2023 Good and Bad News for Orthopedic and Spine Surgeons

Spine and orthopedic surgeons are witnessing both positive changes and enduring challenges in their field as we step into 2023. In this blog post, we will delve into three pieces of good news and two pieces of bad news that are shaping the landscape for spine specialists, orthopedic surgeons, and ortho-spine specialists this year.

In recent times, independent orthopedic practices have faced the dilemma of either standing on their own or aligning with private equity firms to ensure their sustainability. However, 2023 has brought a refreshing change. Two orthopedic groups, namely Midwest Orthopaedics at Rush from Chicago and OrthoIllinois from Rockford, joined forces in January in an arrangement that doesn’t constitute a merger but rather an aggregation. This innovative approach allows both practices to maintain their independence while fortifying their market positions.

Another exciting development is the formation of PELTO Health Partners in the subsequent month. PELTO, an acronym for Physician Empowered Leadership of Transformational Organizations, is a collaboration between EmergeOrtho in Durham, N.C., OrthoIndy in Indianapolis, and Proliance Surgeons in Seattle. This partnership encompasses over 400 physicians, and it stands out because it doesn’t rely on external sources of capital. It, too, preserves the autonomy of its member groups. These alternatives are injecting new vigor into the orthopedic practice landscape.

Innovation is the lifeblood of the medical field, and the spine and orthopedic domains are no exception. More MedTech companies are embracing cutting-edge technologies like augmented reality and artificial intelligence within their spine and orthopedic portfolios. The demand for innovations in spine and orthopedic implants is on a steady rise.

According to Dr. Alexander Vaccaro, MD, Ph.D., “From the standpoint of the medical device and implant manufacturers, longer life expectancies and an aging population are expected to drive continued and accelerated growth of both of these arenas, increasing the need for orthopedic surgeries to address pathologies driven by degenerative changes, such as hip and knee arthritis or lumbar spinal stenosis.” The prognosis for the industry is indeed optimistic, with market sales projected to reach nearly $50 billion by 2028, and a compound annual growth rate of 3.3 percent, according to some estimates. This bodes well for spine specialist orthopedic doctors and their patients alike.

Orthopedic surgeons are seeing a significant boost in their earnings compared to just a few years ago. Recent data from Medscape’s compensation report reveals that orthopedic physician pay has surged to $573,000, accompanied by an average incentive bonus of $134,000. This is a notable increase from the $482,000 average pay recorded five years ago, with the exception of a temporary plateau in 2021. The upward trajectory of orthopedic wages demonstrates the resilience of the orthopedic practice.

While there is much to celebrate, there remains a concerning issue within the orthopedic field—the gender wage gap. Orthopedics ranks among the specialties with one of the largest gender pay disparities, as reported by the “2023 Physician Compensation Report” from Physicians Thrive. The data reveals that women orthopedic surgeons earn approximately 20 percent less than their male counterparts. Representation of women in the field also remains dismally low, with only 10 percent of orthopedic surgeons being women, according to the latest available data.

Addressing this gender pay gap and promoting diversity within orthopedic surgery remains an important challenge to tackle in the coming years.

Another pressing concern that has persisted over time is the decline in reimbursements for orthopedic and spine surgeries. Medicare reimbursement rates for the 20 most common neurosurgery procedures have fallen by 11.2 percent when adjusted for inflation between 2002 and 2021. This decline in reimbursements is not exclusive to neurosurgery but affects the broader spectrum of orthopedic and spine surgeries.

According to the American Medical Association, overall Medicare physician reimbursements have seen a substantial decline of 22 percent over the same time frame. One specific area of concern is the steady decline in reimbursement for cervical disc replacement. Despite a significant increase in the utilization of this procedure, inflation-adjusted Medicare reimbursement has fallen by 1.2 percent annually. In 2009, reimbursement for cervical disc replacement was $1,928, but by 2021, it had dwindled to $1,679.

In conclusion, the year 2023 presents a mixed bag of news for spine specialists, orthopedic surgeons, and ortho-spine specialists. Positive developments, such as innovative partnerships, robust technological advancements, and increased pay for orthopedic physicians, are balanced by persistent challenges, including the gender wage gap and declining reimbursements. Navigating this complex landscape will require resilience, adaptability, and continued dedication to improving patient care in the orthopedic and spine surgery domains.

In the face of these changes, orthopedic and spine surgeons must remain vigilant, flexible, and committed to delivering high-quality care to their patients while advocating for fair compensation and gender equity within their profession. As the medical field continues to evolve, staying informed and adaptable will be key to success for orthopedic and spine doctors, whether they are orthopedic spine specialists or general orthopedic surgeons.