, deepening analytics-driven improvements, and turning platform savings into better services for our practices and their communities.
I’m proud of what we’ve built so far, and I’m excited for what we’ll do next.
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Graham Young helped launch USOP in 2020 as employee No. 1. Currently leading M&A, business transformation, and platform strategy, he believes that smart governance plus steady work is the recipe for lasting impact.