Dr. Frank Kolisek: 3 big challenges in orthopedics + whether large groups can remain independent


Frank Kolisek, MD, is a joint replacement surgeon at Indianapolis-based OrthoIndy and OrthoIndy Hospital.

Throughout his career, Dr. Kolisek has spent two four-year terms as president of OrthoIndy and has served as a principal investigator for several clinical studies. He is involved in computer-assisted and robotic surgeries, and the design of hip and knee implants.

Here, Dr. Kolisek discusses the biggest challenges and opportunities for orthopedic surgeons today.

Question: What are the top two to three challenges orthopedic surgeons face heading into 2019?

Dr. Frank Kolisek: Three big challenges include:

1. Handling the increased burden of pre-certification for various treatments and medications whereby each insurance company and even different insurance products within the same company have different criteria that must be met. These criteria are often unilaterally made by the insurance company.

2. Continued downward pressure on our reimbursement for services rendered.

3. Dealing with the 'opioid issues.' Patients who have just had surgery should be treated differently than those patients on chronic pain medications. This past year was the most difficult in my 27 years of practice in trying to manage my patients' postoperative pain as we can't get them enough pain pills to even get through the first week of surgery, because the insurance companies and pharmacies all make their own rules as to how many pills they will dispense, and they are all different. One solution doesn't work for the chronic pain patient and the postop patient. I hope we can help figure out a plan specifically for the postop patients.

Q: What technology are you most excited about in the future?

FK: As a joint replacement surgeon, I am excited about the opportunity to possibly improve patient outcomes by using more sophisticated preoperative information about a patient's knee or hip and then using advanced robotic technology to hit the planned target for that particular patient more reproducibly. This is exciting, and I look forward to seeing whether we do, in fact, improve outcomes, and whether we can increase operating room efficiencies so as to lower physician stress both mentally and physically. Time will tell.

Q: What is your best opportunity for growth?

FK: This really depends on the situation and the competitive climate that you work in. I do believe that well-run large orthopedic groups will be able to remain independent and prosper in this ever-changing healthcare environment. We must never forget that we are here to take care of patients first, and when we do a good job with that, then the business side usually works out.

To participate in future Becker's Q&As, contact Laura Dyrda at ldyrda@beckershealthcare.com

For a deeper dive into the future of orthopedics, attend the Becker's 17th Annual Future of Spine + Spine, Orthopedic & Pain Management-Driven ASC in Chicago, June 13-5, 2019. Click here to learn more and register.

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