Dr. Barbara Bergin's outlook on orthopedics in ASCs

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Barbara Bergin, MD, orthopedic surgeon at Austin-based Texas Orthopedics, Sports & Rehabilitation Associates, spoke about the growth of women in the orthopedic field and her outlook on ASCs on "Becker's Ambulatory Surgery Centers Podcast."

Click here to hear the full episode and subscribe to the "Becker's Ambulatory Surgery Centers Podcast."

Here is an excerpt from the conversation:

Question: How do you see orthopedics in the ASC industry changing in the next three years?

Dr. Barbara Bergin: I can't speak for three years specifically, but the things that are happening, and to a certain extent COVID-19, have accelerated this. People are starting to think more in terms of having total joint replacements in ASCs, and that was making slow progress.

Insurers were reluctant at first to pay for total joint replacements in ASCs, and patients were reluctant as well. It takes a lot of forethought to coach a patient through an outpatient surgical procedure as complicated as a total joint replacement. When I began my training, a knee arthroscopy would stay in the hospital for three days. A rotator cuff procedure would require a stay in the hospital for four days. Then all of a sudden we were admitting patients overnight, a 23-hour observation. So we were still putting anterior cruciate reconstructions, shoulder procedures overnight. That transition even took a long time to occur.

But now it's looking like a total joint replacement is going to be done more and more in the ASC setting, especially on healthy patients who are not on Medicare. Medicare may have said they're going to allow surgery in the ASC setting, but the amount that they pay is so little that it barely covers the cost of the implant and the other equipment that's necessary to perform the surgery. So I think it's going to be a little while before Medicare patients will be done in an outpatient setting. However, Medicare patients are older and often have other medical conditions which may be better taken care of or addressed in the inpatient setting.

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