Ask Orthopedic Surgeons is a weekly series of questions posed to orthopedic surgeons around the country about clinical, business and policy issues affecting spine care. Becker’s invites all orthopedic surgeon and specialist responses.
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Please send responses to Claire Wallace at cwallace@beckershealthcare.com by 5 p.m. Central time Friday, Feb. 14.
Editor’s note: Responses were lightly edited for clarity and length.
Question: What is the most dangerous trend for orthopedics right now?
Jason Brustein, DO. Orthopedic Surgeon at Resurgens Orthopaedics (Woodstock, Ga.): The most dangerous trend in orthopedics right now is declining reimbursement. I think that there is a real squeeze on physicians, hospitals and ambulatory surgical centers to continue to provide top-notch care for an aging population that requires surgery and wants to remain active but has more medical complexity than ever. At the same, declining reimbursement is making it exceedingly more difficult to care for these patients. The headwinds in healthcare have created an environment where the costs of goods and staffing are increasing, and the reimbursement is decreasing. Eventually, payers and physicians will need to reconcile what is “fair” reimbursement for the care that is being delivered. I think it is the hope of many of us that the quality of our care and our associated outcomes will directly translate into financial remuneration.
Jeffrey Carlson, MD. Orthopedic Spine Surgeon at Orthopaedic & Spine Center (Newport News, Va.): My concern for orthopedics and medicine in general is the growing distrust of the medical profession. I am concerned this will lead to dangerous outcomes for patients with little recourse. As medical and nonmedical information has become more distributed through online access, everyone can give medical advice without consequences. Patients will research their symptoms for a diagnosis and treatment options, which can be very helpful. A well-informed and inquisitive patient is more involved in their care and likely to make the best decisions for their healthcare. Those patients that are not as inquisitive tend to settle on the diagnosis and treatment that they want no matter what other more informed sources relate to them. If a social media influencer with sponsorships conveys a convincing message, those patients that are less curious may take that information as factual and not seek clarification from their physician. If that influencer appears to be a healthcare professional, (physician or non-physician) that information is given more credibility. Our profession, having been viewed as experts, has done itself significant damage to our own credibility and trustworthiness by passing our own non-scientifically based conjecture to the patient’s needs. We must be cautious in separating our opinion from facts to regain the ground we have lost. Patients should hear from their physicians that the diagnosis and treatment options that are being discussed are based on sound medical science when it is available, or our personal opinion, or our experience or that we don’t know the right answer. The involvement of the patient in their care is critical, and with a plethora of information sources, they will need our profession to help guide the decision-making process.
