Increased demand gives orthopaedic surgeons a golden opportunity to lead and take control
To continue to provide expert and timely care, orthopaedic surgeons need to improve the evidence base and change the shape and size of the workforce, according to a presenter at the 15th EFORT Congress – a combined programme in partnership with the BOA.
“The wind of change is here and we must change, I believe. If we don’t take the leadership and change, others such as politicians and mangers will. They will do it in a way that is unacceptable and unpalatable to us and actually I do not believe it will benefit our patients,” said Timothy Briggs, MBBS(Hons), MChOrth, FRCS(Ed), FRCS(Eng), at a 5 June symposium on international health care.
He said an increased demand for orthopaedic services, an ageing population who is living longer, a decreasing workforce and obesity have added to the health care burden around the world. In 1950, there were 856 million people older than age 60 years in the world. By 2050, there will be more than 2 billion people older than 60 years.
The annual budget in the United Kingdom for musculoskeletal disease is £10 billion, he said. Overall, 25% of surgical interventions in the secondary care sector are for musculoskeletal disease.
“We are big players in the game because we are 33% of the surgical workforce,” Briggs said.
The world debt is $52 trillion as of mid-March 2014 and while GDP spending varies around the world, governments will prioritise spending. In the United Kingdom, he said 70 of 250 hospitals were in financial deficit at the end of the last financial year. Despite an increase of 1.91%, they actually needed an increase of 4.6% to stay neutral. He said the NHS will be underfunded by billions in 4 years and orthopaedic surgeons will have to get used to tariff deflation. Additionally, if orthopaedic surgeons don’t address the challenge, general practitioners will continue to be under pressure not to refer patients for orthopaedic care.
“We can no longer hold our head in the sand.” he said.
To continue to provide timely care, orthopaedic surgeons have to change practice to be cost effective so patients get the best outcomes and taxpayers get the best value. To achieve this, Briggs said orthopaedic surgeons need to look at the size and shape of the workforce and improve the evidence base. Orthopaedic surgeons also have to look at patient expectations and get treatments correct the first time. Orthopaedic surgeons should work with industry and other partners to provide a sustainable health care environment.
“We have a golden opportunity to drive and take control. What we need to use and make sure is that we have high-quality, cost-effective evidence-based treatments,” Briggs said.
Briggs T. Introduction and managing the perfect storm. The international healthcare time bomb: An avalanche of orthopaedics. Presented at: 15th EFORT Congress: a combined programme in partnership with the BOA; 4-6 June, 2014; London.
Timothy Briggs, MBBS(Hons), MChOrth, FRCS(Ed), FRCS(Eng), is the president of the BOA, chair of National Clinical Reference Group in Specialist Orthopaedics, and chair of the Federation of Specialist Hospitals in London.
Briggs has no relevant financial disclosures.