Orthopaedic Specialists of Alabama was founded over 50 years ago. In the intervening years, OSA grew from a group of three physicians practicing in a small office in Trussville to one of the largest medical practices in Alabama, an organization with 30 physicians seeing patients in eight full-time offices and eight outreach clinics, each office fully staffed with nurses, PAs, and physical therapy departments, along with state-of-the-art equipment that included an imaging center. It’s safe to say that OSA was the Vulcan of Birmingham healthcare, a steadfast institution that would certainly be here forever.
Which proves, of course, that nothing is ever really certain. In recent weeks, a tornado of rumors has ripped through the city. OSA was finished. Dissolved. Gone. Is this true or not? That depends on who you talk to.
Scott Morris, MD
Scott Morris, MD, the son of John Morris, MD, one of the OSA founders, says that the group is not dissolving, but rather restructuring, which became necessary as the number of physicians in the group declined from 30 four years ago to 17 at the beginning of this year, resulting in painfully high per-physician overhead.
“At that point,” Morris says, “the Shelby group said they may want to revisit the overhead. So we all decided to just restructure. Then Shelby decided to go off on their own. But the rest of us chose to stick together.”
The remaining group of 11 physicians will continue to operate full-time offices at St. Vincent’s Main, St. Vincent’s East, Princeton, and UAB West. “In the interest of efficiency, these offices will be responsible for their own costs, and we’ll have an overall structure where we’ll have efficiencies in size,” Morris says.
In an effort to become as lean as possible, the group has made a broad range of cuts that include square footage, administration, and equipment. Morris expects the group to outsource a number practice management functions such as payroll, human resources, billing, and possibly even the practice administrator’s role.
So, is this a new chapter for OSA or does OSA no longer exist? One thing for certain is that this looks markedly different than the OSA of a few years ago. And they will not be called OSA. The group has been re-named as Birmingham Orthopaedic Associates.
What happened? How did a group of 30 doctors become a group of 11 in four short years? In the end, only the associated physicians will know for sure. However, an outsider surveying the landscape can pick up a few clues.
It may not be a coincidence that the group began to shrink shortly after former CEO Jim Isom retired. Isom’s long tenure with the group marked a period of growth from five physicians when Isom started in 1976 to 30 when he retired in 2006.
Isom, who says that he knows nothing about the current situation, believed that the group needed to grow in order to compete in a changing health care environment. “I had a vision of what we needed to do,” he says. “And the doctors who were my bosses seemed to trust me enough that they agreed to do what I recommended. The doctors and I had, in my opinion, a great relationship. I thoroughly enjoyed my relationship with the doctors, which is not always the case for administrators.”
It is possible that the environment was not as stable after Isom left, given that the practice had three different CEOs during that time. If there was instability, this could have negatively impacted the practice. However, in the end, it may have simply been the large size that motivated some physicians to leave.
Stan Faulkner, MD & Timothy Cool, MD
Stan Faulkner, MD, whose father James Faulkner, Sr., MD was one of the founders of OSA, had a long personal connection to the group. “However,” Faulkner says, “with its growth and large number of physicians and locations, OSA became an impersonal corporate entity that our founding physicians didn’t envision. My preference has always been for my practice to provide the personal service my patients deserve and the care they expect. For this reason, I left OSA and reunited with my former partners, Lawrence Lemak, MD and Scott Appell, MD at Lemak Sports Medicine.”
Timothy Cool, MD, who left OSA to start a practice with Drs. Carter Slappey, Donald Slappey, Jr., and Spain Hodges, seems to have similar perspective. When Cool started with OSA in 1989, he found it to be a great place to work. “I was immediately struck by the down-home nature of the physicians and the great relationships between patients and staff,” Cool says. “I found my new co-workers to be supportive and accepting of me as a new surgeon. However, as the older generation of physicians began to retire and the culture changed, the personality of the group began to shift a little. I learned that if you have 20 surgeons in a room, you likely have 20 opinions on how things should be done.”
Regardless of whatever dissatisfaction former OSA physicians may have had with the practice, many of them harbor fond memories of the group.
Carter Slappey, MD
“Most of my early memories involved the practice in some way,” says Carter Slappey, MD. “As kids, we used to help our father around the office, follow him into the hospital on rounds; even on weekends, we’d be there in the Emergency Room if he got called in. Everyone in the practice- all the doctors and their families- used to take vacations together and have dinner together.
“For the staff, it was a long-term commitment to the practice family. People who came to work there stayed for life. I recall many retirement parties where the person leaving had been with us for thirty plus years. Our employees were loyal because they knew they were going to be taken care of. And we tried to make it a positive environment for the staff and the patients.”
Spain Hodges, MD
“I am third generation in the OSA family,” Spain Hodges, MD says. “My grandfather, Jim Faulkner, was one of the early physicians in the practice. My uncle, Stan Faulkner followed in his footsteps.
“I began my OSA career as a kid working summers helping with casts and working the x-ray machine. I remember many trips to the O.R. where I would be in there with my grandfather or my uncle. That was what got me interested in medicine.
“After I got out of school I had the privilege of working with not only my family, but with so many great physicians in a practice that had a tremendous amount of respect in the community. I learned so much from them about how to treat patients physically, mentally, and emotionally. I want to be the kind of doctor my grandfather was… that’s the kind of career I want to look back on years from now.”
Donald H. Slappey, Jr., MD
“My father formed his medical practice in Woodlawn immediately after medical school, so I have been around the practice my whole life. I spent almost every summer helping out at the office: mowing grass out front, sweeping the parking lot, filing records. It was a family atmosphere practice.
“When I came out of orthopaedic training, there was never a question where I wanted to work. Originally, the practice was located in Woodlawn and was called Slappey, Faulkner & Morris. Later, as the practice got larger, the name changed to Orthopaedic Surgeons East. Still, everybody was on a first name basis- the patients, the hospital staff, and the doctors were all part of the family.
“Then, we got even bigger and had offices outside of the east Birmingham area, so we changed our name to Orthopaedic Specialists of Alabama. We had generations of doctors treating generations of patients. I believe that the level of personal service my father created for his patients is critical to quality patient care.
“In January, I came together with a small group of great orthopaedic surgeons and we started a fresh practice at St. Vincent’s East. It has been a good change for us, built on a lot of good memories. I hope to someday pass on to my son the same kind of legacy my father created for me to follow.”
Where Are They Now?
Alabama Orthopaedic Surgeons
Timothy Cool, MD
Spain Hodges, MD
Carter Slappey, MD
Donald Slappey, MD
Birmingham Orthopaedic Associates - Princeton
John Featheringill, MD
Birmingham Orthopaedic Associates - St. Vincent’s East
Matthew Burke, MD
Karl Hofammann, MD
Victoria Masear, MD
Michael Martin, MD
Scott Morris, MD
Gwen Williams, MD
Birmingham Orthopaedic Associates - St. Vincent’s Main
Shane Buggay, MD
Jeff Cusmariu, MD
George Hill, MD
Birmingham Orthopaedic Associates - UAB Medical West
Ryan Cordry, DO
Lemak Sports Medicine
Stan Faulkner, MD
Shelby Baptist Group
Daryl Dykes, MD
Michael Gerhardt, MD
Lloyd Johnson, MD
Chad Mathis, MD