Increase government spending for medical research and education: Although the total U.S. funding Medical and health research and development (R&D) continues to grow in a positive direction, federal R&D funding are oftentimes uneven across health agencies. A focus on increasing federal funding for organizations like the National Institutes of Health (NIH), the nation’s medical research agency (and an organization that only receives 0.10% of our annual funding budget), and the Accreditation Council for Graduate Medical Education, a not-for-profit organization that sets the standards for U.S. graduate medical education programs, is particularly important to establishing a new standard of care for our country.
As a part of my interview series with leaders in healthcare, I had the pleasure to interview Anthony Romeo, M.D.,
Dr. Romeo is one of the nation’s leading shoulder, elbow, and sports treatment surgeons with more than 27 years of clinical experience — 15 of which were spent as a team physician for the Chicago White Sox, the Chicago Bulls, and as a consultant for numerous NFL, NCAA, and Olympic-level athletes. Having spent his career in the pursuit of excellence for his patients, Dr. Romeo has pioneered new approaches to shoulder replacement surgery and developed advanced orthopaedic implants and surgical procedures that are supported by cutting-edge research and patient-focused outcomes. Dr. Romeo is also the Chief Medical Editor of Orthopaedics Today and the Executive Vice President of DuPage Medical Group’s state-of-the-art Musculoskeletal Institute.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
My dad had a big influence on my medical aspirations. As a physician in the Navy during the Vietnam War, my father developed incredible surgical hands and a unique skill set that differentiated him from other physicians once he eventually opened his own practice in Idaho. As a kid, I was constantly observing my dad at work, and was exposed to many different areas of patient care. By the time I was in high school, I knew I wanted to become a doctor.
My interest in the field only intensified after having sustained two sports injuries. When I was 14 years old, I fractured my ankle playing football and this helped me to realize I wanted to be an orthopedic surgeon. Then, when I was playing football at Notre Dame, I suffered a right shoulder AC joint separation. It became clear that while many doctors at the time had good answers in response to knee injuries, not many knew much about shoulder injuries. My less-than-ideal recovery sparked my interest in shoulder, elbow, and sports treatment specifically. I knew there had to be a better way to treat these types of injuries, and I set out on the path to find out what that was. That was 37 years ago — and I haven’t looked back since.
Can you share the most interesting story that happened to you since you began practicing treatment?
In 2010, a famous baseball player for the Chicago White Sox ripped off his latissimus tendon from his throwing shoulder. At the time, the prevailing recommendation from a number of prominent baseball physicians was to leave it alone as the surgery required to repair the tendon was still unknown. He was told that this course of care would get him back to pitching eventually, but that he may not be able to perform at the same level. Luckily, he visited Dr. James Andrews, who not only recommended it should be fixed, but also advised the player that I should be the one to do the surgery. As a high-earning MLB starter, there was a lot of pressure riding on this surgery. Thankfully, the surgery was successful in restoring his tendon and muscle attachment. In fact, in this player’s second year back from the surgery, he made the MLB all-star game. In 2013, one year after his surgery, he was a key member of the pitching staff for the Boston Red Sox and helped them secure a World Series title. The year after that (2014), he was traded to the San Francisco Giants, and went on to help them win a World Series that year. To this day, he is one of just two pitchers to win two consecutive World Series championships on two different teams.
Today, the surgery itself is an important consideration for any athlete, especially a baseball pitcher, who desires to return back to the same level of performance they achieved before the injury. On a personal level, the surgery remains a pivotal moment in my career. While I had been devoted to becoming a top-level shoulder and elbow surgeon through innovation, teaching, education, and research for the 17 years prior to this surgery, its success propelled my career forward and expanded my recognition from my peers to the general public.
What advice would you give to other healthcare leaders to help their team to thrive?
The healthcare industry is shifting rapidly into a value-based system, which heavily relies on patient-related outcomes data. This data is crucial to a provider’s ability to collaborate with other physicians and ensure that the quality of care given to patients is of the highest standard. Having data all in one place also helps to save downstream costs for the patient, eliminating human errors like duplicity of care or unnecessary surgery. Therefore, healthcare leaders must set up their electronic medical record (EMR) and care model in a way that enables extensive outcomes data collection and analysis. This system makes sharing the data with other providers much more streamlined — and when providers are on the same page, variability in care is reduced and overall patient care greatly improves.
