Michael Redler,, MD, is a founding partner of The Orthopaedic and Sports Medicine Center in Trumbull, Conn. He is a visiting assistant professor of orthopedics at the University of Virginia as well as an assistant clinical professor at the Frank H Netter School of Medicine at Quinnipiac University. He has been an advocate for outpatient orthopedic surgery and ASCs for several years.
Dr. Redler will share his expertise as a speaker at the Becker's ASC 26th Annual Meeting: The Business and Operations of ASCs, Oct. 24-26, 2019 in Chicago. To learn more and register, click here. For more information about exhibitor and sponsor opportunities, contact Maura Jodoin at mjodoin@beckershealthcare.com.
Here, Dr. Redler discusses the strategic plan for his practice and ASC in the future.
Question: How do you plan on growing your practice over the next two to three years? What are the best opportunities in your market?
Dr. Michael Redler: I think about this all the time. I'm in Connecticut, so there is a big challenge with having two major healthcare systems in our market. The health systems have put their tentacles out and are trying to control more of the market place. If you are a medium-sized, well-established private practice, in a lot of markets you can potentially end up feeling the brunt of those efforts.
We have become a division of Connecticut Orthopaedic Specialists; what COS has allowed us to do is have a statewide footprint while being our own division. For patients in our area, we are still The OSM center, a group that patients have relied on for 24 years, but in terms of the inner workings, of our IT, EMR, billing services and corporate structure, are handled on a much bigger platform with more efficiencies than we could on our own. The level of expertise is also greater than if we had a small or mid-sized practice, and we are able to achieve a bigger footprint in terms of negotiating contracts that will rival the bigger health systems.
I think those of us who want to control our destiny in private practice have to seriously look into this model. We are now able to do things comparable to what the large health systems in Connecticut do.
Q: In what ways are you seeing technology and implants change? What are the smartest developments on the horizon?
MR: The ingenuity within some of the top orthopedic companies in terms of implants has continued to grow exponentially. Twenty years ago we could fix shoulders arthroscopically, but now what we use in terms of implants is amazing. There has always been a fine balance between continued innovation preventing things from getting too expensive. There are some companies that have the mindset that their products are better and you have to take it or leave it; sometimes you can get a terrific outcome with the second-best product on the market at a more competitive price.
It's a fine balance for making decisions for your patients and the economics of your surgery center and working within the confines of your insurance reimbursement. What we can do with minimally invasive surgery now keeps getting better and better, but you have to make certain you are dealing with companies that are going to work with you in terms of appropriate price point for new technology.
Q: What role do you see outpatient surgery centers playing in the orthopedics and spine field in the future?
MR: It's unbelievable what fabulous synergism has occurred within ASCs and orthopedics. We are perfectly situated to do procedures at the ASC with regional anesthesia, long-acting local anesthetic and nerve blocks. There is very little I can't do at an ASC right now in terms of procedures. Surgeons at our ASCs are doing laminectomies, anterior cervical discectomies and fusions, total knee and hip surgeries, and even some major trauma procedures on an elective basis because you can do it with a regional block.
We have a lower infection rate than any hospital in the country and patients can recover at home. There is a marriage between orthopedics and the ASC, and unless the patient has significant medical issues, or major catastrophic trauma, there will be fewer patients who aren't good candidates for the outpatient setting. There is a terrific cost savings in the ASC and the variety of orthopedic cases at our center has really grown.
Q: Are the insurance companies more willing to recognize this savings and reimburse for care in the ASC?
MR: They are doing better. The insurance companies encourage cases to be done at the ASC and are paying premiums, including professional fees, for some procedures to be done in ASCs. Carriers are getting smart enough to start rewarding surgeons in terms of their professional fees for performing the higher complexity cases in the outpatient surgical center.