Steven Mash, MD, an orthopedic surgeon at the Illinois-based DuPage Medical Group, discusses how orthopedic surgery has changed in the past decade, and what he thinks is in store for the next.
Question: What led you to specialize in orthopedics?
Dr. Steven Mash: When I was in medical school we rotated through various disciplines, and one of the disciplines I was privileged to rotate through was orthopedic surgery. There was an attending at Mount Sinai Hospital, here in Chicago — I remember he let me put a traction pin in somebody's tibia. He really got me interested in orthopedic medicine. At the end of medical school, I did a six-month externship at Northwestern University, where I also came in contact with a couple of orthopedic surgeons who I hit it off with. It's luck of the draw; people who I found that engaged my interest.
Q: How has orthopedic surgery changed since you graduated from medical school?
SM: Medicine has changed tremendously in the time that I've been practicing. Outpatient total joint replacement was unheard of even 10 years ago, but 20 years ago? No way. Even the simplest of operations used to require an admission to the hospital the day before the operation. There was a whole ritual of being visited by the anesthesiologist, the surgeon, the nursing staff — and, if you were in an academic hospital, the resident or intern. If you were in orthopedics, they would shave the body part you would be operated on the night before the proceedure, which we now know actually caused increased infections. Patients stayed in the hospital five or ten times longer than they do today. I see this ever-shortening timeframe for when patients are really in the acute care environment as a continuing theme, which I expect is going to continue to move forward into all of medicine.
Q: What do you see as the biggest areas for growth in the orthopedic surgery field today?
SM: I think there are three particular areas for orthopedic growth. The first is the move toward short stay and ambulatory surgery for all kinds of orthopedic procedures; total joints are in the conversation today, but lots of complex shoulder surgeries and minimal incision surgeries are going to change the face of orthopedics dramatically in the next decade. The second is the changing use of biologics. All of the kinds of things we're using now to supplement bone healing has really changed throughout my career, and clearly is going to be changing tremendously into the future. For example, the ability to treat arthritis with stem cells, tissue modification and gene modification seems just around the corner. These developments are going to change the entire face of what medicine looks like for orthopedics. Lastly: further consolidation of medicine to include orthopedics. Our specialty is one of the last specialties that's experiencing the merger-and-acquisition craze. There's an aggregation of practices into larger groups, and that's going to change the opportunities for physicians — and for the patients that we serve — as the delivery model changes.
Learn more from Dr. Mash at the 15th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference + The Future of Spine in June 2017! Click here for more information.
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