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Balancing Act
Master the clinical and business needs of an ever-evolving specialty.
Gregory P. DeConciliis, PA-C, CASC
Publish Date: September 20, 2021   |  Tags:   Orthopedics

Outpatient orthopedics has come a long way in a very short period of time. I vividly remember when my mother-in-law had her knee replaced in a hospital and how she couldn’t sleep afterward because she was in such agonizing pain. Then, when she finally did fall asleep, she was constantly awoken by providers who wanted to take her vitals or perform physical therapy. Every time patients walk out of our ASC hours after their knee replacements, I can’t help but think how much better my mother-in-law would’ve done if she’d had her surgery today.

We’re doing many orthopedic procedures outpatient today, and it’s a privilege to work in this constantly evolving, always-challenging field, to see things we never would’ve imagined being done in a surgery center being done each day. When I was in physician assistant school, I initially thought I’d go into the primary care field. But the moment I did my first orthopedics rotation, it was all over for me. In ortho, we’re glorified carpenters, and I love how we can fix people and literally put them back together and make them like new.

The culture of a high-throughput orthopedic facility is truly something to behold. The entire OR staff operates almost like a race car pit crew. Of course, the clinical aspect of care is only part of our roles as surgical leaders at ASCs and HOPDs. We must also partner with vendors on a variety of mutually beneficial arrangements and use superior communication skills to discuss costs, efficiencies and waste with surgeons. These are not easy discussions to have, but they’re essential to the success of healthy outpatient facilities.

We must also be acutely aware of case costing and reimbursements. Some cases might simply be too cost-prohibitive to perform, and we may need to do some major renegotiating with insurers and vendors to make them work. This is a lot for anyone to juggle, but I love walking the tightrope between the clinical and business needs of running an outpatient center — and I suspect quite a few of you do as well. The best surgical leaders are clinical experts and skilled business professionals.

In the world of outpatient orthopedic surgery, we can deliver a VIP experience for our patients.

This is especially important now as, after years of peaks and valleys, ortho is once again booming thanks to the growth of outpatient spine and total joint replacements. In this special issue of Outpatient Surgery Magazine, you’ll read about the exciting new opportunities in this fast-paced field (spine, fracture repair and new foot and ankle surgeries), the procedures that have been done outpatient for some time now (total hips and knees) and the fundamental elements of a successful facility (fluid waste management and multimodal anesthesia).

In the world of outpatient orthopedic surgery, we can deliver a VIP experience for our patients and, fueled by COVID-19 and a desire to avoid hospital stays at any costs, an increasing number of individuals are seeking out same-day surgical care. They’re savvier than ever, and will entrust their well-being only to facilities that can provide a high-quality experience from start to finish. Are your staff and surgeons as prepared as possible to take advantage of this tremendous opportunity? OSM

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