When orthopedic patients walk into a surgeon’s office — sometimes after a long commute, months of pain or multiple referrals — the encounter can feel rushed before it even begins. For William Levine, MD, Frank Stinchfield chair of orthopedic surgery at Columbia University in New York City and orthopedic surgeon-in-chief at NewYork-Presbyterian/Columbia, that reality is no longer acceptable.
Across his leadership roles, Dr. Levine is doubling down on something he believes the system has gradually eroded: time, communication and genuine partnership with patients. For him, 2026 is about rebuilding that foundation — and raising expectations for what it means to support patients in both operative and nonoperative care.
The pressure to see more patients — and what gets lost
The modern orthopedic visit is often defined by volume. That reality, Dr. Levine said, is undermining both the surgeon experience and the patient experience.
“You hear people say, ‘I’ve seen 30 patients, 40 patients, 50 patients,’” he said. “If you take a step back and think about that — and if you think from the patient’s perspective — that’s not a good situation.”
Whether patients are coming from Westchester, N.Y., Long Island or elsewhere, he said, they deserve more than a rushed visit squeezed into a packed schedule.
The same issue shows up during surgical planning. For surgeons, he explained, the process can become automatic.
“You immediately kind of know what the screenplay looks like.”
But patients rarely walk in with that same clarity — nor do most receive the structured education needed to understand the next six to 12 months of their care journey.
Dr. Levine believes this gap is one of the profession’s most preventable failings.
A simple intervention with outsized impact
To bridge that gap, Dr. Levine recently created short, focused videos answering the questions patients most commonly ask before surgery.
“It’s nothing fancy,” he said — just a three-minute clip that patients receive the week before an operation. But the effect has been dramatic.
“Since I’ve done that, the number of questions and concerns called into the office have nearly vanished,” he said. “It’s been remarkable what an impact it’s had.”
Patients can watch the video multiple times, share it with family members and absorb the information at home, without the stress of rushed appointments or dense paperwork. Encouraged by the results, Dr. Levine plans to expand these videos into a suite of resources covering more conditions and procedures.
Slowing down to build trust — and avoid misaligned decisions
Over nearly three decades, Dr. Levine has become increasingly committed to reshaping how surgeon-patient decisions are made. Much of that shift, he said, comes from watching the unintended consequences of productivity-based compensation.
“Most compensation plans are productivity-based, and that’s not great,” he said. “There’s pressure to do more, see more, operate more — and that can lead to ethical dilemmas.”
It also means many patients arrive after hearing recommendations for surgery they may not need.
“In New York City, I see on average five patients a week who’ve been told to have an operation — who frankly don’t need an operation,” he said. “They can easily be treated nonoperatively.”
His goal is not only to avoid unnecessary surgery, but to prevent a dynamic where patients feel pushed into a procedure they aren’t emotionally prepared for.
He explained that no patient should feel pressured into surgery. If they aren’t fully ready, even a small complication can feel far worse and be interpreted very differently.
In shoulder surgery especially, postoperative rehab determines much of the ultimate outcome. Dr. Levine often has frank conversations about pain tolerance, motivation and commitment before even considering scheduling.
“If a patient isn’t 100% ready and committed to do everything they need to get the best outcome possible, then they shouldn’t have an operation,” he said.
The uneven partnership — and the honesty it requires
Dr. Levine is candid about the inherent imbalance during the surgical journey.
He explained that the partnership between patient and surgeon is not equal. For surgeons, he said, the operation is the easy part because they have done it hundreds or even thousands of times. The postoperative care — especially the rehabilitation and the patient’s ability to work through discomfort — is often what determines the difference in outcomes.
He described advising a patient with poor pain tolerance that he might actually worsen after surgery if he couldn’t handle rehabilitation.
“It’s not a blame situation,” he said. “I just don’t want you to have an operation and get worse. You don’t want that. I don’t want that. Your family doesn’t want that.”
He said these kinds of honest conversations are something he could not have had early in his career — they come with time, experience and seeing the patterns that shape patient outcomes.
Managing expectations: The theme that defines his practice
Looking ahead to 2026, Dr. Levine wants to elevate the work of patient education and expectation-setting to a completely new level.
“I think we need to harness AI and machine learning in a way that allows us to create learning modules and bite-sized bits patients can access on their smartphones,” he said.
His vision is a personalized digital guide for every major procedure — explaining anatomy, how injuries occur, what surgery entails, what postoperative life looks like and answering the small but meaningful questions that patients often hesitate to ask.
Whether it’s showering with a sling, managing bathing or navigating daily tasks one-handed — addressing those topics upfront can significantly improve the patient experience.
“All of those things are going to help patients ultimately have a better experience,” he said. “The theme here is managing patient expectations, and I’m trying to elevate that to a whole different level.”
What comes next
For Dr. Levine, the future of orthopedic care is less about new tools in the operating room and more about how surgeons guide patients through the journey before and after surgery. It’s about time, communication, trust — and the tools that make all three more accessible.
His commitment is simple, but not easy: fewer unanswered questions, fewer rushed encounters and a deeper understanding of the human experience behind orthopedic decisions.
And as the field moves into an AI-augmented era, he believes surgeons have an opportunity to reshape what informed consent, shared decision-making and true partnership really look like.
