Guest Column: Dr. Asheesh Gupta, NoVa Orthopedic & Spine Care Center

Published December 6, 2016

For most new physicians, there are only two options for employment after fellowships: Join a private practice and hope that it weathers the ongoing changes in healthcare, or join a large health system or hospital and trade in your independence for an attractive starting salary.

Each of these options has pros and cons. At a private practice, even if it remains financially viable, it is challenging to build your own referral network and patient base as a younger physician. And as part of a large health organization, you often start at a high salary but then renegotiate at a lower rate after you have a few years of experience. You also get told exactly where to go, what to do and when to do it – and many of us find that level of oversight stifling and inhibiting creativity.

At CAO, we are creating a third option. And it’s already working for me.

Just a few years after completing my dual fellowships in sports medicine and hip preservation, I’ve been able to really network with colleagues in other care centers within CAO and build an amazing referral source for my expertise. As someone who specializes in hip preservation surgery, my fellow orthopaedic surgeons are my most important referral source. But in the independent private-practice setting, it is often difficult to create these relationships with local physicians who may view you as a competitor.

It is also thrilling to know that we are at the forefront of industry changes. As physicians within The Centers for Advanced Orthopaedics, we have the confidence and security of knowing that we can navigate this disruption and maintain successful practices, because we are proactively adapting to the rapidly changing healthcare environment with the guidance of our leadership team and committees. And with that security, we can focus on innovation and providing the best care to our patients with data-driven results.

As CAO, we have an influential voice – and we are already using it to shape the industry. We were the first to approach insurance companies and start to build our own bundled payments, for example.  And we are at the forefront of data collection and analysis to understand and improve patient reported outcomes. In the future, thanks to our size, we will have the ability to research outcomes with statistical significance – such as the largest series of ACL repairs on the East Coast. Accumulating and synthesizing this data and research will allow us to have a better negotiating stance with healthcare providers, improve our marketing, and foster new avenues of growth with industry.

I believe that the organization we have created in CAO gives us the best of both worlds. We have the backing of a large, influential organization, with lower overhead costs and higher reimbursement rates. But we can still maintain our individuality, which is what makes us such a strong presence in our individual markets. When I finished my fellowships, I remember how challenging it was for my colleagues and I to decide what type of employment would be best for our long-term careers. So much about the future of the medical business is unknown. But as up-and-coming surgeons with innovative ideas and lengthy careers in front of us, we are the ones who will play an integral role in shaping this industry. With the backing of CAO and the opportunity to work with colleagues across care centers, we now have the opportunity, resources and influence to truly make a difference for our patients.  

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