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Increasing senior caseload will pose challenges for European orthopaedists
Throughout most of the European Union, we are seeing greater caseloads in nearly every specialty area within orthopaedic surgery, especially in sports medicine and joint reconstruction.
We can attribute this largely to the increased numbers of patients needing orthopaedic services because they are choosing to lead more active lives well into their “Golden Years.” Many patients want to remain physically and in some cases athletically active well into their 50s, 60s, 70s and even their 80s after their surgery.
Add to that the fact that the generation known as the “baby boomers” (ie, those born in the years following World War II) are getting older and are adding to the senior population. In many countries, the senior population is the fastest-growing age group. These patients will require and demand good medical care, including orthopaedic services.
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Meeting a growing need
It is not difficult to see how we will be in high demand during the next decade. However, this increased need for our services poses special challenges.
In several European countries, there have not been enough trained and certified orthopaedic surgeons available to treat this growing number of patients. The national health care services have had to look outside their own countries in some cases just to fill the need. Patient waiting lists have gotten longer, and in some countries, it is not uncommon for a patient to wait a year or more for an elective hip or knee implant.
In addition, how are orthopaedists expected to accommodate these aging patients when 95% of all orthopaedic surgery is performed in government-funded hospitals, such as in Denmark? Will the federal governments rise to the occasion and agree to provide the extra financial support needed to treat these patients? Will we be capable of training enough new, young orthopaedic surgeons adequately to handle this increasing caseload, and will we have the time and facilities to do so?
Government vs. private payers
An interesting question to ask is, how does this situation differ from that in countries that depend on private insurance? Will the current insurance providers be able to accommodate the increasing costs of treating an active, aging population? We are now looking at treating a generation of patients who receive their first joint replacement in their 50s or 60s, only to return to the operating theater 15 or 20 years later for a new or revised implant. Will our governments and insurers be willing – and able – to pay for that?
These are questions that need to be asked sooner rather than later. We are already seeing the early effects of this increased caseload, and to wait another 5 or 10 years for our governments to start asking these important questions will be too late.
Health officials throughout Europe need to start working closer with international orthopaedic organizations such as the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) or the International Society of Orthopaedic Surgery and Traumatology (SICOT), or with the national orthopaedic societies and various specialty organizations, to address these issues.
For more information:
- Per Kjaersgaard-Andersen, MD, is an assistant professor of orthopaedic surgery at South Danish University, Vejle, Denmark. He is also the president of the Danish Orthopaedic Society and is an editor for Orthopaedics Today Europe. He can be reached at pka@dadlnet.dk.