Where orthopedic practices are investing in 2024


From purchasing new technology to putting a focus on staffing and leadership, here is what eight leaders told Becker's they are investing in this year to strengthen their orthopedic practices and musculoskeletal programs: 

Question: What is the biggest investment you will make this year?

Alfonso Del Granado. Administrator and CEO at Covenant High Plains Surgery Center (Lubbock, Texas): The two biggest investments we are making this year are:

1. We are buying outright our leased Intuitive daVinci X robot. While we remain concerned about the higher case costs, there are three factors we have considered:

Even with a break-even robotic surgery program, the additional cases contribute to margin and allow us to keep staff productively employed and available for when higher-margin cases are booked. The key here is to have regular open communication with your surgeons to minimize console time for cases that could be as easily performed with traditional laparoscopic instrumentation. Having the robot available draws in area surgeons who may also bring additional non-robotic cases to our centers. Looking to the future, more residents are graduating with a strong preference, or even a basic need for, a robotic platform.

2. We are midway through completion of an additional OR at one of our centers where we have been blessed with utilization rates of more than 100% for the last couple of years. Although the space was originally shelled for an OR, it’s still a significant investment that carries some risk of underperforming, and I have not been able to shake off the persistent unease that took root as a result of the COVID pandemic. Nevertheless, we are reasonably confident of continued growth.

Andrew Lovewell. CEO of Columbia (Mo.) Orthopaedic Group: The biggest investment we are making this year is patient-focused. We are going to improve patient access, and patient experience and add services that complement what we do today. We recently opened a walk-in urgent injury clinic called OUCH (Orthopaedic Urgent Care Hub). We took time to create a strong strategic plan for this and executed it quite well. It has been so successful early on that we are looking to expand hours and add possible additional locations already. Next, we have several strategic locations where we plan to open outreach clinics and partner with local health systems to expand access to high-quality orthopedic care. As the trusted provider in MSK and Orthopedic care for almost 60 years, we want to make coming to see us easier and more accessible. Our outcomes, cost and value are a draw for any market that we enter. We're also looking to add several physicians and other providers to our organization to increase our service offerings. More pain management, total joint replacement and podiatry physicians are coming to our practice this year. Additionally, we will add other adjacent services to our practice such as rheumatology, nerve studies, and others. Overall, our investment plans are rooted in the patient-first approach that we maintain everyday. 

Andrew Oh, MD. Interventional Pain Management Specialist and Anesthesiologist at Pain Care Specialists of Oregon (Salem): The biggest investment this year will likely be bulk purchasing of implantable medical devices. Bulk purchasing can significantly decrease overhead and improve margins, but also has tax benefits as well.

Caleb Ashmore. Orthopedic Rehab Services Supervisor at Harris Health System (Bellaire, Texas): This year, I'm investing in my leadership potential. I started an Executive MBA with an emphasis on healthcare organization leadership at the UTD Naveen Jindal School of Management. This program is a collaborative cohort with Harris Health, Baylor College of Medicine and UTHealth, and offers invaluable cross-organizational networking opportunities. The unique cohort approach fosters connections with fellow Houston healthcare leaders and leads to gaining valuable and diverse perspectives. I've learned a tremendous amount regarding motivational leadership for healthcare organizations, honing my coaching skills as a leadership style, organizational behavior and marketing management. This year promises to be one of incredible professional growth and development.

Jacob Rodman. CEO of Raleigh (N.C.) Neurosurgical Clinic: The biggest investment we will make this year was on upgrading our physical plant. We moved offices this year to a new, updated space that includes our office based angiography suite, our pain suite and our ASC on the second floor. It was not a cheap venture, but the feedback from our team and patients has been tremendous. It also cuts down on the commute for our surgeons.  

Janet Carlson, MSN, RN. Executive Director for Ambulatory Surgery Centers of Commonwealth Pain & Spine (Louisville, Ky.): The biggest investment I will be making this year is recruiting and onboarding top tier clinical nursing leadership for my new ASCs. Talented and knowledgeable human capital is the most important investment a business can make. Once that leadership team is assembled, we can execute on our ambulatory surgical strategic vision and provide outstanding care to our patients in all of the communities we serve.

Jeff Dottl. Principal at Physicians Surgery Centers (Ventura, Calif.): The largest single investment we are making this year at Rancho Mirage Surgery Center  is two Mako surgical robots. This is a major investment in the outpatient robotic joint replacement program. It is made possible by our affiliation with Eisenhower Medical Center and the physicians at Eisenhower Desert Orthopedic Center. We are so excited as we move our long-standing total joint program to the next level with the addition of these two Makos. Robotically assisted surgery is now available for inpatient and outpatient joint replacement patients. We performed our first robotic TJA just after New Year's and we will soon have performed over 100 robotically assisted total joints.

Ken Rich, MD. President at Raleigh (N.C.) Neurosurgical Clinic: We are fortunate to have all the expensive equipment we need such as microscopes, Image Guidance and so forth. What we plan on doing this year is attacking the debt it took to get our two-and-a-half-year-old up and running and profitable. To get to a debt-free situation makes a huge difference in economics.

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