An orthopaedic economic impact study reflecting $2.3 billion in revenue going back into Missouri annually is setting a precedent as the first-ever report of its kind to be written, and is a conductor for exploring research, prevention, and safety issues for musculoskeletal conditions.
The study was generated through a $20,000 grant received from the American Academy of Orthopaedic Surgeons (AAOS) and the Missouri State Orthopaedic Association (MSOA). Sedalia orthopaedic surgeon Dr. Douglas Kiburz co-wrote the study with Dr. Akin Cil, president of the MSOA. Kiburz is the Missouri delegate to the AAOS Board of Councilors. The funds for the study allowed the doctors to hire a St. Louis economic development firm to conduct the survey and put the numbers together for the report.
The study was published this month in AAOS Now, the official news magazine of the American Academy of Orthopaedic Surgeons. It studies how money for orthopaedic health care is spent in the state, generating $1.79 billion in goods and services, $28 million in state taxes and supplying 11,000 jobs. When the impact of physical therapy is added to the equation, a total of $2.3 billion is attributed to the total economic output.
According to the study, orthopaedic medicine has a fiscal impact on Missouri’s economy in several areas. The profession creates jobs, has payroll and salaries, pays income and property taxes on orthopaedic facilities, and also shows revenue from non-medical and medical equipment, services and goods.
“Nobody’s ever asked the question of any state, beyond health care, does it have an economic impact?” said Kiburz from his office at Bothwell Orthopaedic and Sports Medicine on Tuesday. “We weren’t sure either, so I said ‘well let’s find out.’”
Kiburz said, when talking about orthopaedics in general, one out of two adults in the United States will have a diagnosis of musculoskeletal problems, while 18 percent of doctor visits are due to musculoskeletal conditions. With an aging population the cost is only going to increase.
“What do we do for prevention and what do we do for safety?” he noted.
He added that his purpose with the study was to explore the issues and show how the numbers and data in the orthopaedic field stacked up, plus to see what doctors in the field are trying to do as far as research, safety and prevention. Kiburz said he hopes the study can be used in other states.
“They don’t have to repeat it, they can reference it,” he said.
He said the $2.3 billion doesn’t include therapy outpatient services, orthopaedic-related building and orthopaedic departments.
“It’s probably a much bigger number, we wanted to be conservative, ” he noted. “We said ‘let’s take the very basic things and see what we’ve got.’ The main orthopaedic realm is about $2.3 billion a year … that’s what orthopaedics brings to the state.”
The study shows how orthopaedic medicine impacts the economy but also stresses why it’s an important issue that overlaps lifestyles encompassing workplace and leisure activities.
Kiburz cited issues such as helmet safety, childhood obesity, playground safely, osteoporosis and bone health. Having the manpower to take care of those issues is also something Kiburz addressed.
“With the aging population, total knee replacements are going to be up 174 percent in the next 15 years,” he said. “How do you handle all those? There’s a huge manpower issue, particularly in rural areas. You can’t get people to come to rural areas and become a country doctor anymore.
“If you look at the number, the money spent on musculoskeletal, that is going to increase 1(00) or 200 percent,” he added. “How are we going to handle it manpower-wise — so that’s when you say prevention and safety.”
Kiburz said the study will help them at a state level as they speak to legislators or when they approach the National Institute of Health.
“When you are talking to lawmakers, you are talking pocketbook,” he noted. “We like to say ‘here is the impact that orthopaedics has, we’d like to see some of that money coming back to research, safety and preventative problems.’”
He added that they have three meetings each year. One of them is in Washington, D.C., where they visit their senators and representatives.
“We usually take the top five bills that have some orthopaedic influence and find out where they stand and will they co-sponsor a bill, will they be in favor of it?” he noted. “Because we know right behind us is going to be the lawyers, the pharmacy, the hospitals. Physicians are probably behind getting involved in the political process … so our job is more of an advocacy.”
He added that usually the legislators are open and welcome information.
“One of the legislators we went to said ‘every other group comes in here wanting money, but you guys come in wanting legislation,’” Kiburz said. “‘You want safety legislation, you want patients to have access to the doctors they want.’”
He has also been working on getting a sports medicine bill passed to allow doctors to travel with their teams across state lines.
“They don’t have malpractice coverage and a (medical) license in another state, so they are kind of at risk,” Kiburz noted. “So I have been talking to MSOA and at the national level to get a bill that would allow physicians to go with their teams and cover their teams when they travel.”
Kiburz said as far as orthopaedic health is concerned it comes down to prevention and the programs the “orthopaedic house is actually looking at to help people take care of themselves.” He added that people need to take a personal responsibility for their health also. Often people want to be healthy but lack the discipline to act on the concept.
“There is only so much you can do for people,” Kiburz said. “If you are overweight and you don’t exercise, and you smoke and don’t watch your diet, at some point there has to be some personal responsibility for your health. Otherwise we can’t afford to take care of all those things.”
Kiburz added that for him, being on the AAOS Board of Councilors is a way to give back at a grassroots level.
“To me it’s a way of giving back to a satisfying and productive profession, to represent Missouri for two terms at the national level,” he said.
Faith Bemiss can be reached at 530-0289 or @flbemiss; photo by Faith Bemiss | Democrat