The most difficult part of being an orthopedic surgeon


Being an orthopedic surgeon is no easy task.

Three orthopedic surgeons connected with Becker's to answer, "What is the most challenging part of being an orthopedic surgeon today?"

Ask Orthopedic Surgeons is a weekly series of questions posed to surgeons around the country about clinical, business and policy issues affecting orthopedic care. We invite all orthopedic surgeon and specialist responses.

Next question: What's disrupting orthopedics?

Please send responses to Riz Hatton at by 5 p.m. CST Thursday, April 4.

Note: Responses have been lightly edited for length and clarity.

Nicole Lopez, MD. Orthopedic Surgeon at RWJBarnabas Health Medical Group (West Orange, N.J.), Clara Maass Medical Center (Belleville, N.J.) and Clinical Chief of the Orthopedics Department at Cooperman Barnabas Medical Center (Livingston, N.J.): One of the most challenging parts of being an orthopedic surgeon is helping patients to understand and navigate their health insurance coverage to ensure that they receive necessary care, such as physical therapy, occupational therapy and advanced imaging, in a timely manner. Despite these challenges, the most rewarding aspect of my career is the joy I find in doing meaningful work alongside like-minded colleagues and witnessing the positive impact on my patients' lives.

Amirhossein Misaghi, MD. Pediatric Orthopedic Surgeon at Children's Hospital of Orange County (Orange, Calif.): Orthopedics is a field that is ever growing and changing, and many subspecialties have their own different challenges. Personally, I take care of a rather unique group of patients, namely children with bone and soft tissue cancers. As a pediatric orthopedic oncologist, the most challenging thing for me is not only discussing potentially life-threatening conditions with my patients and their families, but also coming up with robust surgical solutions that meet evolving needs over time. My surgeries must ensure complete tumor resection and account for my patients' current small size and young age, while also considering and planning for their expected bone growth and hopefully many more years of life and activity. Treating cancer in children can be very complex, but when I care for these vulnerable patients as part of a team, and when I can see them come back for follow-up year after year, watching them grow and advance in school and in life, there truly is nothing more rewarding. 

Myra Trivellas, MD. Orthopedic Surgeon at Hoag Orthopedic Institute (Irvine, Calif.): The most challenging aspect of being an orthopedic surgeon today lies in harmonizing the demands of the business of medicine with the intrinsic goal of providing exceptional patient care. Regrettably, the current healthcare landscape often undervalues the comprehensive attention, dedication and time required to truly serve patients. Most physicians embark on their journey not driven by financial gain or the commercial aspects of medicine. While acknowledging the role of finances in sustaining operations, medical professionals continue to invest substantial time and effort, driven by a genuine commitment to patient well-being.

Each day, surgeons pour their expertise and cognitive resources into their work, often reaching the point of mental fatigue. Yet, despite their diligence and dedication, reimbursement struggles persist, with many services barely covering their costs or resulting in financial losses. This reality underscores the dissonance between the noble pursuit of healing and the economic realities of modern healthcare.

However, within this challenge lies an opportunity for innovation and advocacy. By leveraging strategic approaches and advocating for systemic changes, orthopedic surgeons can steer toward a more sustainable healthcare system. Collaboration and perseverance are needed to reshape the landscape, ensuring that both patients and practitioners receive the value they deserve.

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