The 'existential question' facing Florida spine groups

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Florida's population growth, aging population and tax-friendly environment make it a key market for orthopedic surgeons to practice, but growing competition and consolidation present growing challenges for independent providers in the Sunshine State. 

Florida saw the second-highest population growth among states last year, adding 365,205 residents, according to the U.S. Census Bureau. The rise in population coincides with the growth of several large orthopedic providers in the state, including Philadelphia-based Rothman Orthopaedics, New York City-based Hospital for Special Surgery, Tampa-based Florida Orthopaedic Institute and Orlando Health. 

The rapid growth of some of these large providers make Florida arguably one of the most competitive markets to practice orthopedics, but present challenges for smaller, independent groups when it comes to growing their practices and increasing patient referrals. 

"This has been a bit of an existential question for our practice," Maahir Haque, MD, of Spine Group Orlando, said during a panel at the 21st Annual Spine, Orthopedic & Pain Management-Driven ASC + The Future of Spine Conference in Chicago. "Certainly with the financial difficulties of COVID, there was some increased anxiety actually in the Orlando area because the large hospital systems were purchasing a number of the primary care practices."

Dr. Haque was worried that patient volumes and referrals would decline at his practice by loss of referral sources.  

"In fact, whether it be through the change in population or perhaps based on the strength of our presence in the market, we haven't seen a single year in which we've had a decrease in patient volumes," he said. "While it remains an existential question, I think we prepared for possibly an eventuality which did not occur, and that's left us stronger."

Spine Group Orlando has been providing care to patients in Celebration, Fla., for 29 years, according to Dr. Haque, who has been practicing there for the past eight years. 

"Our niche and strength is our placement in our community; we are the most prominent and best serving private orthopedic practice in our community in Osceola County," Dr. Haque said. "Because of that, a lot of our referrals come by word of mouth and by historical precedent. We will be looking at web and direct-to-consumer marketing in the future. But because of the size of our practice and the need to be lean in a community where there's some very large hospital-based players, certainly our patients and word of mouth are really a substantial portion of our referral base."

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