3 key insights on outpatient orthopedics — Headwinds, key trends & what to expect

Three experts shared their thoughts on outpatient orthopedics with Becker's ASC Review:

1. Approaching advancements, from Shariff K. Bishai, DO, an orthopedic surgeon with Associated Orthopedists of Detroit:

"History is the best way to look at the future. I'm a shoulder surgeon primarily, and previously we did rotator cuff or looking at instability surgeries open. It's not to say you can't do them open now, but as we started to enter into arthroscopic and minimally invasive procedures to fix those injuries, we realized that opioid consumption was reduced because there's something that has to be said of making small holes into the joint versus opening the skin, moving muscles, tendons and ligaments around. As we advance toward doing things more arthroscopic or minimally invasive or with robotics in the future, I think that will help in decreasing the need for opiates."

2. The trends to know, from Nicholas Grosso, MD, president at The Centers for Advanced Orthopaedics in Columbia, Md.:

"In recent years, we have started to see a wider variety of the types of surgeries being performed in the outpatient setting. In addition to total joint surgeries like hip, knee and shoulder replacements, anterior cruciate ligament reconstruction and rotator cuff repairs are now routinely done in the outpatient setting without any increased risk for the patient. In fact, I’ve noticed private practice physicians are moving as many surgeries as they can into outpatient centers, where patients see significant cost savings with positive surgical outcomes."

3. The biggest challenges, from Ravi Bashyal, MD, orthopedic surgeon and director of outpatient hip and knee replacement surgery at NorthShore University HealthSystem in Skokie, Ill.:

"The biggest challenge is managing all the touch points, which means managing all the interactions with the patients and their families. The messaging to the patient has to be consistent, from the initial office visit with me and my team, to the anesthesia encounter immediately before surgery, to the post-op discharge instructions from the recovery room RNs — and all the interactions with staff in between these. It can be a challenge to have all the stakeholders in this process on the same page. It takes effort and persistence to accomplish this, but once done, allows for a seamless concierge-level experience for patients and their families."