Nicholas Paddock is Senior Director of the University Orthopaedic Center at University of Utah Health, where he has led operations since 2019. He brings more than 15 years of leadership in academic medical center orthopaedics, including nearly a decade as Director of Orthopedics at Dartmouth Hitchcock Medical Center, and began his career in small business turnaround in the United Kingdom. His work focuses on financial architecture, organizational restructuring, and strategic growth planning within complex health systems, including the realignment of the department into ten specialty divisions and bringing its Surgical Skills Training Lab to fiscal independence. He holds a bachelor’s degree in economics from the University of York. Change management is the strength he most enjoys applying to leading teams through transition.
Leadership and Impact
If you had a magic wand and could permanently solve one of your department’s biggest challenges right now, what would that be?
Successfully navigating a major system restructure just announced by our leadership that will see the centralization of many currently localized functions. The concern is one of over-centralization—that departments could become cost centers and lose some of the dynamism that comes with having meaningful control over revenues. Our challenge is to negotiate this change as effectively as possible, preserving the entrepreneurial energy that has defined our department while working constructively within the new organizational architecture.
Looking back over the past three years, what are the two most impactful things you have accomplished in your role?
First, supporting our Surgical Skills Training Lab in achieving financial sustainability. The lab opened five years ago and bringing it to a point of fiscal independence has been a significant undertaking—one I am genuinely proud of.
Second, the restructuring of the department into ten specialty divisions and the realignment of our financial architecture to better align with our strategic priorities. This was a fundamental reimagining of how we operate, and I believe it has positioned us well for the years ahead.
If you could perfectly execute the accomplishment of three goals for your department over the next three years, what would those goals be?
First, the reassignment of several of our SOS 11 hospital-based clinics to SOS 22, creating a fiscal glide path for future growth with our external partner hospital systems.
Second, perfectly synchronize our hiring plans over the next three to four years with the opening of a brand-new hospital in West Valley City in 2028/29.
Third, establish a DME business by bringing our currently outsourced operations in-house. This initiative has been repeatedly deferred as our system undergoes its major reorganization, but I remain committed to making it a reality when the timing is right.
The AOC and the Power of the Collective
How can the AOC better utilize its digital platform to support meaningful, efficient connections between industry and academic leaders?
Honestly, I’m not entirely sure—and I’ll admit that I personally struggle with social media and the distractions that much of today’s “innovation” creates. As a case in point, I’m nearly three months behind in writing these answers to send to the AOC leadership team. The constant barrage of information and demands on time are a constant threat to deliberate and impactful leadership. I’m very open to advice and learning in this area—maybe a discussion group on the AOC digital platform on this topic would be a good test case!
What is the most valuable way that the AOC has helped you and your department?
Relevance. The AOC Conference is the only conference I attend every year without exception. Each time I leave feeling reinvigorated and reconnected to the extraordinary mission we are all a part of. The team building and team development opportunity is also hugely important to me—I bring a large team each year with these objectives very much in mind.
The Human Side of the Role
Share one personal accomplishment from 2025 that you are especially proud of.
Supporting my eldest daughter in her transition to college and watching her continue to grow during her freshman year. Being there to help with the move in/out and visiting over the course of the year has been an absolute delight. A wonderful reminder of the importance of making time to make the most of each phase in our lives.
When was the last time someone told you they were proud of you for the work you do, either at work or at home, and what was that about?
I’m originally from the UK, and my parents still live there. During a visit last year, my mother expressed how thrilled she is to see our family thriving in Salt Lake City following our move in 2019 from New Hampshire. As the adage goes, we don’t live to work—we work to live. Amidst all the pressures, not losing sight of that for both ourselves and our teams is critical.
What is your “superpower”, a skill or strength you have that you genuinely love to use in your job and feel you are especially good at?
Change management. I thrive on change and become restless without it. I started my career in small business leadership and turnaround, and looking back I can see that I was well suited to those challenges. I try to use my comfort with change to help my teams and organizations adapt to the challenges we face—turning what can feel threatening into something energizing.
Reflection and Perspective
If you could go back and give yourself one or two pieces of career advice earlier in your journey, what would they be?
Ease off a bit. Perfection is not attainable and make more time for personal exercise!
How do you think AI will meaningfully change your role, or the way your department operates, five years from now?
It is already improving the efficiency of administrative tasks, and that will only accelerate. My greatest hope, however, is that AI will alleviate our care teams from much of the tedium of routine tasks. The more time our carers can spend in direct patient engagement, the better everyone’s experience of the healthcare process will be — and research shows that engaged patients see better outcomes.
Just for Fun
What is your go to favorite meal?
As an Englishman, I have to say fish ‘n’ chips—with mushy peas or curry sauce, of course!
If you could binge on any fast food and be guaranteed not to gain any weight, what would it be?
Caramel ice cream with chocolate-encased caramel chunks, smothered in copious amounts of—you guessed it—caramel sauce.
If you were snowed in for a weekend and could binge watch one TV show, what would you choose?
Two old but formative comedy cult classics from my youth growing up in England: Blackadder and Red Dwarf. Failing those, Star Trek would certainly do the trick.