From Front Desk to $100M+ Healthcare, with Alejandro Fernandez from Synergy Orthopedic Specialists, BOAC E55

Alejandro Fernandez has seen healthcare operations from almost every level of the organisation.He started in the early 1990s working medical records and the front desk of a doctor's office while paying his way through college. He learned bookkeeping, billing, coding and revenue cycle management before eventually moving into healthcare leadership, private equity and large-scale physician group operations.Along the way, Alejandro helped grow Gastro Health from 18 doctors when he joined to around 150 providers and more than $100 million in revenue by the time he left. He also participated in almost 30 transactions as the organisation expanded. Today, he is CEO of Synergy Orthopedic Specialists in California. In this episode of The Business of a Clinic, Jared and Alejandro look at what three decades of healthcare change have actually achieved.Medical records have moved from paper to computers. Claims went from physical forms and dial-up modems to electronic systems. AI can now help with documentation, imaging, scheduling and patient communication. Yet Alejandro still walks into medical practices and surgical centres operating on paper, while many of the fundamental processes around reimbursement, access and administration remain extremely complex. They discuss the economics behind running a physician group, why doctors are trained to provide medicine rather than manage P&Ls and administrative systems, and what healthcare operators should be doing to create more space for clinicians to focus on patients.A central theme of the conversation is empathy. Alejandro argues that improving healthcare operations is not only about removing work or introducing automation. It is also about adding a better human experience around the clinician. Patients are often sick, worried or in pain, and the administrative experience around their care should recognise that.The conversation then turns to AI. Alejandro shares where he sees genuine opportunities for technology to increase capacity and remove low-value administrative work, while warning against assuming every new AI product can already do everything vendors promise.His framework for the future is simple: start with access, build empathy into the patient experience, then add technology wherever it genuinely helps.