Hi, everyone. This is Lucas Voss with Becker's
Healthcare. Thanks so much for tuning in to
the Becker's Healthcare podcast series. It's great to
have you, and I'm excited to welcome you
to part one of our series on the
evolution of soldier surgery and the increasing shift
to ASC
Environments. And joining me for today's discussion,
fantastic
to have him, is doctor Aaron Chamberlaine. He's
a board certified orthopedic surgeon with the Intermountain
Orthopedic Specialty Group. His clinical interests include leading
edge surgical management of shoulder and elbow problems,
as well as innovative arthroscopic
and open reconstructive surgical techniques. Doctor Chamberlain is
passionate about advancing and innovating surgical care of
the shoulder and elbow, which we'll hear about
in a little bit. Doctor Chamberlain, it's great
to have you. Thanks so much for being
here today. Thank Thank you, Lucas. It's good
to be with you. Absolutely.
We need to start at the beginning.
How does one get into shoulder and elbow
orthotics?
I'd love to hear a little bit more
about how you got into the space and
then what interests you in the space.
Yeah. I think it's, you know, as with
many things, it's it's a long road and
a series of decisions. Right? So from medical
school, we we kind of have an an
idea of what type of,
you know, physician we wanna do and, you
know, and types of things we wanna practice.
And so a lot of us make a
decision. We wanna go surgical versus nonsurgical. And
once we've made a decision to go surgical
and orthopedics is a is a common area
to consider,
within orthopedic surgery residency, one of the subspecialties
you can select is shoulder and elbow surgery.
And and one of the things that drew
me to shoulder and elbow surgery was the
the the kind of vast,
diversity of surgical techniques we use, you know,
anything from an arthroscopic
minimally invasive technique to more,
large reconstructive
open surgical techniques and being able to manage
and and try to try to manage everything
from all from simple to complex in the
shoulder
rather than just doing, you know, part of
that spectrum of care that there's subspecialty of
shoulder and elbow surgery.
And that training lends itself well to
that, kinda be the master of the joint,
so to speak, and be the the subject
matter expert.
And then along with that interest, I I
was,
fortunate,
to work alongside some fantastic mentors. So in
my residency,
doctor Rick Mattson, who's, considered one of the
father figures in shoulder shoulder surgery in The
United States and North in the world, really,
working alongside him in residency along with doctor
Winston Warm. And then doing a a shoulder
and elbow fellowship was kind of that next
decision where, you know, trying to follow follow
doctor Mattson's lead,
and and his guidance and went into the
shoulder and elbow fellowship at Washington University in
Saint Louis and was able to work with,
again, some fantastic mentors in doctor Ken Yamaguchi,
doctor Lisa Gallitz,
doctor Jay Keener,
at WashU in Saint Louis and had a
great, experience there, learned a ton about shoulder
and elbow surgery, and was able to stay
on there as faculty,
for a little over a decade, as part
of the shoulder and elbow,
faculty,
before joining Intermountain Health,
a few years ago.
Feel like your title should just be a
master of joints. I love that. That's a
fantastic title to have. And, again, speaking of
titles, you certainly have a a unique role
within Intermountain Health. I was wondering if you
can talk a little bit about what your
day to day looks like there,
and how you really see health care evolving
in your space, but also certainly beyond.
Yeah. So my title within and my role
within Intermountain Health is so I'm the senior
medical director for the Musculoskeletal
Clinical Program. So orthopedics essentially for our for
our system. It's one of the larger health
systems, in the country, and so we have
a large large geography. But my role is
to oversee and and guide, clinical best practice,
and innovation
care delivery of for orthopedics for our health
system.
On a day to day basis, my my
time is roughly split half and half between
my administrative role as well as my clinical
practice that I that I continue to work
with. But my what really intrigued me about
this role and this job with Intermountain is
the opportunity
to kinda work in an area that I'm
passionate about, which is how do we innovate
and solve the bigger picture problems we see
within health care.
How do we solve and work toward more
affordable health care, better clinical outcomes, more efficiency?
How do we innovate in a way that
takes advantage of the,
the technologies that we see evolving, and how
can they best help us in health care
and specifically within musculoskeletal
care. So that's that's my my role and
my area of focus, within my senior medical
director
role within Intermountain in addition to my clinical
practice.
And you spoke a little bit about how
how health care is evolving and, obviously, some
of the challenges that we're seeing that that
are evolving with
health care certainly here this year,
into next year.
And we've seen a lot of this impact,
especially practices like yours in terms of shoulder
cases really migrating rapidly to ASC settings primarily.
What do you think has driven that specific
shift, and what impact has it had on
both patients, but then also certainly on providers?
Yeah. The shift to ASCs has been one
of the biggest,
changes we've seen in musculoskeletal
care over the last several years.
