Outpatient Migration and Independence in Orthopedic Practice with Robert C. Rhoad, MD
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This is Carly Beam with the Becker Spine and Orthopedics Podcast, and I'm thrilled to be joined today by Dr. Robert Rode, Orthosensee. He's going to share some great insights about private practice, outpatient migration, among some other topics in orthopedics. So Dr. Rode, thank you so much for being here today.
Dr. Robert Rode, Orthosensee, Carly, thanks for having me. I appreciate the opportunity.
So before we dive into our discussion, I'd love if you could introduce yourself and tell us a bit about your background.
Certainly. I'm Dr. Robert Rode and I'm in Cincinnati, Ohio. Our group is OrthoSensee. I'm an orthopedic surgeon and I specialized in hand, wrist, and elbow. My background is orthopedics and trained at University of Pennsylvania and then trained with David Green in San Antonio and came to Cincinnati where our group, Wellington Orthopedics, over the years merged into OrthoSensee to form a pretty good sized group in Cincinnati, Northern Kentucky, Indiana, and now also with a division in Louisville. So we've grown over time and hope to be able to stay independent as physician-owned independent orthopedic group.
Excellent. And so first I wanted to touch on outpatient migration in orthopedics. What is your outlook for that? And what's been working at your practice in this area? And where do you see things growing?
Absolutely, Carly. You know, we, as an independent group here in Cincinnati area, we work with just about every hospital system around. Within all of that, there is definitely a steady trend of services moving from perhaps inpatient but to outpatient. That would include from the inpatient hospital to an outpatient environment, but also to an ambulatory surgery center and then ultimately office-based care. When considering that, as we know, one of the first questions we ask is, hey, can we do this logistically? And then perhaps more importantly, can that be done safely with comparable or even improved outcomes? And then finally, are the patients that we're treating very satisfied with the experience and their own patient reported outcome and at the time of the procedure and then later looking back?
So obviously that requires a lot of different change and delivery model, but Also, insurance payers are definitely interested in that. In our organization, whether it's taking care of a wrist or a hand or a total shoulder, total knee, total hip, we want to make sure we're improving and optimizing those patients before surgery and pre-care to make sure that these are appropriate patients and they're definitely viable for outpatient care. We also would say that we're looking to grow our in-office services with time. Things that we can do, such as in my practice, trigger fingers, carpal tunnels, even fingertip amputations for trauma, as opposed to in a larger hospital. Those are some of the things we're looking at.
I think all across the country, very similar kind of trends.
I'd love to dive in a bit deeper about specifically these office-based procedures. How are you thinking about what you could potentially move to that setting, as opposed to even in ASC?
Well, definitely with patients, there are some that are going to be comfortable with that and some that may not. And so my own practice is I don't force that. But for some of the patients who are looking for the convenience, the simple soft tissue hand cases are ideal for that. And if you have the right staffing and if you have the right patient and the right equipment, safety level and a healthy individual. I think trigger finger, carpal tunnel release, and some small fists in the fingers can be done very safely with excellent outcomes just in the office-based setting.
Yeah. And then are there any key considerations that physicians and practice leaders should think about when it comes to expanding what cases they offer outpatient?
Well, I think certainly if you have the space and you have the staff and then you have gone through a developmental program to look at the different important parameters of safety, and I would recommend that when somebody is looking to do so, is visiting an established, well-run, and mature office-based program to really look, watch, learn,
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