Big Changes in Orthopedic Practices

Like all medical specialties in the United States, the practice of orthopedic surgery is going through a remarkable change. Healthcare reform, intensified scrutiny, a dramatic change (and opportunity) in population demographics, and practice shifts from private to hospital employees (and sometimes back to private practice again) create uncertainty, challenges, and opportunities.

Why This Is Important
Practice dynamics are changing (and unsettling) for orthopedic surgeons. In 2015, an estimated 21 percent of orthopedists worked in accountable care organizations, a 3 percent increase from 2014. It was also estimated that number would increase an additional 8 percent in 2016¹ (Chart 1).

In 2007, hospital-employed orthopedic surgeons had more control over which products they used in surgery. In a study, 61 percent of orthopedic products were physician preference items.² In 2015, the supply chain spend on physician preference items dropped to approximately 40 percent.³

On average, orthopedic surgeons report they perform 29 procedures per month. Procedure numbers range from 32 procedures per month for full-time orthopedists to 6 procedures per month for part-time orthopedists. Hospital-employed orthopedists report average incomes of $402,000, almost 10 percent less than private practice orthopedic surgeons, who report average incomes of $441,000 (Chart 2). Since 2012, 20 percent of employed and 41 percent of self-employed orthopedists report that they are offering new supplemental services.⁴ Among others, these services include imaging, physical therapy, and pain management services, as well as the supply of orthotics and braces.

There is a wide range in the number of hours orthopedists spend seeing patients per week. Forty-four percent of orthopedists report spending greater than 45 hours each week seeing patients (Chart 3). Seventy-six percent of orthopedists report spending 16 minutes or less per patient visit. Only 24 percent report spending more per patient visit.

With the high investment in time required to be a full-time orthopedic surgeon, it is no surprise that burnout is reported by 45 percent of all orthopedists. The issue is multifactorial and includes the impact of U.S. healthcare reform, an increase in bureaucratic duties and paperwork, and simply spending too much time at work.⁵ In 2015, 57 percent of self-employed orthopedists reported spending more than 10 hours per week on paperwork; similarly, that figure increases for hospital-employed surgeons to 61 percent.

Helping Out
In the Medscape survey,⁶ an average of 32 percent of surgeons reported that they find reward in “being very good at what I do, finding answers and diagnoses.” What can your company do to appeal to this aspect of surgical practice? 

References

1. Medscape Orthopedist Compensation Report 2015. Accessed August 23, 2016 http://bit.ly/odtms160901 [login required]
2. Montgomery K, Schneller ES. Hospitals’ strategies for orchestrating selection of physician preference items. Milbank Q. 2007 Jun; 85(2):307–35.
3. http://bit.ly/odtms160902 [PDF]
4. Op cit 1
5. Medscape Orthopedist Lifestyle Report 2015. Accessed August 23, 2016 http://bit.ly/odtms160903 [login required]
6. Op. Cit 1

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Maria Shepherd has more than 20 years of leadership experience in medical device/life-science marketing in small startups and top-tier companies. After her industry career, including her role as vice president of marketing for Oridion Medical, where she boosted the company valuation prior to its acquisition by Covidien/Medtronic, director of marketing for Philips Medical and senior management roles at Boston Scientific Inc., she founded Medi-Vantage. Medi-Vantage provides marketing and business strategy and innovation research for the medical device industry. The firm quantitatively and qualitatively sizes and segments opportunities, evaluates new technologies, provides marketing services and assesses prospective acquisitions. Shepherd has taught marketing and product development courses, is a member of the Aligo Medtech Investment Committee (www.aligo.ca). She can be reached at 855-343-3100 x102 or at mshepherd@medi-vantage. Visit our website at www.medi-vantage.com