• Beyond CPAP: How ENT Dr. Len Covello Is Rethinking Sleep Apnea Care
    May 12 2026

    Most sleep specialists are just CPAP purveyors. If the mask fails you, they often have no next step. Dr. Len Covello is changing that narrative.
    Neal Goldstein sits down with Dr. Len Covello, an otolaryngologist and sleep surgery innovator who developed the sleep surgical program at Powers Health. This episode cracks open the “system failure” in sleep medicine and provides a holistic roadmap for those failing traditional treatments.

    What you will learn
    ● Why the “CPAP or bust” mentality creates a massive blind spot in modern sleep medicine
    ● The mechanics of Hypoglossal Nerve Stimulation and why it’s a game-changer for moderate to severe apnea
    ● How common medications like acetazolamide can “trick” the brain into fixing central sleep apnea
    ● The surprising link between GLP-1 weight loss medications and surgical eligibility for sleep patients
    ● Why screening in hospitals often leads to “order drift” and how to ensure patients actually get treated
    ● The “Quarterback” model: why you need a single clinician to own the entire holistic sleep journey
    ● How to navigate restrictive insurance criteria (BMI and AHI) to get the life-changing surgery you need

    Timestamps
    00:00 — Introduction: Dr. Len Covello’s 30-year journey in ENT
    03:31 — The evolution from traditional ENT to sleep surgery specialist
    05:40 — Why the UPPP throat surgery was “justifiably discredited”
    07:03 — Hypoglossal Nerve Stimulation: How stimulating the tongue nerve works
    11:22 — The CPAP blind spot: why 50% of patients are falling through the cracks
    15:54 — Creating a high-quality alternative to the CPAP mask
    21:50 — Using GLP-1s and weight management as a bridge to sleep surgery
    24:32 — Fixing Central Sleep Apnea with acetazolamide
    28:45 — The STOP BANG screening method and why it often fails in hospitals
    32:20 — The Sleep Counselor: Why patient navigation is the missing link
    34:34 — The financial argument for payers: preventing AFib and heart failure

    Guest bio and links
    Dr. Len Covello is a board-certified otolaryngologist at Community Hospital in Munster, Indiana (Powers Health). He is a pioneer in sleep surgery and developed a comprehensive program focusing on neurostimulation and holistic airway management. Dr. Covello also consults for financial and medical institutions on the future of sleep technology.
    Website: https://www.powershealth.org
    LinkedIn:

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    Disclaimer
    This episode is for informational and educational purposes only and does not constitute legal, financial, or medical advice.

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    40 mins
  • Sale to PE: The Two Hats a Selling Physician Wears
    Apr 28 2026

    In this episode, Neal Goldstein breaks down the “two hats” physicians wear in private equity transactions: seller and rollover owner/employee. He explains that while most physicians focus heavily on upfront cash, indemnities, and non-competes in the sale, they often don’t pay as much attention to equally critical employment and rollover equity agreements.

    Neal highlights why it is important to focus on rollover and employment terms. Rollover equity can represent a substantial portion of total deal value, and its terms—vesting, forfeiture, buyback rights, and valuation—vary widely and directly impact long-term outcomes. He also emphasizes that physicians’ interests diverge based on career stage, productivity, and risk tolerance, making these provisions highly personal.

    The episode offers a practical roadmap of what to scrutinize in both employment and rollover agreements, urging physicians to give as much attention to their “second hat” as their first—because that’s where significant financial risk and upside often lie.

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    23 mins
  • Being Strategic: Lessons from the PE Firms
    Apr 21 2026

    In this episode of Group Practice, host Neal Goldstein discusses why private equity (PE) firms are often able to operate more strategically than independent physician groups—and how those groups can adopt similar approaches without selling. Drawing on his experience, Neal explains that PE firms benefit from centralized decision-making, clear performance metrics like EBITDA, and shorter investment horizons that drive disciplined execution.

    Neal highlights four areas where he sees PE firms create value: physician staffing (particularly succession planning and strategic hiring), expense management (focusing on eliminating inefficiencies such as excess real estate), deployment of capital (retaining earnings to fund growth), and corporate infrastructure (including strong leadership roles like COO, CFO, and CDO).

    The core takeaway is that while PE has advantages, physician groups can improve performance by adopting even a few of these strategic disciplines—particularly around capital reinvestment, operational efficiency, and leadership structure.

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    26 mins
  • Back to Non-Competes: Addressing Listener Feedback
    Apr 14 2026

    In this follow-up episode of Group Practice, host Neal Goldstein addresses listener feedback about non-competes in physician practices. He tackles three key questions: Are non-competes ever appropriate? What’s the point of enforcing them if they’re often struck down? And what alternatives exist?

