Hospitals across the country are competing aggressively for orthopedic surgeons, ambulatory surgery centers and market share.
Harpal (Paul) Khanuja, MD, believes the systems that win over the next decade will focus on something else. Making it easier for surgeons to deliver exceptional care.
“It’s really going to come down to the value proposition,” Dr. Khanuja told Becker’s.
The internationally recognized hip and knee replacement surgeon recently joined Atlantic Health Morristown (N.J.) Medical Center as chair of orthopedics after more than two decades at Baltimore-based Johns Hopkins University, where he served as professor of orthopedic surgery and held multiple leadership roles.
His arrival comes at a pivotal moment for orthopedics. As CMS, commercial payers and employers place increasing emphasis on value-based care, health systems face growing pressure to simultaneously improve outcomes, expand access and manage costs.
For Dr. Khanuja, those challenges are closely connected. “I think what’s really going to bring surgeons to an institution and a health system is delivering quality outcomes, making it easier for them to do that and helping them do that,” he said.
Atlantic Health Morristown Medical Center already enters that conversation from a position of strength. The hospital ranks as one of the top in New Jersey for orthopedics and among the top orthopedic programs nationally, according to U.S. News & World Report.
But Dr. Khanuja sees an opportunity to build on that foundation.
An orthopedic leader shaped by two worlds
Dr. Khanuja’s perspective is shaped by experiences in both academic medicine and community-based care. After spending years within one of the nation’s premier academic health systems, he is now leading an orthopedic department where many physicians continue to operate in private practice while partnering closely with the health system.
That distinction matters. “I can see some of the differences between academic medicine and community medicine, and where there are advantages of each,” he said.
He also arrives with a newly completed MBA from Johns Hopkins Carey Business School, an experience he said fundamentally changed how he thinks about healthcare leadership. “As a surgeon, and unfortunately for many of our trainees, we don’t always get that big-picture healthcare perspective,” Dr. Khanuja said. Healthcare is often described as a business, he noted, but it operates under a unique set of regulatory, financial and operational constraints that make it fundamentally different from most industries.
Understanding those complexities has become increasingly important as orthopedic leaders are asked to think beyond their departments and consider broader health system strategy. “My orthopedics department exists within a hospital, and that hospital exists within a health system,” he said. “The MBA helped me better understand those relationships and how strategy has to work across all of them.”
Separating innovation from hype
Like many healthcare leaders, Dr. Khanuja believes AI and robotics will reshape orthopedic care. He is equally convinced that the industry remains in the early innings.
“I think the potential of AI and robotics is unlimited,” he said. “I do think they’re going to be a mainstay of what we do over the next 10 years.” At the same time, he cautions against confusing adoption with value. While robotics has become increasingly common in joint replacement surgery, Dr. Khanuja said outcomes still depend far more on surgeon skill, clinical judgment and institutional quality than on the technology itself.
“If you told me a family member was having a knee replacement, I wouldn’t ask whether they were using robotics,” he said. “I’d ask who the surgeon is and where they’re having it done.” That distinction, he said, reflects the gap that still exists between promise and proof.
Today’s highest-performing robotic surgeons are often the same surgeons who produced excellent outcomes before robotics entered the operating room. “The people using it best are the surgeons who already did a great job without it and are now using it to get even better,” he said.
Rather than viewing technology as a replacement for surgical expertise, Dr. Khanuja sees it as a tool that should complement it. “We’d be foolish not to continue pursuing it,” he said. “But I don’t think we’re at the point where we can say this is definitively the gold standard.”
Expanding access while preserving quality
Growth remains another major priority. New Jersey continues to experience population growth in several regions served by Atlantic Health System, creating opportunities to expand orthopedic services and improve access to care.
According to Dr. Khanuja, that expansion will require close collaboration between employed physicians, private practice partners and health system leadership. “It’s a competitive area, but the population is growing, and we want to be part of that growth,” he said.
The challenge, he added, is maintaining quality while scaling. Atlantic Health has pursued partnerships, physician recruitment efforts and new practice locations throughout the region, but Dr. Khanuja believes growth only works if clinical outcomes remain the organization’s defining characteristic.
“We have the quality, and we have the know-how to do it,” he said.
Building a culture of continuous improvement
As he begins his tenure as chair, Dr. Khanuja said the culture he hopes to foster centers on three principles: quality, safety and continuous improvement. His vision includes expanding research efforts, strengthening the department’s residency program and creating an environment where team members at every level feel comfortable challenging existing processes and proposing new ideas.
“We should always be questioning, always innovating and always looking for what we can do better,” he said. That philosophy extends to leadership itself. Rather than emphasizing hierarchy, Dr. Khanuja described a collaborative approach built around multidisciplinary teamwork and open communication.
“Everyone is an expert in their own area,” he said. “Multidisciplinary teams are important if you want to succeed.” The goal, ultimately, is not only to maintain Morristown’s reputation for orthopedic excellence but to help shape the future of the specialty.
“We don’t only want to be a place that delivers great care,” Dr. Khanuja said. “We want to help move the field forward.”
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