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Wow. And he did OK?
He did great. There's a lot of talk about the suitable age for outpatient joint
replacement, but that's not the determining factor. I've operated on patients in
their 80s who were spry and healthy, and ready to go home after surgery. I've
also operated on 50-year-olds who were out of breath getting up on the exam
table. They weren't fit for a haircut.
Can surgery centers and hospitals that both
offer outpatient joints coexist in the same community?
I think so. Surgery centers will inevitably cannibalize some patients from hospi-
tals, but I don't think it's a zero-sum game. There are lots of patients who need
joints replaced, but aren't getting them done for a variety of reasons. As we
make the operations easier and more convenient — and less of a big deal —
we'll get more patients into the system. Hospitals will lose some patients, but
their overall business will grow.
So hospitals can compete?
Well, there's no way they'll ever beat the small overhead and nimbleness of
surgery centers. Rush is planning to build an ASC primarily for hosting joint
replacement procedures. I think you'll see more hospitals doing the same, so
they can come closer to leveling the playing field with freestanding
facilities.
OSM
Dr. Berger (r.a.berger@sbcglobal.net) is a joint replacement and reconstruction special-
ist at Midwest Orthopaedics at Rush and an assistant professor at Rush University
Medical Center in Chicago.