Collecting patient-related outcomes data can also help monitor, evaluate, and improve the care individual physicians are providing, which is one of the pieces that is currently missing from most value-based care models. Many systems now are still too heavily focused on process outcomes, measures used to assess and compare the quality of healthcare organizations. These might include tracking things like the percentage of people receiving preventive services (such as mammograms or immunizations), or the percentage of people with diabetes who had their blood sugar tested and controlled. While these outcomes are easier to measure and collect, they don’t necessarily provide the feedback necessary to validate and improve the care delivered by the individual providers, which can have a tremendous impact on cost. Establishing a system where patient-related outcomes that are directly related to the quality of the care they have received by a provider creates a level of transparency and opportunity for improvement throughout the entire patient’s journey.
According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high-income nations. Can you share a few reasons why you think the US is ranked so poorly?
We rank poorly because the measurements that are used to rank healthcare systems are focused on population metrics, which is significantly affected by the availability of care. In most first world, high-income nations, there is a system that covers every citizen of their nation — and they have excellent benefits for measurable areas that determine the ranking of their healthcare system compared to other nations. Measurements such as availability of care, perinatal mortality, management of chronic disease (and their consequences) are lower in the US because a significantly larger part of our population does not have coverage — either by choice or because of lack of affordability outside of legal gainful employment. Having no care at all is clearly a risk factor for lower overall population outcomes.
However, when looking at the other end of the spectrum, such as the ability to treat a newly recognized problem — like a severe injury or an episode of illness — with a patient who has healthcare, we would be ranked at or near the very best in the world in most categories. So we are doing a great job taking care of those patients who have insurance and have episodic care needs, but that doesn’t help those who don’t. And because our country often drives the innovation and research that leads to better treatments and more advanced protocols of care, it increases the cost of our health care and makes it even more unattainable for many in our population.
If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
Increase access to care for everyone: As mentioned above, the US’s biggest issue with its healthcare system is that it doesn’t work for our entire population. While there is no “perfect” healthcare model to subscribe to, we can make some solid steps to helping counteract this problem. The fragmented system we are currently operating in, in which the private sector cares for the rich and national services care for the poor, creates a disparity between the quality of care provided for each sector. We need both populations to be cared for by the same “provider.” There has never been a better time than now to test new models as the old system is not working for a large segment of our population.
Lift barriers preventing access to ASCs: Forty years ago, nearly all surgeries were performed in hospitals. However, to offset hospitals’ limited resources, high fixed costs, and long wait times, Ambulatory Surgery Centers (ASCs) and other similar facilities were created as an alternative location for specialized surgeries. They provide a host of patient-facing benefits, including reduced wait times, upfront rates, reduced costs, and highly personalized care. Over the years, the number of ASCs has grown in response to demand from patients, physicians and insurers. Despite their advantages, there remain a slew of politically-based barriers limiting providers’ availability to perform procedures in these alternative facilities, and these must be lifted for the sake of our patients’ convenience, comfort, and care.
Provide healthcare costs upfront: Between co-pays, deductibles, and denials, patients and providers alike have a difficult time understanding what healthcare is going to cost. This problem is getting worse with more difficult pre-authorization requirements and the ability for payers to retrospectively deny coverage. Healthcare providers need real-time and easy to access cost and outcome information when they are in the room with patients, so they have an easier time answering questions and building treatment plans that fit patient needs, bettering outcomes in the long run.
Embrace technology to make data-driven decisions: In this day and age, data is king — and in the healthcare space particularly, it’s what will help providers make well-informed decisions that place the patient at the center of care. To leverage this data, providers must invest in technology that seamlessly integrates with their workflows, like electronic health records (EHRs) and revenue cycle management software. These digital solutions are also capable of integrating medical and financial data to deliver pricing information to patients, physicians, and medical staff in real time, helping optimize the delivery of care.
Increase government spending for medical research and education: Although the total U.S. funding in medical and health research and development (R&D) continues to grow in a positive direction, federal R&D funding are oftentimes uneven across health agencies. A focus on increasing federal funding for organizations like the National Institutes of Health (NIH), the nation’s medical research agency (and an organization that only receives 0.10% of our annual funding budget), and the Accreditation Council for Graduate Medical Education, a not-for-profit organization that sets the standards for U.S. graduate medical education programs, is particularly important to establishing a new standard of care for our country.
