The best way to deliver healthcare is still a work in progress

September 23, 2022

3 minute read


Romeo reports receiving royalties, being a speaker’s bureau member and consultant for, and doing contract research for Arthrex.

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The delivery of health care is disrupted. Uncertainty about how to provide the health care patients want at an affordable price has led to efforts to disrupt the status quo.

Global markers of population health, such as life expectancy, maternal mortality, and access to care, are achieved at less than half the price in other industrialized countries compared to the United States. According to CMS, national health spending has grown to $4.1 trillion in 2020, representing 19.7% of our gross domestic product. Despite the continued rhetoric about value-based care offering reduced costs, there is little to no evidence that the overall cost to government and consumers has gone down, even in highly integrated systems.

Anthony A. Romeo, MD

Another sector of the economy

Healthcare in the United States, in many ways, has become the most impactful sector of the economy. Financial gains and rewards are sought by each component involved in the delivery of care. This includes health care systems, hospitals, private insurance companies, pharmaceutical companies, pharmacy benefit managers, medical device companies, administrators, and physicians. Profit margins, not cost savings, are the most valuable outcome.

With all the negativity in the health care news, a distorted perspective on our profession and our professional lives as orthopedic surgeons can impact many decisions and endeavors. We often value negative facts more than positive facts. This human trend is preyed upon by many health care information providers, be it newspapers, television, or social media.


The consequences of negativity surrounding health care can lead to a growing sense of lack of control, dissatisfaction with our accomplishments, frustration with our work environment, and fear of an unknown future in the profession we have. chosen. The impact is reflected in over 30% of orthopedic surgeons and over 50% of orthopedic residents reporting burnout. It’s hard to believe, but orthopedic surgeons are said to have the highest prevalence of death by suicide of any surgical specialty.

Burnout, depression, mental illness and suicide are not characteristics typically attributed to our specialty. These conditions were not caused by the COVID-19 pandemic, although it has increased the percentage of physicians reporting these concerns.

With the overall average age of practicing orthopedic surgeons at 56.5, many are considering or have already chosen to retire early to leave what they perceive to be an increasingly toxic work environment. These decisions have advanced the discussion of the serious risk of a shortage of orthopedic surgeons to treat an aging and active population, which could place additional stress on those who continue to work.

Our role in health care

Despite the perceived chaos, negativity, frustration, burnout and diminished satisfaction, we need a paradigm shift in how we think about our role in the overall health system and our contributions to orthopedics. As difficult as it may seem to take on additional responsibilities, we need to show leadership and show ourselves how we can improve musculoskeletal care for our patients. We must find reward in serving our patients through caring care, training the next generation of providers, and developing a team approach to managing the myriad of conditions we see in a busy practice. Many of us are continually preoccupied with maintaining a work-life balance, as we should be, and many of us will struggle to cope with these efforts throughout our working lives. We are constantly drawn to our professional responsibilities because we truly enjoy the opportunity to care for patients with musculoskeletal issues.

Health care is an incredibly complex, demanding, chaotic and unpredictable sector of our economy. The best way to deliver healthcare is still a work in progress. Despite all the technology available, the highest priority for most patients remains developing a relationship of respect and trust with their doctor. Throughout the health care system, orthopedic surgeons are blessed to be at the top of the desired attributes of medicine in many ways. We need to value our position and help our peers do the same.

#deliver #healthcare #work #progress

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