There are three orthopedic surgeons who currently travel to Winnemucca for scheduled patient visits.
Some relatively minor orthopedic surgeries are performed at Humboldt General Hospital, but most people who need orthopedic surgery must leave Winnemucca.
Humboldt General Hospital's administration and board of trustees are taking a serious look at two different medical program providers, each of which would like to bring in orthopedic surgeons who would rotate to provide orthopedic surgical services at the hospital.
Winnemucca is already familiar with Rural Physicians Group, which made its presentation first to board members. Rural Physicians Group RPG has worked with HGH since 2011, providing the hospitalist doctors who are always on call at the hospital and, more recently, providing the two general surgeons who rotate to provide surgery and related services at the hospital.
It was this existing relationship that RPG representatives focused on in their pitch.
RPG's proposal was to bring two to three experienced orthopedic surgeons who would rotate every five to seven days to provide services in Winnemucca. Outpatient clinic services would be available to serve patients before, and after surgery as well. When in the community for their rotation, the surgeons would live in the house HGH purchased several months ago near the hospital campus and would be on-call 24-hours a day, seven days a week, 365 days a year. As with the current hospitalist doctors and surgeons who work with RPG, the doctor on call would always be available to patients by cell phone.
The effort to bring an orthopedic surgical program to Winnemucca would be RPG's first foray into providing orthopedic surgeons and setting up a practice in a community. RPG's representative said the company had been working for five years to develop the program they would propose to bring into Winnemucca.
RPG's charge for bringing in the orthopedic surgeons and setting up the orthopedic surgical practice at HGH was $821,250 per year. This amount would include a guaranteed income amount and benefits for surgeons. HGH would bill patients for hospital costs and the surgeons would bill patients for the surgery and pre-post care.
The other company interested in providing orthopedic services through the hospital is Synergy Surgicalists (SS), a company run by two partners who are orthopedic surgeons themselves. SS provides orthopedic surgical services to five hospitals and communities already. Dr. John Campbell said this would give orthopedic surgeons who might come to Winnemucca to work the advantage of having a larger number of surgeons at other locations within the same company, with whom they could collaborate.
"We're the only surgeon-run orthopedic surgical company in America," said Campbell. He said that because he and his partner are orthopedic surgeons themselves they have an advantage in attracting and keeping the specialists.
SS proposed to bring in a team of three orthopedists who would rotate to provide services and become the community's orthopedic surgeons. As experienced surgeons, they would train the hospital's nurses and support staff on orthopedic protocols.
Campbell said his company creates efficiencies by setting up specific clinical treatment protocols and utilizing orthopedic implant standardization, rather than having each doctor using different methods and types of implants.
The costs of the SS proposal were higher than the RPG proposal. SS would charge nearly $1 million a year. Both companies outlined return on investment, saying the hospital would easily retain that amount and more in the community by offering orthopedic surgical services to area patients.
Board members asked what type of orthopedic procedures could be performed at the hospital, with current operating rooms and facilities.
Both presenters felt basic orthopedic trauma services would be possible, as well as arthroscopic surgery, rotator cuff tears, and similar procedures, as well as basic trauma services. More advanced orthopedic surgeries, such as total knee and hip replacement surgery would be a possibility if the hospital goes forward with a new second-floor surgical building project, planned for future phases of construction at the hospital.
Both companies' representatives said they believe that, with an orthopedic surgical practice, HGH would be able to retain enough of the patients who are currently going out of town for orthopedic procedures to make the program cost effective. HGH would also be able to upgrade trauma services significantly.
Board member Kevin Chatfield wondered whether the community would be able to provide the physical therapy services that would be needed after those additional surgeries and orthopedic services.
Physical therapist Mike Snow, a partner in Rehab and Industrial Services in Winnemucca, said nearly all the people who are having orthopedic surgery outside the community are currently having their physical therapy needs taken care of locally. He noted that physical therapy after surgery is often done several times a week, so people are already staying in the community for those services.
Andrew Hillyer of Humboldt Physical Therapy was not available for comment, but staff at the business noted patients of the orthopedic surgeon based out of Humboldt Physical Therapy do have physical therapy after surgery locally rather than traveling several times a week.
The hospital board wasn't asked to make a decision between the providers who presented; the issue will be considered in future meetings.
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