Market Profile of U.S. Orthopedic Surgeons. Market Insights Report MARKET INSIGHTS

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Griselda Tate
5 years ago
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1 Market Profile of U.S. Orthopedic Surgeons Market Insights Report MARKET INSIGHTS

2 Market Profile of U.S. Orthopedic Surgeons Overview: Profile of U.S. Orthopedic Surgeons Orthopedic Surgeons by Number, Region and Move Rate 1 Practice Size and Patient Volume 3 Ownership, Affiliations and Specialty Associations 4 Affiliations to Hospitals for Admitting Privileges 5 Government Insurance Acceptance 5 IHS Employment and ACO Participation 6 Physician Access and Drug Sample Acceptance Rates 7 Electronic Health Records Adoption Rate 8 Annual Compensation of Orthopedic Surgeons 8 Promotional Spend Towards Orthopedic Surgeons Q Q Channel Mix - Details, Samples and Meetings 9 Total Product Details 9 For more information about this report, please contact: Jack Schember, Director of Marketing, Jschember@us.imshealth.com phone: x 1259

3 Introduction An orthopedic surgeon has been educated and trained in the diagnosis and treatment of diseases and injuries of the musculoskeletal system. An orthopedic surgeon is either a medical doctor or a DO who has completed a five-year residency focused on surgical treatment. The most common treatment areas are spinal disorders, arthritis, sports injuries, trauma, fractures, bone tumors, and cerebral palsy. An orthopedic surgeon may complete additional training with a spine fellowship and specialize in spine surgery. Orthopedic surgeons work closely with other healthcare providers and often serve as consultants to other physicians. They may practice in an orthopedic or multispecialty group, in a solo practice, or as a hospital system employee. Orthopedic surgeons are key targets for the medical device and diagnostics industry; but they are difficult to pin down. Engagements and details are difficult, owing to the surgeons frequent movement from offices to hospitals to surgery centers. Orthopedic Surgeons by Number, Region and Move Rate The number of orthopedic surgeons in the U.S. dipped slightly in 2015 after four years of sustained growth. Today there are about 35,742 physicians who named orthopedic surgery as their primary or secondary specialty. They are very likely (60%) to have a secondary specialty. Of the top 20 physician specialties by number of practitioners, orthopedics ranked seventh, just behind cardiovascular surgeons. They practice at 11,552 medical sites. Number of Orthopedic Surgeons in the U.S. 40k 35k 34,372 32,802 34,165 35,177 36,115 35,742 30k 25k 20k 15k 10k 5k

Orthopedic Surgeons by Region 8,814 8,249 7,502 11,177 West includes AK & HI Orthopedics moved to new locations, took new jobs, retired, passed away or made other professional changes at an average

4 The southern states have the highest concentration of orthopedics. One-third of the country s orthopedics are located in the south. But as a percent of population, the northern states have the highest number of practitioners. U.S. Orthopedic Surgeons by Region 8,814 8,249 7,502 11,177 West includes AK & HI Orthopedics moved to new locations, took new jobs, retired, passed away or made other professional changes at an average rate of 13.45% annually over the past 6 years, a number consistent with the average physician move rate of 13.55%. Orthopedics are trending towards job stability. Orthopedic Surgeons Move Rate (deceased, moved, retired) 20% 18.2% 15.0% 15% 10% 13.4% 12.4% 12.3 % 12.0 % 11.9% % % % 14.5% 13.6% 15.6% 15.4% 12.4% 12.0% 5% 0% Orthopedic Surgeons All Physicians 2

5 Practice Size and Patient Volume Orthopedic surgeons tend to favor mid-size practice settings. Nearly half (47.5%) prefer to practice in locations where there are between 3 and 10 physicians. Conversely, about 30% pull towards the largest of the large practices with 11 doctors and beyond. Three physicians practicing together as a business meet SK&A s definition of a medical group. Office Size of Orthopedic Surgeons 13.1 % 7.1 % No. of Doctors Per Office % 23.6 % 2 3 to % 6 to % 11 to plus Total 4,676 3,098 7,878 9,100 8,450 2,541 35,742 Orthopedic specialty offices are quite busy when it comes to patient visits and consultations. The pie chart below represents patient visits per practice location. Most practices (39.3%) see at least up to 50 patients per day. Daily Patient Volume 32.6 % 39.3 % 11,661 14,044 1 to to to % 4, % 6, plus 3

Ownership and Specialty Associations Orthopedic surgeons maintain a low level of independence compared to other specialties. Just 25% designated themselves to be independent or solo practitioners.

