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  • Brian Cole

Look behind and stretch ahead in 2023

This time last year, many physicians looked forward to reclaiming a sense of normalcy in their lives and practices. We started 2022 hoping for a return to a pre-pandemic way of practice. Instead, we found a profession permanently changed.

In 2022, orthopedic surgeons were challenged to deliver the same efforts for less pay. We saw 4 million people leave health care, including talented nurses, physician assistants and medical assistants. Staff shortages affect our practices and have been almost unbearable at times. As more burden falls on our shoulders, physician burnout is increasing.

Corporatization of medicine

Another challenge in the “new normal” is the corporatization of medicine. As health care systems are increasingly recognized as financial vehicles to build wealth, more private venture capitalists are homing in on orthopedic practices as attractive investments.

In 2022, we saw increased efforts to extract value and income. Despite the claim that we are protected from the corporate practice of medicine, diverting revenue to value-created investments typically restricts resources and support for practice, which directly affects physician-patient relationships.

For better or worse, we have seen a renewed focus on primary care providers as gatekeepers of health care concerns, including musculoskeletal care, despite lack of evidence that this improves value. We are left wondering as Fortune 500 companies focused on health care have reported record profits just as major hospital systems have reported record deficits, financial distress and bankruptcies.

Year of adaptation

It is not all gloom and doom. If 2022 laid the health care system bare, then 2023 should be the year of adaptation. Orthopedics remains an exciting, dynamic and innovative specialty. We may have incredible headwinds to manage, but we also need to recognize that the U.S. health care environment offers the opportunity to practice orthopedics at the highest level in the world. Better still, we are seeing an influx of game-changing technologies. The innovations promise to reduce time and cost while supporting outcomes and personalized care.

Artificial intelligence (AI) is the future of surgery. Intraoperative and postoperative AI can improve a surgeon’s performance, reduce variability and improve patient outcomes. In the short term, we’ll see augmented/mixed reality for improved intraoperative visualization, tactile perception and remote surgical collaboration. We’ll see AI-guided surgery assistance that provides real-time intraoperative safeguards and reduces outliers, reduces adverse events and improves safety. AI will help surgeons with limited specialized experience upskill significantly by providing expert training in technical skills and decision-making.

Medical apps will continue to offer personalized care and improved patient communication. Automated outreach improves patient engagement, satisfaction and retention. The technologies will encourage patients to take a larger role in health outcomes by delivering timely guidance and reminders.

In addition, 4D printing is the next generation of bone repair technology by combining programmable biomaterials, living cells and bioactive factors. The orthopedic and regenerative medicine specialties are keenly watching tissue printing research as it can revolutionize how orthopedics is practiced.

Big data within orthopedics is still in its infancy. However, it has proven to be an excellent tool for longitudinal, observational research. The biggest value is predictive analytics done by data mining, analysis of current and historical data, predictive modeling and machine learning.

Exciting place to be

Tomorrow’s OR is an exciting place to be. Innovations will support better patient outcomes and wider access to health care services. Innovations, such as smart sensors, wearables and remote vitals, will help standardize care by creating efficient and reproducible procedures. The advent of 5G may allow surgeons from the other side of the world to assist remotely.

As we conclude 2022, let’s be thankful we made it through the year. Let’s be grateful for relationships and the wonderful people in our lives. Let’s look forward to what comes next. The year 2023 will be the year of adaptation to a new norm. Expect to see more amazing technology and opportunities to provide the best patient care.

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