Bryan Springer, MD, doesn’t see innovation and value-based care as separate goals. To him, they’re the same conversation — and the future of orthopedic surgery depends on how well healthcare leaders merge the two.
Dr. Springer, chair of orthopedic surgery at Mayo Clinic Florida in Jacksonville, said his team is taking an aggressive, systemwide approach to driving both efficiency and better outcomes.
Blending innovation and value-based care
Over the last two decades, he said, hospitals have already squeezed out most of the obvious costs — shorter hospital stays, fewer inpatient rehab visits and more efficient discharges. The next opportunity lies in smarter care delivery.
Using large datasets, AI and automation, his team is rethinking how evidence-based medicine can be applied more precisely and efficiently.
Smarter care through data and AI
“We spend a lot of time and money on unproven treatments in the time leading up to surgery,” Dr. Springer said. “Now we have these huge datasets — registries, payer data — and we can use AI and large language models to distill best practices and eliminate what doesn’t work by practicing evidence based medicine.”
At Mayo Clinic Florida, that effort has already changed how teams operate. Ambient listening tools automatically generate clinical documentation, freeing physicians from typing or dictating notes. In the operating room, AI-driven analytics help identify bottlenecks in turnover times, instrument processing and efficiency.
“These tools are helping us streamline processes and spend more time where it matters — with patients,” Dr. Springer said.
He sees the initiative as part of Mayo’s “three shields” mission of patient care, education and research. Training residents and fellows to think within value-based models, he added, is just as critical as developing new technologies.
“The goal,” he said, “is to take what we learn in research and translate it directly into better outcomes.”
Expanding access through virtual care
As demand for hip and knee procedures continues to rise, access has become a defining challenge. Springer said the key is to rethink what “access” really means.
“There’s this misconception that access has to be in person,” he said. “There are times when patients need physical touch, but often they just need a touchpoint — a way to connect with their care team.”
Mayo’s “Bold. Forward. Unbound.” initiative reflects that philosophy. Through telehealth and remote monitoring, patients can share data, ask questions and maintain virtual contact with their care team between visits. That model, Springer said, lets physicians reserve in-person appointments for when they’re truly necessary.
He offered a familiar scenario: a patient traveling three hours for a brief postoperative check.
“We think we’re doing them a favor by seeing them in person,” he said, “but oftentimes that means hours on the road, possible overnight stays and extra time off work for patients and care givers. Many visits could easily happen virtually.”
Even patients once thought to resist telemedicine have embraced it, and what might have seemed unthinkable a few years ago has quickly become routine.
“We assumed older patients would resist virtual visits,” he said. “In reality, they’ve embraced them the most.”
Confronting workforce and policy challenges
While technology has improved efficiency, workforce shortages continue to challenge orthopedic departments nationwide. Dr. Springer said staffing gaps in anesthesia and sterile processing are among the most pressing issues. High turnover, he noted, makes it difficult to build the consistent, high-functioning teams that drive quality and throughput.
“You can have all the anesthesia and nurses in the world, but if you don’t have your instruments, you can’t operate,” he said. “Sterile processing departments have seen enormous challenges with workforce across the country with high turnover leading to workforce shortages.”
His team is tackling the issue on two fronts: reducing instrument inventory to simplify logistics and exploring automation that could one day support semi-autonomous sterile processing systems running efficiently around the clock.
Dr. Springer also pointed to payer policy as a growing friction point in orthopedics. Prior authorization, he said, remains a major barrier for patients and physicians alike.
“It delays care, adds administrative burden and ultimately impacts patients,” he said.
He believes AI could help streamline documentation and approvals, but lasting change will require policy updates.
“If quality metrics show that providers consistently deliver great outcomes, there should be some level of trust,” he said. “Programs like gold carding could reward high-performing organizations and reduce unnecessary roadblocks.”
Private equity and consolidation are reshaping the business side of medicine as well. Dr. Springer acknowledged that private equity provided critical lifelines to many practices, but said the next few years will test how sustainable those models are.
“Delivering healthcare is expensive, and smaller groups needed capital,” he said. “But as those investments mature and costs continue to rise, it’s unclear who will sustain them long-term.”
He contrasted that with physician-led systems like Mayo’s, which remain mission-driven and less financially leveraged.
“I feel fortunate to be in a model where we can stay focused on patient care,” he said. “That’s harder to do in other environments.”
What’s shaping the future of orthopedics
Looking ahead, Dr. Springer expects reimbursement reform, workforce redesign and technological integration to be the defining issues shaping orthopedics.
“Physician fee schedules haven’t kept up with inflation,” he said. “We need physician-led reform — and we need to make telehealth rules permanent. They’re essential for maintaining access.”
He worries that without change, declining reimbursement could eventually threaten patient access.
“At some point, those pressures start to affect care delivery,” he said. “The last thing we should do is put patients in the middle. They need to stay at the center of everything we do.”
For Dr. Springer, that focus remains constant no matter how fast technology evolves.
“We’re leaders in robotic surgery and orthobiologics,” Dr. Springer said. “The challenge is offering those technologies in the face of declining reimbursement, but the goal is the same — to keep patients first and continue improving care but we have to figure out how to deliver high quality value based care in this challenging environment.”
