When Leesa Galatz, MD, thinks about the future of orthopedics, she doesn’t start with robotics or reimbursement models. She starts with people.
“At the end of the day, we operate on people, not on X-rays,” said Dr. Galatz, chair of orthopedic surgery at Mount Sinai Health System in New York City. “In order to decide what really has value to patients, we need to hear from them.”
That philosophy — that innovation should begin and end with the patient — guides Mount Sinai’s approach to translational research. Dr. Galatz sees it as a collaboration among physicians, researchers and payers.
Surgeons, she said, help guide treatment decisions and focus on outcomes that matter most to patients. Researchers work hand in hand with clinicians to speed the “bench-to-bedside” process. And insurers, for better or worse, play an increasingly visible role in determining how patients access care.
“It’s really important for insurers to focus on evidence-based treatments and treatment pathways that make sense,” she said. “And to reimburse appropriately for these services.”
At Mount Sinai, that alignment is reinforced through infrastructure designed to move discoveries from the lab to real-world use. Physicians are supported in developing new technologies, securing patents and finding industry partners through Mount Sinai Innovation Partners.
“We try to create common-sense clinical pathways for patients,” Dr. Galatz said. “And we advocate for them to receive the care we think is appropriate.”
When it comes to technology, Dr. Galatz believes tools like navigation, preoperative planning and 3D imaging have already transformed orthopedic surgery.
“All the things that we used to do, where we took measurements on X-rays, are now computerized,” she said. “Preoperative planning on a computer is a huge advance — you have a defined plan of what you’re going to do when you go into the operating room.”
AI, she said, is the next step forward. With cleaner, verifiable data from electronic medical records, orthopedics can gain clearer insight into patient outcomes.
“We can leverage some really powerful tools to make sure we’re collecting the right data at the right time,” she said. “But there needs to be human oversight to make sure the data is really clean.”
Economic shifts are also reshaping the field. Dr. Galatz pointed to the rise of bundled payment models for high-volume procedures like total joint and spine surgeries. Negotiating a single price for a full episode of care, she said, has created both opportunity and pressure.
“We really have to streamline our care and become very efficient,” she said. “We also have to pay attention to quality, because we can’t afford complications. It’s made us take a critical look at what’s important — what we really need in terms of ordering tests and what matters most for patients after surgery.”
That same mindset extends to supporting the next generation of orthopedic surgeons. Dr. Galatz said expectations among younger physicians have changed, and the field has evolved with them. Residency programs now place more emphasis on well-being, inclusivity and flexibility.
“Expectations of young orthopedic surgeons are a little bit different,” she said. “We’re much more understanding and permissive in terms of maternity leave, paternity leave, sick leave, family bereavement — all those things. They should be entitled to those benefits just like anybody else.”
Addressing workforce shortages, she added, will also require rethinking how people work. “We need to take a critical look at what needs a human being and what doesn’t,” Dr. Galatz said. “If AI can handle mechanized work, like charting or checking pharmacy interactions, then nurses and physicians can spend more time with patients — where they’re truly needed.”
Looking ahead, Dr. Galatz is watching the rapid shift of orthopedic care to outpatient settings. While the change benefits patients through convenience and efficiency, she said it also creates challenges for hospitals that have long relied on orthopedic volume.
“Historically, all these procedures have been done in a hospital setting,” she said. “As this volume moves to outpatient care, it’s leaving a void on the hospital side. It’s really important for hospitals to plan to backfill with other services, such as cancer care, that still require an inpatient setting.”
For Dr. Galatz, that shift underscores the importance of keeping orthopedics connected to the larger healthcare ecosystem — and to its core mission.
“We can’t lose our influence in the system just because care is shifting,” she said. “Innovation only matters if it improves people’s lives.”
