EP391: Lessons for Private Equity and Others Trying to Do Right by PCPs and Their Patients, With Scott Conard, MD

Lessons for Private Equity and Others Trying to Do Right by PCPs and Their Patients, With Scott Conard, MD (EP391) One Doctor's Journey Shows What Happens When Good Primary Care Meets Bad Incentives. Episode 391. Stacey Richter talks with Scott Conard, MD, who shares his personal journey building a 510-clinician value-based primary care practice—and what happened to patient care after it was acquired by a hospital system with misaligned incentives. WHAT YOU'LL LEARN ✅ Why a PCP can produce high-value care even within a fee-for-service model, given the right practice patterns ✅ How working in name-only "teams" without real support sets primary care up to fail ✅ What a "Whole-Person Risk Score" is and how it shifts care from transactional to relational ✅ Why doctors get pushed and pulled by decisions made far above the clinic level ✅ How one North Texas health system acquisition raised community healthcare spend by $100 million in a single year ✅ Why moral injury—not just burnout—results when good clinicians watch misaligned incentives override patient care WHY THIS MATTERS Conard's story is a case study in how even a proven, cost-saving value-based practice can get swallowed by incentives that prioritize revenue over population health. Understanding this pattern helps private equity, health systems, and PCPs themselves recognize the warning signs before good care gets sacrificed to fiduciary euphemisms. MENTIONED IN THIS EPISODE Encore! EP335 with Brian Klepper, PhD: Apple Podcasts | Spotify | Other Apps EP381 with Karen Root: Apple Podcasts | Spotify | Other Apps EP364 with David Muhlestein, PhD, JD: Apple Podcasts | Spotify | Other Apps EP384 with Wendell Potter: Apple Podcasts | Spotify | Other Apps === LINKS === 🔗 Show Notes with all mentioned links: Episode Page ✉️ Enjoy this podcast? Subscribe to the free weekly newsletter 🫙 Support the podcast with a small donation to the Tip Jar 📺 Subscribe to our YouTube channel 🎤 Listen on Apple Podcasts 🎤 Listen on Spotify === CONNECT WITH THE RHV TEAM === ✭ LinkedIn ✭ Threads ✭ Bluesky ✭ X 00:00 Introduction. 05:26 What triggered Scott's career journey? 06:02 What caused Scott to rethink what is good primary care? 06:42 Why did Scott realize that he is actually a risk-management expert as a primary care doctor rather than someone who treats symptoms? 07:56 Encore! EP335 with Brian Klepper, PhD. 08:24 How did Scott's practice change after this realization? 08:35 What is a "Whole-Person Risk Score"? 11:37 "You start to move from a transactional model to a relationship model." 14:02 Did Scott have any risk-based contracts? 14:39 Why is it so important to look at total cost of care and not just primary care cost? 20:44 EP381 with Karen Root. 29:14 Why did Scott move over to help corporations? 31:42 EP364 with David Muhlestein, PhD, JD. 32:22 "Everybody thought they were honoring their fiduciary responsibility, and the incentives are completely misaligned." 33:02 EP384 with Wendell Potter. 33:15 "It's the system that's broken; it's not bad people."