In the next five years, the biggest disruptors to orthopedics will affect the number of patients who need surgery and how payers will affect reimbursements, Cory Calendine, MD, said.
Dr. Calendine, of Bone and Joint Institute of Tennessee in Franklin, spoke about his predictions for the coming years on “Becker’s Spine and Orthopedics Podcast.”
Note: This is an edited excerpt.
Question: What do you think will be the biggest orthopedic disruptors over the next five years?
Dr. Cory Calendine: GLP-1s. We got to figure out what they’re going to do to orthopedics. There’s some publications that show that if you’re on a GLP-1, you’re less likely to need a revision after hip and knee replacement.
But there’s the thought process that these drugs are only weight loss drugs or vanity drugs. Or that it seems like everyone is on them. I read a statistic that said 1 in 8 adults in the U.S. have tried a GLP-1. That’s an incredible number. So what effect is that having? If it reduces revision rates, that’s incredible. Another study out of the Journal of Sports Medicine, showed that actually there’s a lower rate that you ever have surgery in the first place.
A lot of people were worried that if these patients that have arthritis are going to lose weight, it becomes less symptomatic, and the demand for hip and knee replacement goes down. I understand that logic. But the reality is, once you’re bone-on-bone, no GLP-1 is going to take away your knee or hip arthritis. Those patients maybe are waiting longer because they’re getting some symptomatic relief from weight loss. Those patients are able to wait longer on their hip and knee replacement but there’s a whole nother selection of patients that were high risk surgical candidates due to obesity, that are now able to have their surgery and have their surgery safer.
The ASC continues to be a disruptor, and we’re still trying to figure out that space. How do we get more efficient? Are payers going to figure it out? But the ASC, I think, is still a significant disruptor, and that is not a settled thing. It’s continuing to disrupt.
Then there’s this continued reduction in reimbursement not just for facilities, but for physicians as well. I think there’s going to be a breaking point at some point. With the decrease in reimbursement and the rising labor cost, there’s an intersection at some point where we could potentially have serious access to care problems, and hopefully we figure out the efficiency model and some of these payment models in time so that it doesn’t just completely collapse.
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