Here are five points on orthopedic surgeon income and payment models based on the Medscape Orthopedist Compensation Report 2012. 1. Concierge practice — Only 1 percent of orthopedic surgeons said they were transitioning to a concierge practice. This is in line with physicians overall, where only 1 percent reported having a concierge practice.
2. Cash only — Another 1 percent of orthopedic surgeons have cash-only practices, which are more often found in primary care than among specialists. This is slightly lower than overall physicians, 3 percent of which reported having a cash-only practice. Driving the increase is plastic surgeons, with 15 percent having a cash-only practice, and physiatrists, with 11 percent who have cash-only practices.
3. Accountable care organizations — Currently, 2 percent of orthopedic surgeons said they are participating in an accountable care organization, with 5 percent more planning to participate in the coming year. Thirty-eight percent of orthopedic surgeons believe participation in an ACO will cause a large decline in income and another 26 percent say it would cause a slight income decline. Only 9 percent believe ACO participation would have little or no impact on their income and the remaining 26 percent said it's too early to tell.
4. Defensive medicine cost containment — An overwhelming 76 percent of orthopedic surgeons said they would not reduce the number of tests ordered or procedures performed as a result of cost containment measures. Thirty percent said they would continue practicing defensive medicine while 46 percent said their actions were within appropriate guidelines and cost containment measures weren't in the best interest of the patients, according to the report. Seven percent said they would reduce testing and procedures because it affects their income and another 16 percent said they would reduce testing and procedures because the guidelines are valid.
5. Cost of treatment conversations — Around 32 percent of orthopedic surgeons said they regularly discuss cost of treatment with their patients, while 58 percent occasionally discuss costs if the patients raise the topic. Eleven percent of orthopedic surgeons don't discuss cost of care with patients, either because they don't feel it's appropriate or they aren't aware of treatment cost.
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2. Cash only — Another 1 percent of orthopedic surgeons have cash-only practices, which are more often found in primary care than among specialists. This is slightly lower than overall physicians, 3 percent of which reported having a cash-only practice. Driving the increase is plastic surgeons, with 15 percent having a cash-only practice, and physiatrists, with 11 percent who have cash-only practices.
3. Accountable care organizations — Currently, 2 percent of orthopedic surgeons said they are participating in an accountable care organization, with 5 percent more planning to participate in the coming year. Thirty-eight percent of orthopedic surgeons believe participation in an ACO will cause a large decline in income and another 26 percent say it would cause a slight income decline. Only 9 percent believe ACO participation would have little or no impact on their income and the remaining 26 percent said it's too early to tell.
4. Defensive medicine cost containment — An overwhelming 76 percent of orthopedic surgeons said they would not reduce the number of tests ordered or procedures performed as a result of cost containment measures. Thirty percent said they would continue practicing defensive medicine while 46 percent said their actions were within appropriate guidelines and cost containment measures weren't in the best interest of the patients, according to the report. Seven percent said they would reduce testing and procedures because it affects their income and another 16 percent said they would reduce testing and procedures because the guidelines are valid.
5. Cost of treatment conversations — Around 32 percent of orthopedic surgeons said they regularly discuss cost of treatment with their patients, while 58 percent occasionally discuss costs if the patients raise the topic. Eleven percent of orthopedic surgeons don't discuss cost of care with patients, either because they don't feel it's appropriate or they aren't aware of treatment cost.
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