'Handcuffed within our own profession': What is burning out orthopedic surgeons


While orthopedic surgery is one of the least burn-out physician specialties in 2024, 44% of orthopedic surgeons do report feelings of burnout. 

Surgeons are feeling burnt out for a number of reasons, from low reimbursement rates to sheer boredom. 

Here is why 10 specialists told Becker's they or their colleagues are feeling burnt out this year: 

Anthony Bevilacqua, DO. Orthopedic Surgeon at Sports Medicine & Orthopedic Center (Suffolk, Va.): I have been in practice now for 30 years and feel that the number one frustration is that at every location I work, whether it be the clinic, the hospital, or even the surgery center, all of them have ever-increasing requirements to do the same work. All of it is in the name of patient safety, but much of it is not actually safety oriented or promoting greater safety, just rules. Those additional burdens that the locations place on routine procedures make the need to increase patient volume and procedure volume every year in order to not "lose" money. I don't know of other professional industries where the professionals have to work harder each year in order to make the same amount of money. The government determines what we can charge, but it doesn't determine what attorneys can charge or what other professional workers outside of the government can charge. Therefore, we are handcuffed within our own profession. 

Ghaus Malik, MD. Neurosurgeon at Henry Ford Health (Detroit): The biggest factor is regulatory burden — pages and pages of unnecessary repetitive documentation in EMR, preauthorization through folks who have no knowledge of the procedures, stress on productivity rather than quality and increasing lack of trust of the public in healthcare. 

Gregory Hahn, MD. Orthopedic Surgeon at Johns Hopkins All Children's Hospital (St. Petersburg, Fla.): Decreased reimbursement combined with increased administrative requirements.

Harel Deutsch, MD. Orthopedic Surgeon at Midwest Orthopaedics at Rush (Chicago): I think there are multiple factors. An increasing number of doctors are now working in salaried positions for big healthcare systems, and that results in less control over their schedules and decisions. The lack of control leads to stress and dissatisfaction. Regulatory burden and decreased physician reimbursements result in more doctors forgoing private practice.

Issada Thongtrangan, MD. Spine Surgeon at MicroSpine (Scottsdale, Ariz.): As a solo practitioner, the biggest factor is financial stress or how to stay afloat. I am still delivering quality care while the expenses are going up but our reimbursements are going downhill. The other factors are the significant amount of paperwork and the amount of denial from insurance carriers for what we think is a medical necessity for the patient's care. I spend several hours keeping up with appeals and paperwork while trying my best to deliver quality care and stay afloat. 

Kevin Pauza, MD. Interventional Spine Specialist and Founding Partner of Texas Spine and Joint Hospital (Tyler): Compared to most orthopedic physicians, I observe and possess a positive perspective regarding physician burnout. On the contrary, I'm observing less or no burnout in physicians who aren't still performing the same old spine surgeries, with their same  mediocre outcomes. Instead, I'm pleased to observe excitement in surgeons stepping outside their comfort zone of surgery and providing favorable outcomes without causing irreversible damage in orthopedic regenerative medicine. The surgeons we're teaching for outpatient ASC regenerative medicine show no burnout.

Kevin Stone, MD. Orthopedic Surgeon at the Stone Clinic (San Francisco): Burnout is often due to lack of curiosity. The entire field of orthopedic surgery is open to improvement. A surgeon with the desire to push the art and science of the field will never be lacking in opportunities and stimulation. Systems that restrict surgeon autonomy and ability to experiment crush surgeons' freedom and lead to frustration.

Praveen Mummaneni, MD. Neurosurgeon at University of California San Francisco: Dealing with insurance authorization, dealing with inefficiency in the operating room, too much regulation and no autonomy. 

Roy Sanders, MD. President, Chief Medical Officer and Co-founder of Florida Orthopaedic Institute (Northdale): It's fairly simple. Reimbursement is down, insurance companies typically stall authorization for monetary reasons — upsetting patients and creating surgery scheduling problems — overhead is up, it's tough to find enough staff and patient expectations are higher than ever, oftentimes unreasonably so. This creates immense stress at every level of the practice. 

Thomas Matthews, MD. Orthopedic Surgeon at Mercy Health (St. Louis): As a soon-to-retire orthopedic surgeon, I have some perspectives regarding burnout. Our job is stressful and that relates to chaotic scheduling, call and changing regulations to name a few contributors. Then when trying to exit practice, there is no script on how to proceed. Little time is spent on transitioning to retirement. Overall, a very rewarding practice over 35 years. I would say that with the implementation of EMR and soon AI things will change abruptly, probably not for the better. Unfortunately, this will swing the pendulum for more burnout and less personal satisfaction as an orthopedist.

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