Healthcare leaders have long debated what will reshape orthopedic surgery. Robotics. AI. Navigation systems. Endoscopic procedures. The assumption has been straightforward: the organizations that adopt new technologies the fastest will gain the greatest advantage.
But during a panel discussion at Becker’s 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC Conference in Chicago, several orthopedic and spine leaders arrived at a different conclusion. The biggest disruption may not be the technology itself. It may be the patient.
As more orthopedic and spine procedures move into ASCs and outpatient settings, patients are bringing consumer expectations into a healthcare system that was never designed around convenience. They compare options. Read reviews. Research procedures. Seek second opinions. And increasingly, they expect the same responsiveness from healthcare that they receive from nearly every other service in their lives.
For many organizations, that shift is proving more disruptive than any robot.
The Four Seasons expectation
Brian Cunningham, MD, orthopedic trauma surgeon, vice chair and director of inpatient orthopedics at Methodist Hospital and director of ambulatory surgery at TRIA Orthopedic Center in Minneapolis, believes healthcare is still catching up to how dramatically patient expectations have changed.
Clinical quality remains essential. But patients often assume they will receive competent medical care. What they remember is everything surrounding it. How quickly they got an appointment. Whether someone answered the phone. How long they sat in the waiting room. Whether the experience felt coordinated or chaotic.
“We want them to feel like they’re going to the Four Seasons,” Dr. Cunningham said. The comparison is not about luxury. It is about consistency. Patients increasingly judge healthcare the same way they judge every other service experience. The days when clinical expertise alone could overcome operational friction are fading.
“The olden days of, ‘I’m the surgeon. I’m so smart. People will wait for me,’ that ship has sailed a long time ago,” Dr. Cunningham said.
Healthcare organizations often spend enormous amounts of money differentiating themselves through technology. The panelists suggested many patients are paying closer attention to something far simpler: whether the experience feels easy.
The outpatient transition may already be over
For years, healthcare leaders have described the migration of orthopedic and spine procedures into ASCs as a transition.
Edward DelSole, MD, a spine surgeon at Wyomissing, Pa.-based Keystone Spine and Pain Management, believes that framing may already be outdated.
“I think one big assumption is that we’re still going to be talking about this transition in five years,” he said. The early growth of ASCs was largely driven by economics. Procedures could be performed at lower cost than in hospitals while maintaining quality and safety.
But Dr. DelSole argued that the next phase of competition may look very different. As reimbursement models evolve and site-of-service advantages narrow, organizations will need to compete on something beyond cost alone.
“The value transformation has to be everything else around that,” he said. That means access. Communication. Convenience. The patient experience.
In other words, the factors healthcare historically viewed as secondary may become primary.
Patients are driving innovation faster than hospitals
The traditional view of innovation assumes hospitals introduce new technologies and patients eventually adopt them. The panelists described a reversal. Patients increasingly arrive asking for specific procedures they discovered online. They seek out surgeons who offer techniques unavailable in their local market. They compare treatment approaches before they ever enter an exam room.
Hazem Eltahawy, MD, president and neurosurgeon at Farmington Hills, Mich.-based Neurosurgery and Spine Care Center, said that trend is particularly visible in spine surgery, where patient demand is accelerating interest in newer minimally invasive procedures. Information that once lived almost exclusively inside academic journals and conference halls is now available to anyone with a smartphone. The result is a more informed patient population and a healthcare system being pushed to adapt faster than it once did.
The technology trap
None of the panelists argued against innovation. The challenge, they said, is confusing technology adoption with transformation. Every new platform ultimately faces the same question: Does it meaningfully improve care?
“There is always the challenge between adoption or wait and see,” Dr. Eltahawy said. “Does it actually improve outcomes and increase safety or is it a gimmick?”
Dr. DelSole described becoming increasingly skeptical of technology purchases that begin with excitement rather than strategy.
“The first thing you have to ask is why,” he said. A robot does not automatically create a successful program. Neither does navigation. Neither does AI.
Technology only creates value when it is supported by trained teams, consistent workflows and a clear clinical purpose.
Dr. Cunningham offered a warning that resonated throughout the room.
“We have young surgeons that can’t put in a pedicle screw without navigation and O-arm,” he said. The comment was not a criticism of technology. It was a reminder that innovation should enhance expertise, not replace it.
As more procedures move into outpatient settings, organizations may discover that adaptability matters just as much as technological sophistication.
The transparency gap
Late in the discussion, the conversation shifted away from patients and technology altogether. The focus became economics. Specifically, whether physicians can effectively manage costs when they often lack visibility into the financial data driving organizational decisions.
“You can’t manage it if you don’t know what’s going on,” Dr. Cunningham said. Healthcare leaders frequently ask physicians to improve efficiency, reduce waste and participate in operational decision-making. Yet many physicians never see the underlying cost data.
Dr. DelSole believes that has to change. “Physicians should have access to the cost data associated with the care they provide,” he said. The discussion revealed a challenge facing many healthcare organizations.
Physicians want greater involvement in strategic decisions. Administrators want greater physician engagement. Both sides often operate with different information. As financial pressures intensify, alignment may depend less on organizational structure and more on transparency.
The expertise hospitals cannot replace
The panel concluded with a reminder that healthcare remains a people business. As orthopedic and spine procedures become increasingly complex, organizations often focus on recruiting surgeons and acquiring technology.
The panelists argued that success depends on a much broader group. Nurses. Scrub technicians. Schedulers. Anesthesia teams. Physical therapists.
“There is a lot of expertise that is built around every single member of the team,” Dr. Eltahawy said. That expertise compounds over time. It creates efficiency, consistency and trust. It is also remarkably difficult to replace.
For years, orthopedic growth strategies centered on expansion: more facilities, more technology, more operating rooms. The next era may be defined by something less tangible.
The organizations that thrive may not be the ones with the newest robot or the largest footprint.They may be the ones that build teams patients trust, create experiences patients remember and align physicians and administrators around the same goals.
Because in an industry obsessed with technology, the most important differentiator may still be the human experience.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
