What orthopedic surgeons are most afraid of


Three orthopedic surgeons connected with Becker's to discuss what they are most afraid of.

Ask Orthopedic Surgeons is a weekly series of questions posed to surgeons around the country about clinical, business and policy issues affecting orthopedic care. We invite all orthopedic surgeon and specialist responses.

Next question: The benefits of robotic joint replacement are widely touted, but what do you see as the technology's biggest drawbacks today?

Please send responses to Riz Hatton at rhatton@beckershealthcare.com by 5 p.m. CDT Thursday, April 13.

Note: Responses have been lightly edited for length and clarity.

Paul Perry, MD. President of Tri-State Orthopaedic Surgeons (Evansville, Ind.): As an orthopedic surgeon, my greatest fear is a loss of autonomy, and the subsequent disruption of the doctor-patient relationship. The surgeon-patient relationship is the fundamental core of orthopedic practice. Surgeons should be able to advocate for patients free of the agendas of other participants in the healthcare system. As the independent practice of medicine continues to decline, it will become harder and harder to maintain separation of the patient's needs from the financial goals of the healthcare system and/or insurance company. Some independence in physician decision-making must be protected, and even codified, if we are to maintain the highest levels of patient care.

Arjun Saxena, MD. Adult Hip and Knee Reconstruction Surgeon at Rothman Orthopaedic Institute (Philadelphia): As a private practice orthopedic surgeon for the last 10 years, I am most afraid of rising overhead costs and decreasing reimbursement throughout medicine. I am not talking about my income; I am talking about disincentivizing people to go into healthcare or care for certain populations or go the extra mile for their patients. How often do we see nurses get abused by patients and family members and as they walk out the door that day they say, "This just isn't worth it anymore"? How many surgeons have been victim to a lawsuit because a patient sustained a known complication of a surgery? Surgeons carry the stress of a lawsuit and worry about the immediate and future ramifications, both professional and financial. I fear that access to care will decrease as time goes on, creating a terrible healthcare system that makes us sicker, not healthier. Not what you would expect in the world's greatest country.

Jason Snibbe, MD. Orthopedic Surgeon at Snibbe Orthopedics (Los Angeles): I'm most afraid of the lowering reimbursement from all insurers. The cost of practicing orthopedic surgery has increased due to higher cost of employees, rent and insurance. Insurance companies are basically eliminating private practice in America by forcing private practice doctors to join large medical groups owned by hospitals or large health systems. This has taken away the autonomy of physicians and eliminated their ability to practice the way they want to practice. In my opinion, it is very sad that medicine has gone in this direction. The insurance companies have not increased reimbursement for over 20 to 30 years. It's the elephant in the room that the leaders of our government won't address. 

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