The Maryland Gazette, "Orthopedic doctors join practices in Bethesda-based center"

Published January 20, 2014

Orthopedic doctors join practices in Bethesda-based center

By: Kevin James Shay

Hoping to compete better with large medical operations without losing personal control, some 128 orthopedic physicians in the Maryland-Washington, D.C., area have joined together to form a regional Bethesda-based center.

The development goes against the grain of a trend showing the number of doctors on hospital payrolls nationwide increasing by about one-third since 2000, according to the American Hospital Association.

A surgeon practicing solo or in a small group finds it hard to compete with hospitals and large institutions that have the latest technological resources, said Dr. Daniel Tang, a surgeon with Potomac Valley Orthopaedic Associates, which has offices in Columbia, Gaithersburg, Olney and Silver Spring.

“Becoming employed [by a hospital] is not attractive to those who want to control their own destiny,” said Tang, who earned his medical degree at Howard University Medical School and specializes in general surgery, sports medicine, total joint replacement and foot and ankle procedures. “We are trying to preserve the private-practice aspect, to keep in control of the processes.”

The Centers for Advanced Orthopaedics is one of the largest groups of its kind in the country, with physicians in more than 45 offices in Maryland, the District, Virginia, West Virginia and Pennsylvania, said Denny Tritinger, executive director. “It’s the largest orthopedic center in the region. There are not many in the country this large,” he said.

By not being directly under a hospital or large institution, physicians make decisions quicker to benefit patients, Tritinger said. Costs can also be reduced for patients when small practices join together and eliminate consolidate functions such as marketing, and physicians can benefit from the greater bargaining power with insurers to secure better reimbursement rates, he said.

Then there is the ability to better keep up with rapid changes in health care factors, Tang noted.

“If I am treating a young child with an ACL [anterior cruciate ligament] problem, I can communicate with more than 120 other specialists,” he said. “My patients have [access to] a wider range of expertise.”

Planning for the center began about three years ago, Tritinger said. Contracts with major insurance carriers and other agreements have been signed, he said.

Physicians are considering new ways to treat patients, including opening orthopedic urgent care facilities that could treat someone for, say, a sprained ankle, Tritinger said.

“Instead of going to the ER, they could go to an urgent care facility,” he said. “That could save them some time and money.”

Medical care practices have been under closer scrutiny in recent years, as systems deal with changes from the federal Affordable Care Act.

“If it moves us to improve quality and reduce costs, we all can benefit,” Tritinger said.

Tang said he has seen it take a little longer to get surgeries for patients pre-approved by insurers in the past year compared to previous years.

“I hope that will become better in time,” he said.

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