Burnout, declining reimbursement and practice consolidation are driving orthopedic surgeons out of the field, raising concerns about patient access to musculoskeletal care nationwide. A significant portion of the workforce is also nearing retirement — with 60% of U.S. orthopedic surgeons expected to be over age 65 by 2031 — portending a looming supply challenge.
Here are the key factors fueling the orthopedic workforce crisis:
1. Physician burnout:
According to Medscape’s January 2024 “Physician Burnout and Depression Report,” 44% of orthopedic surgeons feel burned out, roughly on par with 2023’s 45%.
“We are handcuffed within our own profession,” Anthony Bevilacqua, DO, orthopedic surgeon at Sports Medicine & Orthopedic Center in Suffolk, Va., told Becker’s, highlighting the frustration with excessive documentation and dwindling independence.
2. Aging workforce and looming retirements:
More than half of practicing orthopedic surgeons are over age 55, and many are nearing retirement. The specialty is projected to reach a deficit of 5,050 surgeons by the end of 2025.
3. Reimbursement pressures:
Orthopedic practices face mounting strain from falling reimbursements and rising costs.
“As reimbursements diminish and scrutiny of claims goes up, we have been forced to automate our business processes,” James Andry, MD, orthopedic surgeon at DISC Surgery Center at Carlsbad in San Diego, told Becker’s in July.
Reimbursement continues its downward trend: The Medicare conversion factor fell 2.83% for 2025, and average orthopedic surgeon salaries dropped 3% from 2023 to 2024.
4. Consolidation and loss of autonomy:
Over 50% of orthopedic practices are now owned by private equity, increasing costs and reducing physicians’ control.
“There are several modes of consolidation, and ultimately nearly all of them result in a loss of physician autonomy to varying extents,” Joseph Lamplot, MD, orthopedic surgeon at Endeavor Health Orthopaedic & Spine Institute in Illinois, told Becker’s in June. “As such, the desire for autonomy conflicts with physician consolidation.”
5. Threats to access and patient care:
Staffing shortages — among surgeons, OR staff and anesthesiologists — are hindering patient access and clinical efficiency. Surgeons are seeing delays in surgeries, particularly in all-important musculoskeletal care.
“Not enough providers, plenty of patients,” Philip Lim, MD, orthopedic surgeon at Orange, Calif.-based UCI Health, told Becker’s in August. “Population growth continues to outpace the increase in the number of orthopedic residency positions, and this imbalance should translate into providers remaining busy going into the future.”