I I think, in my opinion, we were
shifted and pushed in that direction a little
bit with COVID where being in the hospital
became a problem and and bigger challenge for
us. And so we collectively, in our profession,
I think, learned
how we can help patients get out of
the hospital or have have the surgery done
in a non inpatient way. So whereas many,
many years ago, patients would stay multiple nights
in a hospital, we quickly we had been
moving in that direction, and I think COVID
accelerated that learning process of how do we
safely and effectively
help patients get through a surgical episode and
then and be out of the hospital. And
with that,
alongside that, I should say, there was the
the the ASC strategy that came came to
bear and became a little more accelerated around
that same time point where it became clear
that, you know, with, with some of the
early experience, we could provide a better patient
experience,
better outcomes in in most cases,
and have it, cost less to the patient
and cost less to the system to have
it done in AAC. And so with the
clinical learnings we have shifting from an inpatient
to more outpatient total joint replacement surgery,
Along with that, the economics of the ASC,
I think those
there's been two pretty powerful drivers
to get more cases to the ASCs.
And now we see that that, you know,
health plans,
are are also kind of accelerating that. They've
they've we've seen a lot of partnerships
with health plans where they're trying to provide
incentives to providers to drive cases toward ASC
where the claims expense savings is substantial on
the health plan side. We also see patients,
now more and more requesting for their cases
to be done to ASC. They experience everything
from something as simple as just finding parking
and getting into the building, you know, having
efficient, you know, an an efficient time efficient
experience in the in the for their surgery
day,
and then having a more kind of a
a a personal touch, to their to their
surgical experience we can provide at the ASC.
So I think, you know, moving forward, we're
gonna continue to see that drive,
from the patient standpoint,
in their experience as well as the health
health plan or health insurance standpoint as well.
And then I should say for the providers,
it's my favorite place to work is in
a is in our surgical center. I mean,
we have great efficiencies. We got a great
team. People care, you know, put the patient
first, and we're able to make decisions in
a more nimble way around how do we
think this is gonna positively affect the the
care of patients we see, and we can
we can enact those changes quickly.
I I was going to say or or
ask rather,
what's for you? What's the you've mentioned a
couple of them, but what's sort of the
number one biggest advantage
of performing these cases in that ambulatory setting
for you as a surgeon versus actually being
in a hospital?
Yeah. So for me as a surgeon where
my primary concern is how is my patient
my the patient gonna feel and and what's
their experience gonna be like. I feel most
confident as a provider that I can create
and and provide that experience for my patient,
number one. Number two, you know, I can
I can be I I'm passionate? I think
a lot of my colleagues are passionate around
how do we help health care be more
affordable.
I I know, and I I as part
of my job, I can see the the
the expense the the difference in expense to
the health plan and the patient in many
cases
around doing the surgery at the ASC versus
in a hospital setting. So we're clinically appropriate.
I feel feel pretty strong that I'm able
to save the patient money in their pocket,
and that's one of the things that I
feel strongly about in general is how do
we help our patients feel like health care
is more affordable,
and, you know, and accessible in that way.
And so for me and then thirdly, it's
obviously more efficient for me. I I have
the same team that I work with every
every time I operate. I can, you know,
affect change, and we can make decisions that
are,
that help the process be more safe, more
higher quality, and more efficient.
So for a provider that that having that
ability to affect change like that like that,
I think, is is a big deal.
Speaking
of efficiencies, I think we'd be remiss if
we didn't talk about technology and a little
bit about the innovation that's been happening in
this space. Again, not just this year, but
probably over the last five years and certainly
heading into 2026.
And, certainly, patient expectations are are changing as
well. They they continue to shape the outpatient
orthopedic space.
How do you see this technology,
this innovation that's happening so rapidly on a
regular basis impacting the space? And, certainly, if
you could talk about the patient expectations too
that are rising on a consistent basis,
as well.
Yeah. So our again, starting with the patient,
our patients are expecting, and I think rightly
so,
high precision, you know, experience when it comes
to a surgical intervention, they're expecting precision.
They want to know that we are doing
everything we can to minimize
complications while maximizing their opportunity for a good
outcome.
And so we need, as a profession, to
continue to identify and then leverage any technology
that helps
meet those expectations in the patient. And so
to do that, you know, as far as
identifying how do we, you know, minimize
complications, I think any technology that helps us,
be more precise to avoid outliers as far
as surgical technique or implant positioning, things like
that that may affect, patient outcomes. I think
it's our job and our responsibility to to
find those opportunities to minimize those kind of
complications.
We wanna utilize everything
anything that helps us technically to perform the
procedure better in a more precise way to
understanding data. You know, how do we identify
what are we doing that's helping patients? You
know?
Data is is gold nowadays with with health
care among other industries. But within health care,
we need to do a better job and
and leverage the technology we have available to
understand
outcomes. When we make decisions as providers,
are we measuring and how are we measuring
to understand the effect that it has on
the patient outcome? Does it make a difference?
Yes or no? To what extent is it
making a difference? How much should we be
paying for such a technology because of the
difference it's making? So that's where utilizing that
data and understanding
the effects of our decisions, I think, goes
a long way as well.
Doctor Chamberlain,
the master of joints. I'm establishing this happening.
Thank you so much for your time and
insights today. It's fantastic to have you.
Thank you. Thanks for letting me join you.
Absolutely. We also want to thank our podcast
sponsor, the Pew's and Theys. Make sure to
come back for part two of our series
tomorrow and tune in to more podcasts from
Becker's Healthcare Care by visiting our podcast page
at beckershospitalreview.com.