6 Ownership and Specialty Associations Orthopedic surgeons maintain a low level of independence compared to other specialties. Just 25% designated themselves to be independent or solo practitioners. About 56% said they are tied to either hospitals or health systems. In our survey, about 19% did not indicate their ownership status % Independent 29.7 % Health System Owned 26.1 % Hospital Owned Orthopedics are closely aligned with other practitioners in their office setting. About 3,500 orthopedics indicated they are most associated with internists, which is not surprising considering the invasiveness of many orthopedic surgeries. Physical medicine and rehabilitation specialists also are common partners with orthopedics ,482 Top 4 Specialty Associations Have a secondary specialty? , ,929 1,758 Yes 59.4 % Internist Family Practitioner Podiatrist Physical Medicine/ Rehab Specialist No 40.6 % 4

7 Affiliation to Hospitals for Admitting Privileges Nearly 10% of orthopedics have no affiliation to hospitals, presumably conducting their operations and treatments solely in outpatient surgery centers. The trend towards outpatient service is gaining favor. About 40% of orthopedics are affiliated to just one hospital, while 50% are affiliated to two or more. Affiliation to Hospitals No. of Doctors % of Total 0 3, % 1 14, % 2 12, % 3 4, % 4 1, % Government Insurance Acceptance Owing to the high cost of their complex treatments and rehabilitation, orthopedic surgeons are more likely to accept government insurance plans and navigate reimbursement than the average physician. Nearly 93% will accept Medicare and 66%, Medicaid. Medicare & Medicaid Aceptance Medicare 84.3 % 92.7 % Medicaid 66.1 % 66.3 % 0% 20% 40% 60% 80% 100% Orthopedic Surgeons All Physicians 5

8 IHS Employment and ACO Participation Employing more than 7,900 MDs and DOs in 800-plus medical offices, Kaiser Permanente is the largest employer of health professionals among integrated health systems. Kaiser hires the most number of orthopedics, double the number of the next top employer. Most orthopedics, however, remain independent. Top 5 IHS Employing Orthopedic Surgeons Percent Orthos Part of IHS Kaiser Permanente 331 Yes 29.1 % Partners Healthcare System 165 Cleveland Clinic Health System Community Health System Inc New York-Presbyterian Healthcare System No 70.9 % At least 23% of orthopedics are participating in accountable care organizations (ACOs). While newcomer Frederick in Maryland is not one of the largest ACOs in terms of total physician enrollment, it has the highest number of orthopedics in its network. Top 5 ACOs with Orthopedic Surgeon Participation Percent Orthos Part of ACO Frederick Integrated Healthcare Network ACO 199 Yes 23.4 % Montefiore Accountable Care Organization & United HealthCare 162 Advantage Health Network & Florida Blue Cross Blue Shield WellStar Health Network No 76.6 % Cleveland Clinic Cigna ACO 145 6

Physician Access and Drug Sample Acceptance Rates Orthopedics are somewhat restrictive when it comes to details from sales representatives. One-quarter (25.5%) flat out will not meet with a rep.

9 Physician Access and Drug Sample Acceptance Rates Orthopedics are somewhat restrictive when it comes to details from sales representatives. One-quarter (25.5%) flat out will not meet with a rep. Another 55.2 % will see a rep but require an appointment up front. About 16% allow walk-ins any time. Physician Access 15.8 % 3.5 % Access any time Call for appointment 55.2 % 25.5 % No access Unknown In terms of sampling preferences, 14% expect a direct drop-off at their office, while close to half will accept either a drop-off or mail delivery. With their busy surgery schedule, it s hard to pin down an orthopedic for an interaction or sample signature. Drug Sampling Preference 13.9 % 3.8 % Mail Drug rep drops off drugs 47.5 % 34.8 % Both No preference or unknown 7

10 Electronic Health Record Adoption of Orthopedic Surgeons Orthopedics adoption rate growth over the past three years has remained flat at an average of 70%. Even so, they remain ahead of other physicians in terms of software usage and office automation. EHR Adoption Rate 80% 70% 60% 50% 24,166 25,709 24,954 19,284 21, % 69.8 % 68.7% % % 40% 30% 20% 10% 0% Annual Compensation or Orthopedic Surgeons Across the seven workplace types, orthopedics earn an average of $400,000 per annum, making them among the very highest paid surgeons. Solo practitioners earn the least, understandably, but those employed in healthcare organizations are bested by multispecialty group doctors. Compensation by Practice Setting Multispecialty Group Practice $459,000 Healthcare Organization $449,000 Single Specialty Group Practice $442,000 Hospital $397,000 Outpatient Clinic $388,000 Solo Practice $348,000 Academic, research, military $319,000 Source: Medscape s Orthopedics Compensation Report

11 Promotional Spend Q to Q Channel Mix and Detail Summary Orthopedics are sought-after targets for medical device and diagnostics providers. The industry s preference is to detail the surgeons, but they also invest heavily in sponsored meetings and curricula and some direct mailings. Compared to the pharmaceutical industry, promotional spending and activity from the med-device manufacturers is minor. In a rolling annual forecast provided by IMS Health ChannelDynamics TM, about 80,400 details or engagements were performed on orthopedic surgeons, with the second quarter of 2015 being the most voluminous period. The panel reported on the promotional activity of 38 manufacturers. Promotional Spend to Orthopedic Surgeons, by Channel $4M $3M Samples Meetings Mailings $2M Detailing $1M 0 Q Q Q Q Source: IMS Health ChannelDynamics TM, Dec 2015 Total Product Details (in units) 30k 26,816 25k 20k 18,552 20,528 15k 14,514 10k 5k 0 Q Q Q Q Source: IMS Health ChannelDynamics TM, Dec

Finding the Strategic Tipping Point : To Employ or Not to Employ Orthopedic Surgeons. Melinda Bemis and Craig Pederson

Finding the Strategic Tipping Point : To Employ or Not to Employ Orthopedic Surgeons Melinda Bemis and Craig Pederson INTRODUCTION AND OVERVIEW Today s speakers Craig D. Pederson Principal Edina, Minnesota