Insurance companies preventing orthopedic surgeons from choosing which product or implant they feel is in the best interest of patients is something that has to change, according to this orthopedic surgeon.
When insurers decide to only approve surgeries or procedures when a certain type of implant, device or product is utilized can potentially leave patients without alternative options.
William Cross III, MD, an orthopedic surgeon and associate professor at Rochester, Minn.-based Mayo Clinic, recently connected with Becker’s to share an issue that he sees in orthopedics.
Editor’s note: This response was lightly edited for clarity and length.
Question: If you could change one thing about the orthopedic industry, what would it be?
Dr. William Cross: If I could change one thing about the orthopedic industry, it would be to end exclusivity arrangements where insurers only approve a surgery if a certain type of implant is used that only a single company sells. These situations force surgeons to use one product, even when a better option exists. It ties our hands and puts business interests ahead of patient care.
One example is the way some payers restrict surgeons to using only triangular titanium implants from a single company. This medical device company is the only company that makes triangular titanium SI joint implants. This kind of exclusivity blocks competition, shuts out innovation, and leaves patients without access to potentially superior alternatives.
Patients deserve implants chosen for their unique needs, not dictated by an insurance contract. Ending exclusivity would restore surgeon choice, fuel innovation and put patients back at the center where they belong.
