From growing technologies to developments in the payer landscape, here are the biggest healthcare trends six spine and orthopedic surgeons are following in 2025.
Dr. James Germano, MD. Northwell Long Island Jewish Valley Stream (N.Y.) Hospital: I think robotics is growing exponentially in orthopedics, and we’ll start seeing a combination of robotics and AI working together. AI is really more of a thought process where robotics is more of a mechanical process that helps achieve more exact alignment. I think the combination of the two is a very good fit. I think we’re going to see more of that post-operative patient monitoring, where we’re looking at patients outcomes and how well they do and how functional they are by having trackers on them that can measure how many steps and how people walk and how their function is to really start understanding better how people do after surgery. Again, that’s where AI really does come in, because you get these huge databases of information that we can collect, and then we can do better analysis.
I think the biggest problem we have right now is that hip and knee replacement is such a successful operation for so many people that it’s very hard to determine how to make things better. When someone is 95% successful, that last 5% is really hard to determine. So how do we make up that last 5% to get to 99% and that’s really where we need these huge computing algorithms to help us differentiate. I think that is going to really take us to that next place of orthopedics.
Stefan Kreuzer, MD. ASC Inov8 Surgical at Memorial City (Houston): Currently, in orthopedics and the broader healthcare industry, the trends I follow most closely include computer navigation, robotics and healthcare economics, particularly the shift of inpatient surgeries to outpatient settings. I also pay close attention to the increasing trend of physician employment, which I believe is concerning. Physicians should remain independent; however, health insurers and payers have made it increasingly difficult for individual practices to survive.
Matthew Lavery, MD. President of OrthoIndy (Indianapolis): One of the things I’m continuing to monitor really closely is the sense that we’re moving more towards site neutral payments and orthopedics. I think it’s a continued challenge for everybody. I think it may be a larger challenge for hospitals that have separate certifications and legal requirements to maintain their status as hospitals.There may be some benefits to those people who are in the ASC world, and there may be some challenges that people who are in the hospital world face, and currently with us structured as a hospital, that’s that’s something we have to keep our eye on really closely. So we’ll continue to follow and monitor that. The things that don’t ever change are focused on providing excellent patient care. What is the experience a person wants from start to finish?
The other big trend that we all follow is consolidation in healthcare. I think [OrthoIndianapolis is] an example of trying to find a way to make consolidation and increased size a net benefit to the people we serve. I think there are always questions in the mind of the general public as to whether consolidation is beneficial, but it’s the reality of the world we live in. In healthcare, if you look around, you really don’t see a lot of private practices in existence anymore. They have to compete with large health systems who have a little bit of a different playing field. They have a little bit of a running head start in some ways, whether it’s their tax advantage status or whether it’s their size. When they go to negotiate contracts with payers, that’s very different from small-to-midsize practices. I’ll certainly be watching for the benefits of that consolidation to the end user, and how we can make sure that we’re trying to capitalize on as many of those benefits as possible. If we’re growing in size we want to make OrthoIndiana a more robust institution that long term, can continue to provide a different perspective and opportunity for patients versus just going to a large system. Being physician-owned, we all have a lot of skin in the game, because we want the place we work to be the type of place that our family members and friends would want to come to.
Robert McLain, MD. President of the Western Orthopaedic Foundation: The issues I think that are most concerning are the problems of contraction in health systems. I saw this in the Midwest with the closure of hospitals and the collapse of hospital systems. In the West Coast, virtually every system you talk to has taken a financial beating over the last couple of years. They’re talking about red ink everywhere, so their ability to take on salaries and take on physicians is very tight. I know a number of physicians that have found themselves at a point in their career where they would like to keep working, but it’s just not fiscally reasonable, and they can’t find anybody that would give them an interview. We’re losing some people just because of the contraction in the hospital systems and the economics of the environment.
The transition that was most exciting to me when I was finishing up my career in Cleveland is also exciting out here. Advances in technology really have changed what we’re able to do, particularly in spine surgery. We have the ability to do some really wonderful things with disc arthroplasty, outpatient surgery, and to do things on a more economical basis while getting patients mobilized much quicker.
I’m also watching preapprovals and denial of care. Everybody knows what’s on the table, and recent events have been tragic, but for my patients it’s been tragic for several years. I think the individual physicians in practice and physicians in major medical centers and academic institutions, they’re all fighting the battle of using their best judgment and their expertise to come up with a plan and then having to negotiate with an institution to get approval for. That makes it hard to deliver care to patients. And that’s that’s as big a problem out here as it’s as it’s been anywhere.
Jacky Yeung, MD. Yale School of Medicine (New Haven, Conn.): I’m following motion-preservation closely. I do a lot of disc replacements here at Yale, and it’s so interesting how it’s still not a very well accepted concept, especially among the more experienced surgeons. I think part of it has to do with our exposure to the matter. Other aspects of spinal surgery that I’m focused on is ERAS and how I can couple those protocols with endoscopic surgery so all my patients are going home the same day, safely and comfortably.
Xiaofei (Sophie) Zhou, MD. University Hospitals (Cleveland): Things I’m really focused on are access to healthcare and equality in healthcare. We live in Cleveland, and we’re really lucky. There are multiple hospitals with great healthcare, but there are also communities that don’t have the fortune of having surgeons who are adept at multiple types of surgery. They just don’t have access to the breadth of healthcare that we fortunately have here in Cleveland. But that’s part of the reason why I think residency training and training in general is so imperative because I can only help one patient at a time. But if I can train the next generation to embrace technology and embrace learning, then I think we’re going to be able to put out doctors who are adept and can utilize whatever resources they have to help their community. The focus on education in medicine is something we have to return to in 2025.
