A Season of Change

***Disclaimer – very lengthy blog written by a very green blogger.

Significant changes in life, work, and the way we do things is often difficult to manage. Through the years I have learned to look at change in a different light. Keep in mind, most of the lessons I have learned about change have come by force or out of necessity to either sink or swim.

That being said, there have been a lot of changes in my life lately that have led me to where I am as we move out of 2020 and into 2021.

First and foremost, I have left employment with Steward Orthopedics and will be teaming up with Phoenix Spine and Joint in Goodyear, AZ. Changing your practice location and logistics (?) is always a challenge for both the provider, and more importantly, the patient. It may seem interesting that I have had two practice moves in the early years of my orthopedic career, but I must admit it has always been a move made with the best interest of my patients and the product I deliver in mind. I haven’t yet found a practice that has been able to match my level of care in the care that they provide my patients. With this mismatch in care between the product that I deliver and the product that the practice delivers I continued my search for the practice model that can deliver equal superior level of care that my patients deserve.

The old adage that “if you want something done right, you have to do it yourself” was playing over and over again in my mind. Through a lot of deep thought, discussion, prayer, and counsel with my better half I have decided that I will need to set up my own practice. This is the long-term goal. However, in the short term I have found a great opportunity to team with Phoenix Spine and Joint to further move my product in the direction I want it to go. I am so excited to work with this innovative partner to bring a superior level of care and attention to my patients. Phoenix Spine and Joint has three ambulatory surgery centers in the greater Phoenix area that offer a wide range of outpatient orthopedic surgical care to the valley. Phoenix Spine and Joint is a pioneer in outpatient total joint replacement and an organization that I am excited to align with to further advance my orthopedic care into the future.

The idea of doing outpatient total joint replacements in an ambulatory surgery center is the second change that has been on my mind. Total joint replacement has traditionally been done in the hospital setting. Patients were routinely staying in the hospital for a week or more in the early days of joint replacement.  During my training it was routine to have patients stay in the hospital for 3 days minimum. Over the past ten years we have found that patients were routinely doing better with shorter hospital stays. In the recent past, Medicare has designated total knee replacement and, as of January 2021, total hip replacement as outpatient procedures. This realignment of designation for these procedures aligns very well with my recent partnership with Phoenix Spine and Joint. I have been very impressed with their ability to safely and successfully get patients through the outpatient total joint replacement experience effectively. It has proven to be a very safe environment to perform joint replacement, even in this uncertain public health crisis we find ourselves in over the past year.

The coronavirus pandemic has proven to be one of the biggest and most notable changes in life for all individuals of the world. The people of the world have been tried by these circumstances that surround the pandemic and yet they have in many ways met the challenge head on and have been able to withstand the chaos that has pursued in more ways than one. My prayers are with the families of those that have had to experience the worst of this pandemic. It has also been clear to me that many people have placed their own health and well being on hold for various reasons and this has and will likely continue to pay a toll on those with significant health needs. Hospitals have discontinued elective surgeries on several occasions in certain areas of this nation and around the world. Since hospitals are commissioned to care for the sick a large push has been made to move many of the elective surgeries out of the hospital setting and into ambulatory surgery centers. Even before COVID-19 I have held the view that hospitals are for the sick, and people that are having elective total joint replacements are, for the most part, healthy. I routinely advise patients that if they can limit their hospital stay and recover at home it will be better for them. If you are healthy enough to have joint replacement surgery, then you are healthy enough to go home the same day. Now that is not true for everyone and there may be social needs that don’t allow someone to have an outpatient total joint replacement. However, if it is possible, it seems to be good practice to keep people out of danger of being exposed to COVID-19 in the hospital setting. Patient safety should be the highest priority for any facility.

More change is on the horizon. I have committed to myself and will commit to my patients that I will continue to drive my orthopedic care forward with advanced treatments, individualized care plans, and a superior patient experience that one should expect from their surgeon.  

- Dr Nathan Moore, DO