New York City-based NYU Langone Orthopedics is getting bigger. For Joseph Zuckerman, MD, the harder task is making sure it does not become more fragmented as it grows.
The department is adding faculty, building increasingly specialized treatment centers and expanding the Manhattan orthopedic center it opened in 2012. Similar facilities are planned for Suffolk and Westchester counties in New York.
Its latest recruits offer a window into that strategy. Sabrina Strickland, MD, Andreas Gomoll, MD, and F. Winston Gwathmey, MD, will join NYU Langone Orthopedics Oct. 1 in leadership roles spanning patellofemoral disorders, knee preservation and hip preservation and arthroscopy.
All three arrive with established clinical and academic careers. But Dr. Zuckerman, chair of orthopedic surgery at NYU Langone Health, said those credentials alone are not what determines whom NYU recruits.
The department evaluates surgeons against three missions: clinical care, education and research. Then there is another test that can matter even more. Culture.
“Everybody talks about culture,” Dr. Zuckerman told Becker’s. “Well, we really think about it and act on it a lot.”
The strategy behind 3 major recruits
Dr. Strickland and Dr. Gomoll will join NYU Langone from Hospital for Special Surgery in New York City. Dr. Strickland will help lead the new Center for Patellofemoral Disorders, bringing expertise in patellar stabilization, cartilage repair, ACL and meniscus surgery and joint preservation.
Dr. Gomoll will co-direct the Knee Preservation Center. His work has focused on cartilage repair, sports medicine and preserving the native knee.
Dr. Gwathmey joins from Charlottesville, Va.-based UVA Health, where he established a hip arthroscopy and preservation program and most recently served as vice chair for education and director of the orthopedic surgery residency program. At NYU Langone, he will lead the Hip Preservation and Hip Arthroscopy Center.
Dr. Zuckerman sees the appointments as more than adding three high-profile surgeons. “We are always interested in recruiting surgeons that will enhance the name and reputation of NYU Langone Orthopedics in the realms of patient care, education and academic contributions,” he said.
For Dr. Zuckerman, the opportunity is to build enough expertise around particular orthopedic problems that physicians can do more than treat them. A large faculty allows surgeons with similar interests to organize around a condition or procedure, study their results and pursue the unanswered questions surrounding treatment.
“We want people to focus on outcomes,” he said. “They coalesce around a specific procedure or problem, not only to provide care, but to ask and answer the questions that can improve treatment.”
Why joint preservation is getting more attention
The areas NYU Langone is building around also reflect a shift Dr. Zuckerman sees in orthopedic demand. Patients are remaining active into their 60s, 70s and 80s, supporting continued growth in joint replacement.
At the same time, he sees another opportunity developing earlier in the continuum of care: keeping patients’ native joints intact longer. Advances in cartilage biology and adjunctive treatments are expanding the possibilities around joint preservation, he said.
The goal is not to choose between preservation and replacement. It is to build for both.
“Preserve the joints as best as possible,” Dr. Zuckerman said. “But when that’s not possible, make sure that we give patients an option for replacing joints.”
That helps explain the department’s investment in dedicated programs for knee preservation, patellofemoral disorders and hip preservation and arthroscopy.
Specialization, however, creates its own leadership challenge. The more centers and individual areas of expertise a department develops, the more important it becomes to keep those programs moving in the same direction.
‘Not always on the same page’
Dr. Zuckerman does not expect a large group of orthopedic surgeons to agree on everything. He expects something else.
“People in this department are not always on the same page, but they are in the same chapter,” he said. “They’re working together.”
NYU Langone considers clinical reputation, teaching and academic productivity. But Dr. Zuckerman said cultural fit can matter “much more” than a surgeon’s case volume or publication count.
Orthopedic surgeons are competitive by nature, he said. The goal is not to remove that competition.
“The key is to direct that competition outwardly, not inwardly,” he said.
It is also why Dr. Zuckerman’s definition of leadership is less about the title than what someone does with it. “Being a leader is not a destination,” he said. “It’s a vehicle.”
The measure, he added, is “what you do for the others around you.”
That philosophy becomes harder to maintain as an organization expands. NYU Langone Orthopedics has been expanding quickly.
Dr. Zuckerman estimated the department added nearly 18 faculty members around the previous year and roughly a dozen more this year. It also regularly recruits former NYU residents back after fellowship, giving the department physicians whose capabilities and fit are already familiar.
The newest recruits come from outside that pipeline, but Dr. Zuckerman said they met the same broader standard. Dr. Gwathmey, for example, stood out not only for his clinical expertise in hip arthroscopy and preservation, but for his track record in resident education and research.
“He’s done all the things that I think are important in one’s career as an orthopedic surgeon,” Dr. Zuckerman said. “It was a home run for us.”
The model NYU wants to replicate
The faculty growth is happening alongside a physical expansion of NYU Langone’s orthopedic footprint. The Langone Orthopedic Center in New York City opened in 2012 with multiple outpatient orthopedic programs and supporting services under one roof.
Dr. Zuckerman sees that integration as one of the model’s strengths: Patients can see physicians and access imaging, rehabilitation and other services in the same location.
Now the center is expanding to encompass the entire building. Dr. Zuckerman said plans include three floors of operating rooms and another five floors devoted to orthopedic centers and related services, including hand and shoulder, pediatric orthopedics, orthopedic oncology, foot and ankle, imaging, rheumatology and rehabilitation.
In Manhattan, where space itself can constrain healthcare growth, he sees the project as evidence of NYU Langone’s investment in orthopedics.
But the more consequential part of the strategy may be what comes next. Asked where NYU Langone Orthopedics still has room to build, Dr. Zuckerman pointed outside Manhattan. The health system plans similar orthopedic facilities in Suffolk County on Long Island and in Westchester County.
“We think that’s a model that we should reproduce,” he said.
That puts the arrival of Drs. Strickland, Gomoll and Gwathmey into a larger context. NYU Langone is not simply adding three surgeons. It is building deeper subspecialty programs while expanding the physical infrastructure around them, and preparing to carry that model into new markets.
For Dr. Zuckerman, scale is not the end goal. The challenge is preserving what makes the model work while making it larger: recruit people who can advance care, education and research; give them the resources to build; organize expertise around problems worth solving; and make sure individual ambition strengthens rather than fragments the whole.
They do not have to be on the same page. But Dr. Zuckerman wants them in the same chapter.
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