Thomas Graham, MD, is a clinical professor in the department of orthopedic surgery and associate chief of the division of hand surgery at New York City-based NYU Langone Health. Here, Dr. Graham discusses the biggest issues and innovations in his specialty.
Note: Responses were lightly edited for length, style and clarity.
Question: What do you believe is the most pressing issue for your specialty right now?
Dr. Thomas Graham: As we have an aging population, orthopedics is going to get more and more important. We're the specialty that provides mobility, quality of life, ability to return to the workforce, etc. We're not holding life in the balance, typically — and I certainly honor our colleagues who are heart, brain and cancer doctors — but orthopedics is at the vanguard of delivering care, especially with the changing demographic.
What I'm always thinking about, as I combine my life as a surgeon and a medical executive who's dedicated most of his career to innovation, is adopting the same mantra as all of healthcare. We should be value-based innovators. We need to show that innovation doesn't add cost, it actually positively influences many things. When I [say] "value-based innovation," I'm talking about solving big problems for large populations more economically, more efficiently [and] with greater velocity. All of us can influence that, from the front line to the C-suite.
Q: What advancements or innovations are you most excited about in the space?
TG: It's amazing that advances in metallurgy and polymer science can enhance our ability to deliver state-of-the-art care to our patients. However, we always have to have a little bit broader aperture than just the shiny metal object, just the implant. I think where we're really making headway is in the integration of informatics, healthcare information technologies, and the way we think about the whole episode of care.
We now have at our fingertips a much greater ability to expand our aperture on the patient. I'm very excited about the quantified self, all the data that people are generating through their tracking devices. We need to look at patients more holistically, and we have the opportunity to do that now. We used to rely on this small snapshot, and now we have abilities to chronicle, communicate and data exchange all the time. I come in every day and about 10 patients have written me through the EMR. They can come in and show me their exercise patterns. This is now starting to resemble what we do for professional teams.
Q: What are some of the barriers to innovation in healthcare?
TG: We're a highly regulated field. In fact, if you really think about it, healthcare is quite the antithesis of an excellent business model. Patients don't want your service; they don't want to be sick or injured. Typically, they haven't paid for it historically — it's been a third party. And now, we have extra burdens because many of us are still struggling with integrating EMR keeping, etc., into our patient flow. The fact that you're interacting with a computer and not face-to-face with a patient can be frustrating for many of us who've been in practice for three decades. But it's a reality, so we have to find a way to make all of this information and all these capabilities not a passive addendum but an active partner in the care of our patients.
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