Orthopedic surgeons have seen many positive changes in the last two years, but many challenges are ahead.
Here are three pieces of good news and three pieces of bad news:
The good news
1. Orthopedic pay is rising. Medscape's 2022 physician compensation report shows the orthopedic specialty busting out of a two-year rut during the pandemic. In 2020 and 2021, average compensation stayed at $511,000. But in the latest report, compensation rose to $557,000. Average incentive bonuses have slowly risen since 2020 as well. In 2020, the average incentive bonus was $96,000; in 2021 it was $116,000, and in 2022 it hit $126,000.
2. Female representation is growing. Although orthopedics still has a low percentage of female physicians in the field, the number is slowly increasing. In 2021, Medscape's report found 9 percent orthopedic physicians were women. In its latest report, 11 percent of orthopedic physicians were women.
Despite growth, women in orthopedics still face barriers.
"The biggest barrier is the perception that this is a man's job," Jane Tan, MD, of Atlanta-based Resurgens Orthopaedics told Becker's. "These misconceptions start early and often dissuade female medical students from even applying (essentially, the battle is lost before it is begun). This is why it is important to encourage medical students, and even high school students who have a love of biology, sports, and/or mechanics, to think about this career as a real, tangible opportunity."
3. Total joint replacement demand is rising; surgical technology is advancing. A study published in the April 2019 edition of the Journal of Rheumatology projected hip and knee replacements to more than double by 2040. Shorter-term projections also saw knee replacements rise 110 percent, and hip replacements grow 75 percent by 2025.
More hospitals, practices and ASCs are capitalizing on robot-assisted technology that can provide less invasive surgery, quicker recovery and data insights. Jason Snibbe, of Los Angeles-based Snibbe Orthopedics, said he believes current systems will continue to progress.
"Robotic surgery will improve with automation," he said. "We will be able to cut less muscle and tissue and still provide accurate operations. The design of the implants will change because we will prepare bone in different ways with unique instruments. I think artificial intelligence will provide information about the outcomes of every decision we make during surgery."
The bad news
1. CMS remains a challenge. Last year, the American Association of Orthopaedic Surgeons issued formal comments to CMS on the agency's proposed payment policy changes for 2022. The AAOS focused on two key proposed changes reversing the elimination of the inpatient-only list and pulling back the 298 procedures, including 266 musculoskeletal procedures that were removed from the list Jan. 1.
2. The specialty is facing a shortage. According to financial planners Physicians Thrive, the number of orthopedic surgeons is expected to shrink by about 5,000 physicians. The supply of surgeons is limited in part by the small number of physicians who complete residencies each year, according to physician search and consulting firm Merritt Hawkins. Another factor is the number of retirements in the field. About 60 percent of active orthopedic surgeons are 55 years old or older.
3. Consolidation is pressuring independent practices. From management services organizations to private equity, orthopedic practices are turning to groups that will help bolster their presence in their markets. Supergroups of 100 or more physicians are also gaining prominence. The trend has drawn the attention of orthopedic leaders.
"There is no limit for how big an independent orthopedic group should be, so long as it is structured in a way that maintains efficiencies amid growth," Nicholas Grosso, MD, of Bethesda, Md.-based the Centers for Advanced Orthopaedics said.