'The only way forward is not cheaper; it's better': What we heard in May

Carly Behm -  

Spine and orthopedic experts and leaders spoke with Becker's Spine Review on key topics in May from competition with large physician groups to threats in orthopedics.

1. "Unfortunately, most organizations make the mistake and don't really connect [their] values to the employee and where it's meaningful. So in my view as I've sat here and at Tallahassee Orthopedic Clinic, I've taken time to dissect our strategy, roll it out and then think about culture and our values. To me, people power our organization, so it is nothing more suitable than to come up with values. It's P.O.W.E.R. "P" for "passion," "O" for "ownership," "W" for "We" — not I — "E" for "Excellence" and "R" for "Recognition." Recognition is, in my opinion, really the most important part, because we have a tremendous workforce and we need to do a better job recognizing the good work. As I've done that, it's been very well received," — Mike Boblitz, CEO of Tallahassee (Fla.) Orthopedic Clinic, on how he builds culture at his practice

2. "The key today is you have to be better than your competition or you have to be willing to do something that your competition doesn't really want to do. For us, I do a lot of failed spinal surgery, and many of those patients will come from long distances. That's one area that keeps us competitive.

I like to say that we're sort of the Neiman Marcus or Saks Fifth Avenue of medical practices. By that I mean we spend time and we don't rush patients through. We try to give quality care, give patients the time they need and deserve. So especially if someone's going to be paying out of network or paying cash, they're going to get the extra time that a lot of the other practices just don't have the time to give. If you're in a Medicare in-network practice, you've got to really keep the wheels turning. You've got to maximize the number of patients and surgeries you're doing each day. So there isn't a lot of time in practices like that for the art of medicine," — James Chappuis, MD, of Spine Center Atlanta, on how his practice will compete with larger orthopedic groups.

3. "On the business side of things in the orthopedic landscape, there's kind of this musical chairs being played right now. The music is going, and do you sit in the private equity chair or the status quo or do you try to come together and merge or join an MSO with other private practice groups? Really our goal is to figure out what's the right step for us, and we're trying to learn from some of the other groups around the country," — Grant Zarzour, MD, president of Mobile, Ala.-based Gulf Orthopaedics, on challenges he anticipates in 2022.

4. "Cost will go down. Inevitably [Walmart and CVS Health] will be able to deliver it much more cheaply. I do not think better quality will necessarily follow. Cookbook medicine will be practiced and things will get missed. Ultimately, patients will likely do worse but the spend will be less. Healthcare quality has always been — and always will be — you get what you pay for. The only way forward is not cheaper; it's better. We have spent 10 years under the threat of underperformance from various organizations under the umbrella of HHS." — Brian Gantwerker, MD, of The Craniospinal Center of Los Angeles, on his outlook for retail giants in orthopedics.

5. "With baby boomers living longer than prior generations, their demand for orthopedic care will continue to increase. The disequilibrium between supply and demand for orthopedic surgical care promises to represent a major obstacle for the efficient delivery of care. Decreasing reimbursements promise to further exacerbate this supply-demand imbalance, as aging orthopedic surgeons choose to retire, and medicine becomes less attractive to new college graduates. A desire for work-life balance of graduating orthopedic residents may also prove a factor in productivity of newly trained orthopedic surgeons. A confluence of these social, economic and demographic factors promise to represent a major threat in orthopedics," — Sam Gerber, MD, of Orthopaedic Surgical Associates, on orthopedics' biggest threats.

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