🎙️This post highlights insights from our Healthcare Ops Wave podcast, where Third Way Health CEO Frederik Mueller sat down with Julie Gessin, Chief Operating Officer of Schweiger Dermatology Group.

Listen to the full episode here

Though she is a COO now, Julie Gessin’s career began in the exam room.

She joined Schweiger Dermatology Group as employee #7 and one of its first physician assistants. Over the past decade, she helped grow the organization into a 90+ location practice with more than 2,000 employees and over 1 million patients annually.

In our conversation, she offered a behind-the-scenes look at what it takes to scale a people-centered healthcare organization without losing what makes it special.

Leading from the clinic floor

Julie still sees patients twice a month.

Those days give her a direct line of sight into workflows, staff challenges, and the patient experience. She listens. She observes. She identifies the small fixes that unlock massive value.

For Julie, effective leadership is about staying close enough to see the friction firsthand.

Growth is an operational rewrite, over and over again

Approaching 100 locations now, Schweiger’s scale didn’t happen overnight. The company grew one acquisition, one integration, and one process at a time. Along the way, the operating model kept evolving.

Julie and her team have mapped the full patient journey, end to end, half a dozen times. And they’re still iterating.

They treat operations not as a set-it-and-forget-it blueprint, but as a living system. One that flexes with new markets, shifting patient needs, and expanding service lines. And with the implications of AI adoption, the rate of change is faster than ever.

Culture and clarity scale together

Julie’s philosophy is clear: healthcare is a people business. Growth is only sustainable when staff feel valued, patients feel heard, and decision-making is distributed with intention. Julie’s approach.

She emphasized the importance of defining what success looks like in each role and communicating it clearly—especially as scale introduces complexity.

Julie’s approach mirrors Third Way Health’s values of defaulting to open and being open to feedback.

Vendor partnerships with accountability on both sides

Though Julie works with many external vendors, she remains selective in starting up with new partners.

She looks for partners who act like teammates, challenge her thinking, and understand what’s really happening inside her organization. That means building relationships that are transparent, collaborative, and mutually accountable.

Her advice to other operators: if it touches the patient, be thoughtful. And no matter what, keep internal subject matter experts who can guide, pressure test, and elevate your vendor relationships.

Final Thoughts

Julie’s story is a powerful example of how operational leadership can grow alongside an organization.
She built an operational playbook and iterates every day. Her success shows what’s possible when operators stay grounded in the day-to-day while thinking big about the future.

At Third Way Health, we share that mindset. We partner with healthcare leaders to help scale operations without losing connection to what matters: the people delivering care and the patients depending on it.

Listen to the full episode of Healthcare Ops Wave