Four orthopedic surgeons connected with Becker's to answer, "What is the biggest threat to orthopedics from outside the industry?"
Ask Orthopedic Surgeons is a weekly series of questions posed to surgeons around the country about clinical, business and policy issues affecting orthopedic care. We invite all orthopedic surgeon and specialist responses.
Next question: What is your unpopular or uncommon orthopedic opinion?
Please send responses to Riz Hatton at rhatton@beckershealthcare.com by 5 p.m. CDT Thursday, August 10.
Note: Responses have been lightly edited for length and clarity.
Eric Grossman, MD. Clinical Assistant Professor in the Department of Orthopedic Surgery at NYU Grossman School of Medicine (New York City): The biggest threat to orthopedics from outside industry is the continued devaluation of the services provided in medicine by private and government-sponsored insurance. As physicians and healthcare delivery centers refine, innovate and improve both the delivery of services and patient outcomes, CMS continues to lower the compensated value for these services. All while the cost of delivering those services increases yearly, making it more challenging for physicians and practices to sustain a stable economic model. Declining reimbursement in an inflationary world is not a stable foundation. This will ultimately lead to continued diminished patient access and ultimately to more potential future physicians/surgeons considering other professional pathways and careers.
Nicholas Grosso, MD. President of MedVanta and the Centers for Advanced Orthopaedics (Bethesda, Md.): The biggest threat to orthopedics actually comes from within the industry. At times we can be our own worst enemy. Orthopedic groups that haven't seen the future tend to allow ego to get in the way of improved patient care. Instead of orthopedic groups isolating themselves, we should band together and collaborate so we can collectively capture large segments of the market. This joint effort would not only benefit orthopedic practices but also payers in the upcoming years.
Vivek Mohan, MD. Orthopedic Surgeon at Southern California Permanente Medical Group (Pasadena): Private equity.
Nader Nassif, MD. Division Chief of Joint Replacement Surgery at Hoag Orthopedic Institute (Newport Beach, Calif.): In orthopedics, we work in a constantly evolving environment, with changes in technology both inside and outside the operating room. Artificial intelligence and robotics have potential for improving outcomes in the future. But if not developed appropriately, technology may result in higher costs of care without increasing benefits to the patients.
I believe, however, the bigger threat to orthopedics right now is the pressure placed on the healthcare system by payers: higher labor costs, increasing regulatory requirements, higher burnout rates and decreasing reimbursements. These pressures, combined with a drive by private equity to buy private practices, may result in decreased quality and access to care as more surgeons leave the system and fewer elect to join the ranks.