What concrete steps would have to be done to actually manifest these changes?
There are a lot of routes healthcare professionals can take to improve the U.S. healthcare system — it is a convoluted system, after all. However, perhaps one of the most tangible and realistic strategies to drive positive and lasting change within our healthcare system is through sophisticated data and analytics. This includes:
Breaking down the walls of unknown outcomes to increase transparency across the entire care spectrum, which will further heighten the patient’s awareness of the quality and cost of care.
Identifying large patterns that lead to a greater understanding of population health.
Quantifying an individual physician’s success through high-level data analytics to reduce the variation of care between physicians, therefore reducing the healthcare organization’s spend and keeping costs at a manageable level.
Our healthcare system also needs more physician leaders to help implement the data required to make these changes. Physician and administrative leaders working hand-in-hand — creating a dyad structure — are often more effective at instituting the changes required to improve our healthcare system that are valued by both parties. We stand to gain the most improvements to delivering care, saving money, and leveraging data to optimize health outcomes when these two forces work as one.
How would you define an “excellent healthcare provider?”
- Clinical expertise is incredibly important, don’t get me wrong. However, what separates good physicians from excellent one falls to these three things:
- Always placing the patient at the center of care and striving to provide the best possible patient experience.
- Continuously seeking out new educational opportunities to further his or her professional knowledge.
- A willingness to work with data to improve health outcomes.
Can you please give us your favorite “Life Lesson Quote?” Can you share how that was relevant to you in your life?
The quote, “People don’t care how much you know until they know how much you care,” by Theodore Roosevelt has always stood out to me because it directly relates to my approach to treating patients. I don’t care how good a physician is on paper, or how many accolades he or she has racked up during their years of practice. What matters most at the end of the day is that your patient feels well cared for, heard, and respected. This quote serves as the cornerstone to my practice and is something I tell each surgeon-in-training I’ve mentored over the course of my career.
Are you working on any exciting new projects now? How do you think that will help people?
I recently accepted a position with DuPage Medical Group — the largest independent, multi-specialty physician group in Illinois — as the Executive Vice President of their new Musculoskeletal Institute. Not only am I excited to deliver a new standard of care to the greater Chicago area, a community I love, but I’m also looking forward to doing it with a team of physicians who share my patient-focused principles. By elevating the value-based care model and putting the patient at the center of care, we will build the institute into a true destination for musculoskeletal care that is delivered at the best price, in the most appropriate setting, and with careful attention to patient-related outcomes that will inform how the institute improves its overall patient experience.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I’m a fanatical Audible listener when I’m doing my morning cardio, as well as a committed subscriber to Blinkist, a service that summarizes the core messages of books. There are also many outstanding lectures on YouTube presented by a wide variety of experts I like to tune into.
One of my all-time favorite books is The Seven Habits of Highly Effective People by Steven Covey, and the numerous spin-offs related to the core principles he outlines in this book. I also love to listen to or read anything by Clayton Christensen and the teams he pulls together, especially his theories on how disruptive innovation will revolutionize health care.
I seem to always gravitate toward any type of leadership conversation as I think they’re important to not only helping me become a better leader, but also a better physician and a better person in all facets of life.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.
As an orthopaedic surgeon, my immediate thoughts go to ideas of great technology, surgical precision, and ancillary innovations that enhance the necessary surgical care we provide, such as greater longevity and clinical success. However, when thinking about the entire population, these movements or improvements affect only a small number of people. To bring the most amount of good to a broader spectrum of people, we have to think critically about the social determinants of health. And therefore, my bias as an orthopaedic surgeon would be to focus on a movement that encourages and achieves a consistent level of exercise and proper diet every day of a person’s life. There is no treatment that is more powerful than a daily dose of exercise, and my role would be to help this movement better define what is the threshold necessary to achieve the level of exercise that prevents disease and improves overall function, while developing methods and supplemental tools, devices, and environments to allow this level of exercise to be performed safely.
How can our readers follow you online?
Feel free to connect with me on any of the following social accounts:
Thank you so much for these insights! This was so inspiring!