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Industry        Surgeon

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What’s Ahead for 2015? Surgeons Foresee ACA Challenges

Posted in Health Reform Watch | Dec 2014 | Comments (2)

Tags: obama careorthopaedic surgeonhealth care reform billorthopaedic surgeon insurance premiumsgovernment regulationbundled paymentepisode of care


Government-controlled healthcare remains a top concern for surgeons, affecting reimbursement rates and creating cost pressures and high deductibles.

To further understand surgeons’ expected challenges in the upcoming year and to identify potential areas for growth despite the changing healthcare landscape, we queried members of the ORTHOPRENEUR® Editorial Board.

The full article was featured in the December issue of ORTHOKNOW®

     
What does the future hold for the orthopaedic industry?

How can surgeons and device companies maintain strong relationships to move
the industry forward?


These questions will be explored
in the upcoming
ORTHOWORLD® Symposium.

Learn more here
  

Participants include: 
Jack D. Goldstein, M.D., Sports Medicine Surgeon, Founder of AutomationMed
C. Scott Humphrey, M.D., Shoulder and Upper Extremity Specialist, Founder and Chief Innovation Officer of Shoulder Options
Blair Rhode, M.D., Sports Medicine Orthopaedic Surgeon, Founder of Rhode Orthopedic Group (RōG)
Marshall K. Steele, M.D., Orthopaedic Surgeon, Medical Director of Stryker Performance Solutions

ORTHOPRENEUR: What do you see as the biggest challenge facing orthopaedic and spine surgeons in 2015? What assistance, service or resources can industry provide to you, your patients or the hospital to help address this challenge?

Jack-D.-Goldstein WEB_copyJack Goldstein, M.D.: The biggest challenge is survival in an environment where government has given the control of all of the money in healthcare to the devil (insurance companies) and the devil’s son (the hospitals). It was not too many years ago when surgical centers were being promoted to lower costs, while improving quality and patient satisfaction. In the Northeast, this occurred while being paid 50 percent of what the hospital charged for the same procedure.

Unfortunately, the government now stupidly thinks that giving everything to hospitals and centralizing treatment will save money. History has a way of repeating itself. Hospitals have never been good at saving money. They routinely run myriad tests (mostly unwarranted), running up costs with absolutely no oversight. They are administratively top-heavy and do not even know what it costs to do procedures.

True, validated outcomes measures in the hands of patients and physicians are the only likely source of mediation of the negative forces at play. Unfortunately, nearly all physicians have been searching the ground for nickels and have not seen the train coming to hit them. I am one of the last of the private practice physicians. Most everyone has banded together in groups to get better bargaining power, at a cost to the quality of patient care.

Industry, unfortunately, has been paid better, while we have simultaneously been cut. Since I began practicing in 1990, my reimbursement has been cut to about 30 percent of what it was at that time, excluding inflation. I project that there will be a large shortage of physicians in the near future. It is a poor solution to fill this shortage with PAs and NPs. Even when they are good, they do not substitute for good diagnostic and treatment acumen.The only thing that industry can do to help is to support real outcomes measures, which prove the efficacy of treatment and their devices.

The problem has always been one of education of physicians and their participation. I developed software for data collection over ten years ago for validated outcomes-measures collection, but without EMR cooperation, data connections are expensive to build and maintain and are different for each vendor. Now perhaps the best means would be a patient network for data collection as an app. Doctors could then opt in if desired. This would require no cooperation with EMR companies, and one platform could be used centrally (cloud based), lowering the cost to run and maintain. 



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Bart 12/27/2014 12:49 AM
Actually, I disagree with your statement about PAs. I think the future IS with midlevels. Let them do what they are good at, managing chronic problems and treating acute problems. That helps to decrease the cost of medicine as well.
Jay Crawford, MD 12/11/2014 03:28 PM
Patients and payers have learned that the way to get more out of us is to apply value metrics. We must do the same. I built software for my practice that improves patient engagement and service while applying value metrics that allow me to stratify my appointment assignment based on what is valuable to me. My returns are 40% higher and the patients who see me are 97% satisfied and 64% more loyal. This isn't rocket science, guys. Act like a businessperson if you want to succeed in business. You cannot jump through everyone else's hoops and think that they are interested in your good fortune. Search rockhopperzsg on Google if you want to know more.