The LegacyRx Podcast · Nov 7, 2026 · 33m · 26m saved
With Scott Powell, Board-Certified ENT Surgeon and Partner at Florida ENT and Allergy
Florida ENT and Allergy had four partners when Scott Powell joined, and a merger will soon take it to 31 ear, nose and throat surgeons across three counties. Scott Powell, a board-certified ENT surgeon in Tampa with an MD and an MBA, told The LegacyRx Podcast that he measures that growth less by clinical work than by how well it protects the practice from hospital systems and private equity buyers.
"The success factor pivoted from... how am I building something here? Essentially making a moat around my practice so that I'm protected, the people I bring on are protected." — Scott Powell
Scott has spent more than 15 years specializing in sinus and nasal surgery, and he now spends his own time teaching residents and young doctors the money lessons he says he learned late.
The full interview is covered here so you can skip it. 33 minutes of audio, 7 minutes of reading.
Here are the 9 lessons that matter.
Key Takeaways
A CMS change to ENT billing coming in January could cut pay by about 50%, by Scott's estimate
Orthopedic reimbursement has fallen more than 30% in 20 years, with another 20% cut to joint replacements expected in 2027
About 82% of physicians now work for a hospital system or private equity, Kyle Stephenson said
Kyle expects cash-pay orthopedic practices to return within 5 to 10 years as a way around insurers
Scott built his practice as protection against hospitals, private equity and other buyers that reduce a doctor's volume
Several financial advisors turned Scott away early in his career because he was not yet earning much
Scott teaches his children to see themselves as stewards of family wealth, not owners of it
1. A Moat Around the Practice
Scott earned his MD and MBA together at the University of South Florida. When the dual program's dedicated track fell through partway, he finished the MBA in night classes.
Scott joined Florida ENT and Allergy as its fourth partner and grew it toward 31 surgeons
He came in behind two partners who were nearing retirement, which he described as "coast mode." The group has since grown toward a merger covering three counties. Scott frames that growth as defense against "attackers... trying to undermine my practice or reduce my volume," a group that includes hospital systems and private equity.
