Although there are some variables, overall the future is very bright for the orthopedic field and for the professionals employed there. In addition to new and improved technologies, orthopedic surgeons can expect increasing numbers of patients as well as more autonomy in their duties. It has been clearly projected that the demand for orthopedic surgeons will increase as the baby boomer population ages. Along with higher demand, there will likely be some additional changes and challenges within the coming decade.
More Outpatient and Overnight Procedures
Arthroscopic surgery and arthroscopically-assisted procedures will continue to be implemented, further reducing the need for inpatient care. New joint replacement and spinal procedures are currently being explored that could bring these procedures into the realm of the outpatient procedure as well. New technologies, instruments, devices and advances are likely to lead to less invasive procedures. Increased physiologic surgical interventions are likely, as well as advances in robotics, navigation and bone substitutes. The trend toward outpatient in diagnostic studies, hospital-based imaging and rehab programs will also continue as technologies advance.
Reimbursements
Increased demand and patient load will result in corresponding increases in every aspect of the field, including issues with costs and reimbursements. Medicare and other federal and state-funded programs will continue to finance most of health care across the boards, but it is unlikely that current financing methods will be adequate to keep up with projected costs and demands. Financial challenges will be compounded by periods of unpredictable reimbursement.
A debate over funding is likely to be a major issue going forward. Since there won’t be a single-payer system during transition to universal health care coverage, a gap will emerge as federal and state agencies pay in some cases 50% of proposals. It will be a challenge for private insurance companies to succeed and profit, and reform will be sought by many who are dissatisfied with the system and escalating costs.
Workplace Challenges
Physician ownership and control of ancillary services are expected to be challenged in the future. Hospitals will probably try to take over this income stream, testing their relationship with orthopedic surgeons. The AHA has been lobbying to control this market and will likely ramp up their efforts to restrict physicians’ ability to own surgery centers and ancillary clinics. The shifting infrastructure will continue in the coming years. At the same time, surgeons who own their own clinics will begin to feel the burden of the challenges of business ownership and may be drawn to the security of being an employee. While that may be a short-term solution, the question will remain as to whether or not this shift away from clinics and ancillary services is ultimately a positive development.
Oversight
The future of orthopedics will probably see increased scrutiny and more oversight. Some governing bodies and policy makers have felt that the field is ineffective at overseeing itself; this will cause more documentation to be required along with more in-depth record keeping. Physicians in general are likely to have their motives and industry loyalties more closely examined.
Direct payments to drug and device users will be reigned in and this will impact many areas, including recombinant growth factors, cell transplants, gene therapies, stem cell therapy, tissue-engineered products and the new evolving biologics market. Treatments like these may still be considered experimental even years from now, regardless if they are more effective than current treatments or placebos. Such issues could delay more widespread introduction of these innovative technologies.
A Bright Future
Despite these possible challenges, the future for the orthopedic field looks bright. Treatments, procedures and technologies continue to evolve, making them better for both surgeons and patients. Those in the field of orthopedics will continue to enjoy a sense of job satisfaction in this rewarding field. Contributing to the quality of a patient’s life and musculoskeletal health will continue to be richly rewarding. The orthopedic profession is a demanding but exciting one, and it can expect a positive future as it continues to evolve. In the ideal scenario, orthopedic surgeons and other professionals in the field will be proactive in shaping it for the highest good of all.
About the Author: Thad Baker works with Integris Children’s Hospital and Integris Orthopedics. Thad works to inform the public and educate the community about important health issues.
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