No margin, no mission: Realities facing academic orthopaedic surgery

Robert M. Orfaly, MD, MBA, FAAOS

“No margin, no mission” is often cited to justify controversial aspects of modern healthcare, including cost cutting, prioritizing profit-generating services, and the growing prevalence of administrators with business rather than clinical backgrounds.

Orthopaedic Fundamentals: The economics of orthopaedic surgery

Douglas W. Lundy, MD, MBA, FACS, FAAOS, Scott R. Wolfe

Graduating orthopaedic surgery residents must quickly understand billing systems to practice successfully and sustainably. Yet many enter practice without a clear understanding of these concepts or the financial systems that shape care delivery.

What OHSU Orthopaedics has learned from CMS episodes of care programs

Kathryn Schabel, MD, FAAOS

Why orthopaedics keeps returning to the center of conversations around the Centers for Medicare & Medicaid Services’ episodes of care is not hard to understand.

How physicians shape supply chain decisions in a large group model

Ronald A. Navarro, MD, FAAOS

Who decides what products surgeons use in the operating room — and on what basis? In large healthcare systems, the answers are often assumed to be driven by cost or centralized control rather than clinical expertise.

Resident perspectives on prior authorization: The “hidden curriculum” underlying the administrative burden

Jack M. Ayres, MD, George Sayegh, BS

Orthopaedic surgery residents often experience firsthand the complexities of our healthcare landscape, where clinical decision making intersects with administrative hurdles.