And now for something completely different:
Today we present another in our occasional series of guest-posters. Please welcome Dr Robert Roman, who practices orthopedic surgery in Middletown, Ohio. Dr Roman's an alum of the University of Cincinnati College of Medicine, and has been in private practice for over 13 years. Full disclosure: he is also my brother-in-law, but please don't hold that against him.
Dr Roman is here to tell us about a unique, potentially revolutionary, medical procedure. While it may seem, well, odd to find a post written primarily by an orthopedic surgeon on a blog about insurance, consider this: a core principle here at IB is that the cost of health care drives the cost of health insurance. So who better to discuss cutting edge, and potentially cost-reducing, medical news than someone in the medical field?
You may also be wondering "hey, these are such hot-shot ideas, why isn't this in the NEJM?" Indeed, I posed that myself. Bob told me, quite succinctly, "because the right people don't read that." His point is that he’d like for news of this new method to be available to a broader audience. And what, exactly, is this radical new idea? I'll let him explain:
Total Hip Replacement: The Anterior Approach
Traditional approaches, posterior and lateral, sacrifice or cut muscle, leaving weakness and causing more discomfort [ed: both of these approaches require the patient to lie on his or her side]. In addition, there is an increased risk of dislocation and misjudgment on achieving accurate leg length due to the patient’s position during the procedure.
The anterior approach (the patient is on his her back, not side) navigates between muscle groups, leaving less weakness and pain, and resulting in shorter hospital stays [ed: which also means lowered risk of post-op infections and other complications, which also helps mitigate costs]. Using this procedure also lowers dislocation risk, and (because the patient is positioned on their back instead of their side) leg length can be accurately measured off the opposite leg.
The OSI/Hana table [ed: see graphic below] in conjunction with new instruments have been the technological breakthrough which allows direct, in line with leg shaft approach to the femur.
Thanks, Bob, for your time and expertise.
The major economic advantage is that, after taking into account the initial capital expenditure for the necessary equipment, such procedures could help significantly lower the cost of both the operation and post-operative issues (physical therapy, etc). This in turn can help rein in at least some health care costs, which are primary drivers of health insurance costs.
A win-win scenario.