Why are more total joint procedures
performed in physician-owned facilities?
You don't see many procedures being done at acute
care hospitals — large groups of surgeons who own
their own surgery centers are doing them for huge
profits. That's because the reimbursements sur-
geons get from Medicare and private insurers
for doing the surgeries in hospitals are incredi-
bly low. If surgeons can move the procedures to
centers they own, their income increases signifi-
cantly.
Should facilities invest in robotics?
The technology is nice to have, but it's expensive
and may not be cost effective. It makes fellowship-
trained, high-volume surgeons maybe 2% better.
That's nice, but should a health system invest in a
robot to marginally improve the already excellent out-
comes achieved by top surgeons? Investing in robotics
is about spending to improve the marketing of a joint
program instead of hiring surgeons who are great tech-
nicians. Instead of spending money on robotics, let's
pay outstanding surgeons more money for doing a
better job.
But wouldn't you want robotics used during your knee replacement?
I'd be happy to pay out of pocket to have a good surgeon use a
7 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 1 6
eimbursement, Robots and Patient Selection
R
Sharat Kusuma, MD
Joint replacement specialist and surgical consultant
