Rey Bosita, MD, MBA, an orthopedic spine surgeon at Texas Back Institute in Plano, shares the greatest challenges he believes orthopedic surgeons will face in the new year.
Question: What challenges will 2017 present?
Dr. Rey Bosita: The biggest challenge facing orthopedic surgeons in 2017 will be uncertainty [with] MACRA, MIPS, ACOs, narrow networks and single payers in some states. All of these uncertainties give orthopedic surgeons grey hair because we don't know exactly how any one or a combination of them will affect our practices in the short and long term.
It seems as if the rules of practicing medicine are constantly changing. Furthermore, we have no idea how long the new rules will be in place before they change again. This uncertainty can be paralyzing as surgeons mull over difficult decisions regarding expansion of their practices, adopting new service lines, aligning with health systems and investing in ancillaries. Big bets are being made, and unfortunately there will be both winners and losers.
Young surgeons coming out of training into an uncertain job market may see fewer good private practice opportunities as established surgeons keep their powder dry and wait for the environment to change again. More and more jobs will be in a non-equity physician-employment model affiliated with healthcare systems that can provide the IT, EMR, PACS, insurance contracting and administrative support needed to make a practice work in this increasingly high fixed-cost healthcare market.
As doctors, our number one goal is to treat our patients properly by correctly diagnosing and treating their orthopedic problems. All of these external forces can erode the doctor-patient relationship and interfere with the orthopedic surgeon's primary objective. Anything that impedes the doctor-patient relationship will affect both the quality of care and patient satisfaction, also.