Brian P. McKeon, MD, is an orthopedic surgeon at New England Baptist Hospital in Boston and was head team physician for the NBA's Boston Celtics from 2005 to 2017. Here, he shares his thoughts on outpatient orthopedics.
Note: Responses have been lightly edited for style and clarity.
Question: What changes or opportunities are you expecting to see for outpatient total joints in the coming years?
Dr. Brian McKeon: With improvements in preoperative patient management, I expect that within 10 years, 90 percent of all orthopedic surgeries will be performed in an outpatient setting.
Q: Are there any kind of overarching trends that you're seeing right now in outpatient orthopedics?
BM: Hospital-owned surgical centers are not freestanding ASCs. They are known as HOPDs. The overarching trend is for HOPD facilities to become joint ventures with physicians where surgeons run the ASC. This is all being driven by insurance companies. Hospitals will soon realize that the most cost-effective, efficient patient orthopedic care occurs in freestanding ASCs and is the better pathway for hospital networks in regard to outpatient surgery.
Q: How do you hope the ASC industry will change in the coming years?
BM: ASCs will continue to dominate orthopedic markets as well as other surgical markets, and physicians need to be at the forefront of this important facet of patient care. At the end of the day, free standing ASCs benefit everyone involved: the patient, the physician, hospital facilities and private equities. The most important aspect is that the patient will receive the most productive, efficient, cost effective and safest care.
Q: Is there any new technology you're looking forward to on the horizon?
BM: Freestanding ASCs, like our very own Boston Outpatient Surgery Center, will put the control and decisions back in operating physicians' hands. This in turn opens the door for newer, innovative technology and methods that will vastly improve patient care. The cost, flexibility and volume of ASCs allows for innovative joint replacement implants, such as the Arthrosurface Joint Preservation systems, to become a primary option for minimally invasive outpatient surgery.
Q: Do you have any tips or things to know before starting a total joint outpatient program?
BM: The most critical thing is to know your market, know your surgeons and understand your payer/payee mix. The actual procedure is the easy part. Navigating through the complexities of initiating a program of this caliber is what will be challenging.
Q: Do you think private equity will have an impact on the orthopedic specialty? Why or why not?
BM: I believe private equity will be heading toward this value-driven market. To my understanding, outpatient surgery is currently the fastest-growing segment in healthcare. If you can deliver care in a much more streamlined fashion, with every metric resulting in better care for the patient, freestanding ASCs win this victory.