Becker's Spine Review

10 THOUGHT LEADERSHIP Why this orthopedic leader thinks millennials are changing care delivery By Riz Hatton e needs and preferences of millennials may be the catalyst for change in healthcare delivery. Louis Levitt, MD, vice president of the Centers for Advanced Orthopaedics in Bethesda, Md., connected with Becker's to discuss the healthcare disruptor he is most excited about. Note: is response has been lightly edited for length and clarity. Dr. Louis Levitt: e disruptor that most excites me right now is the concept of generational change in care delivery. e millennial generation — which is now the largest generation of adults aer surpassing baby boomers based on 2019 U.S. Census Bureau data — has incredibly specific preferences for the way they receive care. For millennials, healthcare is all about efficiency, convenience and affordability, which is disrupting the industry in ways we as practitioners have never seen before. While change can be uncomfortable, I believe this generation's demands are forcing us to rethink care models and the way we run our businesses — oen for the better. Let's look at digital health as an example. Do we really need to see a patient for a follow-up in the office, or can we check-in via telehealth or monitor them remotely using digital devices? Can we kick off physical therapy in-person and then provide ongoing care at home? We can now leverage digital tools and artificial intelligence to help with documentation so we can capture robust notes while being more engaged with patients. Technological advances are making care more convenient, efficient and cost-effective, allowing us to meet patients where they are. I also see vast differences in how we build and maintain a patient base today. When I reflect on the beginning of my career in private practice, new patients largely came from primary care referrals, and relationships were everything. I knew my patients clinically, but also personally. It was truly a 24/7, always on environment. If a patient called me from the emergency room, I dropped everything to make sure I could be there as part of the care team, oen alongside the primary care provider. Being at the hospital for rounds was a huge part of patient care and relationship management. is all led to patient loyalty. is all led to patient loyalty — I have patients who have stuck with me for 40 years — as well as referral loyalty. Alternatively, millennials aren't committed to one specific doctor or practice. Today, patients select their physician based on online reviews, and prioritize convenience factors like location, parking availability, online scheduling, average wait times, how quickly they can get an appointment and digital offerings, which has practices innovating to satisfy this generation of patients. Millennials are also influencing the shi away from fee-for-service medicine. Historically, patients preferred service-oriented care, which admittedly is more costly. But consumerism demands efficiency, and now patients want the quickest route to care requiring the fewest services all at the lowest cost. We have unprecedented access to data, which is informing care pathways and changing physician behavior. Where we may have previously immediately ordered an MRI, we are now making data-driven decisions and opting for more conservative treatment, oen based on the insurer's recommendation. is new value-based approach leads to more efficient medicine, reduced costs and better, evidence-based outcomes. In today's evolving healthcare landscape, are private practitioners ready for the new care delivery model? Adapting requires significant resources and scale, leading to a trend of industry consolidation. Notably, 70 percent of doctors are now employed, but this isn't suitable for those keen on maintaining independence. n 'Patients don't like it, physicians don't like it': What 1 orthopedic surgeon would change about the industry By Riz Hatton The orthopedic industry is not without its flaws. Jennifer Wood, MD, an orthopedic surgeon at OrthoVirginia in Reston, connected with Becker's to discuss what she would change about the orthopedic industry. Note: This response has been lightly edited for length and clarity. Dr. Jennifer Wood: I would remove prior authorization from insurance companies as a requirement for surgical treatment. Patients don't like it, physicians don't like it. It takes time physicians could be spending on patient care and ties us up in paperwork. Research shows it contributes to longer wait times, elevated risks, and negative health outcomes for patients. Physicians should be able to recommend and carry through with the most effective care for their patients without being bogged down by administrative checklists. The American Academy of Orthopaedic Surgeons is supporting the proposed CMS interoperability and prior authorization rule, and I stand with them in their efforts to reduce the burdens created by prior authorization and improve patient care. n "While change can be uncomfortable, I believe this generation's demands are forcing us to rethink care models and the way we run our businesses — oen for the better." — Louis Levitt, MD

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