The difference between a good total joint and a great total joint replacement is initially small, but over time the difference can be significant.  A good total joint might last 10 years, but a great total joint could last 30 years.  Being a total joint surgeon is a profession with little or no room for error with every single hand movement. The procedures are demanding and the patient population is complex.

Now, imagine this: The number of total joint replacement surgeons in the United States is cut by over 40 percent. The patient’s option for a surgeon is limited due to demographic or insurance restrictions.  This becomes a significant problem if the joint replacement fails because the subsequent surgery is much more complicated; therefore, fewer surgeons are willing to manage the revision.

Unfortunately, this could be the future of total joint replacement surgeons in America. Orthopaedic residents generally are not going into joint replacement fellowships because of this very issue.  We are 50% filled at best, during a time when we need to be increasing in size. Nationally there is a huge number of impending failures looming. Given the current state of our country, this issue is only going to get worse within the next 5-10 years.

The reimbursement for a single joint replacement surgery has been cut by over 65% in the last ten years.  This isn’t an issue for most surgeons currently in practice; however it does limit the amount of resources they can offer patients.  For example, try calling a doctor’s office and getting an actual person on the phone; these cuts affect everything from the number of front desk employees to the quality of care the surgeon is able to provide.

Cuts of over 65% in 10 years are now being followed with further cuts.  Understandably this makes doctors in training nervous.  Performing this surgery is stressful and I’m afraid it just isn’t worth it for younger doctors considering a specialty surgery career, particularly in joint replacement.

While prevention and patient education remains a goal of all healthcare providers, it does not overshadow the current epidemic that is facing our society with respect to osteoarthritis and its surgical treatment options: the reality is that patients will continue to want the best in surgical care from the best providers.

Please click on the following to see a video entitled “Access Denied:  The Approaching Shortage of Specialist Doctors” and use it to educate your patients on the future of specialized care.  Although it’s a bit biased, it does clearly state the facts.

Dr. Kelley, a third generation surgeon, is a graduate of the University of Iowa School of Medicine.  He performed his orthopaedic residency at the Upstate Medical Center in Syracuse, NY and his fellowship in Adult Hip and Knee Reconstruction at the Mayo Clinic in Rochester, MN.  He is a founder of the North Carolina Orthopaedic Clinic in Durham, NC, an affiliate of the Duke Medical Center where he is a Clinical Professor of Orthopaedic Surgery.  He has authored numerous scientific papers, serves as editor of medical journals, and is a member of a number of prestigious medical organizations.