    Neal argues non-competes remain appropriate in several contexts: competing against hospital systems, PE-backed practice sales, groups with exclusive hospital contracts, and specialties with high capital costs. He emphasizes that despite headlines suggesting otherwise, non-competes are still being enforced and represent valuable contractual rights worth protecting.

    For practices seeking alternatives, Neal offers practical strategies: conditioning tail coverage on non-competition, structuring severance with clawback provisions, strengthening non-solicitation clauses, and negotiating robust no-hire provisions in hospital contracts.

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    31 mins
  • The Future of Podiatry Practice: From Solo to Platform – with Dr. Lowell Weil of Balance Health
    Apr 7 2026

    In this episode of Group Practice, host Neal Goldstein interviews Dr. Lowell Weil, Executive Chairman of Balance Health and formerly the CEO of Weil Foot & Ankle Institute a 53-physician podiatry group founded by his father Dr. Lowell Weil Sr. Dr. Weil discusses the five practice settings for podiatrists: solo/small practices, orthopedic groups, hospital systems, large independent groups, and platform-backed groups like Balance Health.

    Dr. Weil highlights the mounting challenges facing small practices – stagnant Medicare reimbursement, rising costs, and physician burnout – and explains how Balance Health addresses these issues by providing operational support, compliance infrastructure, and professional camaraderie while preserving clinical autonomy.

    What sets Balance Health apart is its physician-majority ownership structure, with over 150 podiatrist-owners, physician leadership at all levels, and a commitment to hiring and developing young doctors. Dr. Weil emphasizes that patient care, not profit, drives the organization’s mission.

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    49 mins
  • Discussion with PFS Labor & Employment Practice Chair, Nora Walsh, on the Evolving Law of Non-Competes
    Mar 31 2026

    In this episode of Group Practice, host Neal Goldstein welcomes his partner, and leader of PFS’s labor and employment practice, Nora Walsh, for a deep dive into the evolving world of physician non-competes. They explore the common law foundations – reasonableness in time and geography, and protectable interests – and how Illinois’s landmark Fifield case added consideration requirements, later codified in the Freedom to Work Act. The conversation surveys the national landscape: outright bans in California, Minnesota, and others; Texas’s practical buyout approach; Florida’s employer-friendly stance; and recent restrictions for healthcare workers in states like Colorado and Delaware. They also discuss the FTC’s abandoned federal ban and why the current administration may still target healthcare non-competes. Key takeaway: Non-competes have not gone away, but employers and physicians alike need to understand their state’s rules, and the risks of overreaching.

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    31 mins
  • Overview of the Anti-Kickback Statute
    Mar 24 2026

    This episode of Group Practice with Neal Goldstein provides an overview of the Anti-Kickback Statute (AKS), a federal fraud and abuse law enacted in 1972 that applies to all federal healthcare programs. Unlike the Stark Law, AKS is an intent-based statute that prohibits knowingly giving or receiving remuneration to induce referrals for federally reimbursable healthcare items or services. The landmark United States v. Greber case established the “one purpose test”— if even one purpose of payment is to induce referrals, the statute is violated. Due to this broad interpretation, safe harbor regulations were created in 1991, protecting compliant arrangements from prosecution. The episode also discusses advisory opinions and the protection those afford. At the conclusion of the episode, Neal explains the “quid pro quo” concept which is at the core of AKS, and he uses a little league sponsorship analogy which was contained in the jury instructions of the TAP Pharmaceutical case.

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    22 mins
  • Discussion with Dr. Richard Harris, national leader in urology and CEO of Uropartners
    Mar 17 2026

    In this episode of Group Practice, Neal Goldstein interviews Dr. Richard Harris, founding member and longtime CEO of Uropartners, about building one of the nation’s premier independent urology groups and the leadership principles behind its success. Dr. Harris recounts the challenging two-year process of merging 11 competing practices into a unified organization—overcoming distrust, strong personalities, and the independent nature of physicians. He discusses Uropartners’ strategic growth through high-quality ancillary services, including a centralized pathology lab, a dedicated urology surgery center, and a comprehensive Advanced Prostate Cancer Center. Each initiative was driven by improving patient care, operational efficiency, and clinical expertise. He also describes launching UroGPO to strengthen purchasing power and innovation across large urology groups, and his national leadership role with Large Urology Group Practice Association. The episode closes with Dr. Harris’s reflections on leadership: vision, integrity, humility, respect for all team members, and leading by example—principles that sustained Uropartners’ culture and long-term success in independent practice.

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    39 mins