The state of orthopedic surgeon autonomy


Autonomy is an important part of what it means to be a surgeon. 

Nicholas Grosso, MD, president of the Centers for Advanced Orthopaedics in Bethesda, Md., connected with Becker's to answer, "How would you describe the current state of orthopedic surgeons' autonomy?"

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 trend do you think will define healthcare in 2024?

Please send responses to Riz Hatton at by 5 p.m. CST Thursday, April 18.

Note: This response has been lightly edited for length and clarity.

Dr. Nicholas Grosso: As an orthopedic surgeon, I've observed a concerning trend of diminishing autonomy compared to what we had 25 years ago. This shift is influenced by various factors reshaping medical practice.

Firstly, payers exert more control, imposing pre-authorizations and guidelines that limit our decision-making, potentially compromising patient care and disrupting the surgeon-patient relationship. Secondly, private equity groups and hospital systems dominate, dictating every aspect of practice management, leaving us feeling disempowered within our own practices. Additionally, government regulations have increased, adding bureaucratic hurdles and emphasizing cost control, leading to care rationing strategies that compromise patient outcomes.

As an orthopedic surgeon, we must regain control and take responsibilities into our own hands.

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