Physician shortage could spell 'doomsday' for orthopedics


The looming physician shortage poses a unique threat to orthopedics.

John Christoforetti, MD, an orthopedic surgeon at the Centers for Advanced Orthopaedics in Bethesda, Md., connected with Becker's to answer, "How will the overall physician shortage affect the orthopedic industry?"

Editor's note: This response has been lightly edited for length and clarity.

Dr. John Christoforetti: Lookout, it could be doomsday! Let's hope not. 

The increasing gap between the demand in society for flawless and inexpensive medical care and the available workforce will impact the delivery of orthopedic care in ways we cannot fully anticipate, but I believe it will push orthopedics more than many other areas. Reduced new talent, unique challenges in orthopedic training and reductive market forces all conspire to uniquely challenge our industry.

Perhaps the most challenging aspect is reengaging the best and brightest undergraduate students from a diverse population to consider a career in medicine. As a parent of teens and college-aged children, I often hear their peers comment on how long, expensive and risky the path to a medical career appears. The top colleges in the U.S. are now imposing the most stringent entrance requirements for their business programs, promising a shorter return on investment compared to fields like medicine or surgery. These post-pandemic learners find it harder than ever to imagine the long hours on-site as other fields promote work from home, lifestyle harmony, high compensation and low risk of litigation.

Many of today's rising stars choose to assuage their desire to work in medicine by planning careers in medical device, software or organizational leadership once they realize that orthopedic surgery residency and fellowships are lengthy and not guaranteed opportunities even after they commit to medical school. This is fueling a potentially deeper cut in the availability of orthopedics than in other areas of medicine.

Some experts suggest that there is a chance that patients will find it increasingly difficult to have access to high-quality surgical procedural care in all but the most densely populated urban areas. Correspondingly, under the banner of cost containment, third-party payers' continued reduction in covered services for patients and professional fees for surgeons will bankrupt all but the payers themselves. With our best and brightest well-trained to sell products or administrate and few around to be at the bedside or operating room table to deliver care, we may also find a drop in the appeal of the industry as a whole.

This is a doomsday scenario that will likely not fully come to happen, but we should consider it carefully.

I like to take an optimistic viewpoint that by consolidating experienced orthopedic traditions in physician-owned and operated practices, we can protect and promote innovative new ways to leverage technology and nonphysician talent for hands-on care. Even our organization will need to embrace education and competitive staffing practices to keep the flame of interest burning in the next generation. After all, a career in orthopedics is a great gift for those of us who are fortunate enough to get the chance.

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