Becker's Spine Review

4 SPINE Good news, bad news for spine and orthopedic surgeons in 2023 By Carly Behm Spine and orthopedic surgeons are seeing positive changes in the industry, but some challenges still remain. Here are three pieces of good news and two pieces of bad news: e good news 1. Alternatives to private equity are hitting the market. Independent practices are oen pressed to choose between standing on their own or banding with private equity to stay afloat. Two new orthopedic groups have bucked that idea and created partnerships that still let practices remain independent. Chicago-based Midwest Orthopaedics at Rush and Rockford-based OrthoIllinois aggregated in January. While the arrangement isn't a merger, aggregating allows both practices to remain autonomous while strengthening their position in the market. e next month, three orthopedic groups came together to form PELTO Health Partners. PELTO, which stands for Physician Empowered Leadership of Transformational Organizations, comprises Durham, N.C.-based EmergeOrtho, Indianapolis-based OrthoIndy and Seattle-based Proliance Surgeons and has more than 400 physicians. Groups with PELTO will maintain their independence, and the platform isn't relying on capital from external sources. 2. Innovation continues to grow. More medtech companies are embracing augmented reality and artificial intelligence in their spine and orthopedic portfolios. And demand is growing for innovations in the spine and orthopedic implant arena. "From the standpoint of the medical device and implant manufacturers, longer life expectancies and an aging population are expected to drive continued and accelerated growth of both of these arenas, increasing the need for orthopedic surgeries to address pathologies driven by degenerative changes, such as hip and knee arthritis or lumbar spinal stenosis," Alexander Vaccaro, MD, PhD, told Becker's. "is is expected to lead to market sales reaching nearly $50 billion by 2028, with a compound annual growth rate of 3.3 percent by some estimates. Certainly, by this metric, the outlook for the industry and demand for orthopedic devices and implants is very optimistic." 3. Orthopedic pay has soared since 2019. According to Medscape's recent compensation report, orthopedic physician pay has hit $573,000 with an average incentive bonus of $134,000. Five years ago, the average pay was $482,000, and except for a plateau in 2021, orthopedic wages have grown. e bad news 1. e gender wage gap persists. Orthopedics has one of the largest gender pay gaps, according to the "2023 Physician Compensation Report" from Physicians rive. Women orthopedic surgeons earned 20 percent less compared to men in the field, according to the report. According to Medscape, representation in the field also remains low. Its 2022 compensation report said 11 percent of orthopedic surgeons were women, and in its 2023 data that figure was 10 percent. 2. Reimbursements continue to decline. Medicare reimbursement rates for the 20 most common neurosurgery procedures fell by 11.2 percent, adjusted for inflation, between 2002 and 2021, according to Medscape. Overall, Medicare physician reimbursements fell 22 percent in the same time period, according to the American Medical Association. Another study in the International Journal of Spine Surgery found a 'steady decline' in reimbursement for cervical disc replacement. Cervical disc replacements jumped 183 percent from 2007 to 2017, and Medicare beneficiary utilization increased 149 percent. Inflation-adjusted hospital charges for cervical disc replacement grew 22.4 percent, and inflation- adjusted Medicare reimbursement fell 1.2 percent per year. In 2009 reimbursement for the procedure was $1,928, and in 2021 it was $1,679. n Person of interest identified in neurosurgeon's death released from custody By Carly Behm A person of interest in the death of neurosurgeon Devon Hoover, MD, was released from custody, Detroit police said May 2. He was taken into custody April 28 in unrelated charges that weren't specified, NBC News reported. Detroit Police Chief James White said in the report that the man "has information about what transpired." Detroit police said in a May 2 tweet that homicide detectives continue to investigate all leads. Dr. Hoover, a neck and back specialist at Ascension St. John Hospital in Detroit, was found fatally shot April 23. His death was ruled a homicide. n 2 pro golfers have orthopedic surgeries By Carly Behm Two pro golf stars underwent orthopedic surgeries in April. 1. Will Zalatoris underwent a microdiscectomy on April 8. Mr. Zalatoris said in the April 10 Instagram post that he is pulling out of the rest of the PGA season. He thanked spine surgeon Michael Duffy, MD, and anesthesiologist Thomas Kelton, MD. Mr. Zalatoris suffered two herniated discs in August, the PGA said in an April 10 report. 2. Tiger Woods had ankle surgery on April 19, according to a statement posted on Twitter. Martin O'Malley, MD, of New York City-based Hospital for Special Surgery Sports Medicine Institute, performed a subtalar fusion to address Mr. Woods' post-traumatic arthritis from a previous talus fracture. n

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