Becker's ASC Review

30 ORTHOPEDICS Will robots replace orthopedic surgeons? By Marcus Robertson M edical technology is always advancing, and robotic surgery has been attract- ing more attention in recent years. Some hail it as the future, while others remain skeptical of the hype. Ravi Bashyal, MD, director of outpatient hip and knee replacement surgery at NorthShore Uni- versity HealthSystem in Chicago, sat down with Scott Becker on "Becker's ASC Review Podcast" and weighed in. Question: Robotics in surgery — is it just another tool? Or will it replace surgeons? Dr. Ravi Bashyal: You can't skip learning how to do the operation properly and just count on the computer to do it for you. I like to think of it in terms of golf. If you think about Jack Nick- laus, all the clubs that he used, his woods were literally made out of wood. He did the best he could with those golf clubs. If Jack Nicklaus from 1975 were to play in a tournament today with the same equipment and the same training and the same prepara- tion, he'd be demolished. But that doesn't mean that he's not one of the all-time greats. The golfers today have better equipment. They have better preparation, they have better planning. They have technology that helps them be a better golfer. [Robotic surgery] takes people and it enhances their skills and ability. I think that if we use it in a non-substitutive manner — meaning we're not using robotics or computers to take the place of our thought process or to make us do less work — we're using them as enablers. That's going to really help us take better care of our patients and have better outcomes, which at the end of the day is what's most important for all of us. I think that on the planning side of things, it allows us to be ready with a game plan when we get to the operating room. And just like any other field, if you've got a good plan going in, you're much more likely to execute effi- ciently and accurately, whether it be robotics or patient-specific instrumentation. A lot of that requires you to have some thought and insight into the case before you're in the operating room, which I really think is half the battle. n How 4 orthopedic groups aim to grow in 2022: OrthoLoneStar, OrthoIndy & more ByAlan Condon T aking on risk-based contracts, expanding ancillary services and capitaliz- ing on higher-acuity procedures such as spine surgery and joint replace- ment are among the biggest opportunities for growth in orthopedics. e leaders of four orthopedic groups expand on their practice's growth strategies for 2022. Question: Where are the biggest opportunities for growth in 2022? J. Bryan Williamson, MD. Medical director of OrthoLoneStar (Houston): e biggest opportunity for growth in orthopedics is to guide the patient journey through all primary musculoskeletal-indicated issues, enabling the complete cycle of care with control of the cost and quality of delivery. In a value-based care environment, the orthopedist will be able to provide better outcomes with lower overall cost while being in the position to benefit from that work. is requires the practice to be able to vertically integrate access to the full range of treatment options with a complete overview of what will work best for each individual being treated. If done well, it's the rare opportunity for patients, physicians and employers all to benefit while providing higher-quality and lower-cost healthcare. Nicholas Grosso, MD. President of the Centers for Advanced Orthopaedics (Bethesda, Md.): e biggest opportunity for growth lies in the shi to the out- patient setting. Here in Maryland, there are a significant number of one-room outpatient centers. We can increase efficiencies while remaining accessible for patients and providers alike by consolidating some of these existing surgery centers into multiroom facilities. Ed Hellman, MD. President and interim CEO of OrthoIndy (Indianapolis): Because we have a physician-owned surgical hospital, we're sort of a hybrid: We're seeing some of the advantages and some of the stresses that practices see, and some of the advantages and stresses that hospitals see. Clearly we need to develop and expand our outpatient strategy because just like the community hospital down the road, procedures are going to move out of the hospital to an ASC. We need to have those ASCs positioned in the community where we can serve patients close to home, efficiently and with a positive margin as we move out of the hospital. at's likely our biggest potential for growth. We're looking at a hub-and-spoke model. I think having clinics that are closer to home that can provide services where patients live and work and bringing only the higher-acuity procedures to our main hospital location makes the most sense. Kim Mikes, BSN, RN. CEO of Hoag Orthopedic Institute (Irvine, Calif.): As one of the largest providers of orthopedic care in the Western region of the U.S., Hoag Orthopedic Institute has the opportunity to enhance our efforts to highlight what differentiates us in our markets. We are an orthopedic and spine specialty hospital and ASC network. Our team of physicians and staff members are experts at orthopedic and spine care. With that expertise comes all the benefits of quality outcomes, high volume, standardized value-based care and low infection rates. We need to ensure that the Southern California community knows that Hoag Or- thopedic Institute is where you come for orthopedic and spine care. We are also increasing our ability to take care of higher-acuity orthopedic and spine patients. Our biggest growth opportunity will be in the higher-acuity spine market. n

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