Tiger BufordYour Orthopedic Industry Expert (free today)

What has changed Ortho healthcare in the last 10 years, the complicates selling new products.

27 Jun 2025 · 1 min

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1:00

In this presentation, the speaker explains how the consolidation of hospitals into larger health systems over the past ten years has reduced the influence of individual orthopedic surgeons and slowed the adoption of new products. He contrasts an earlier, fast decision process—where a small value analysis committee (VAC) could approve a new product within about 30 days—with the current, more complex process in multi‑hospital systems, where the same VAC is now part of a larger network (e.g., a 10‑hospital system with ambulatory surgery centers) and decisions can take 45‑60 days or longer. The speaker uses a specific example of a hospital that became part of the "Our Lady of No Air Conditioning" health system to illustrate how added layers of supply chain, risk management, and additional stakeholders extend timelines and dilute clinicians' "juice" in product selection.

Chapters

and doctors have less juice in bigger systems. And I'm gonna show you how little juice they have at some one point. And there was a value analysis committee. It was a small group, but they would decide on new products. So I'd call on this doctor, he or she would say, I like this. I'd go talk to those 3 people or I'd have the doctor talk to 'em. And they would say, cool, they'd make a decision. Usually took about 30 days if not faster. Around 2019, it started to look a lot more like this. That same hospital was now part of Our Lady of No Air Conditioning's health system. Still the same people on the VAC, maybe a couple of other people, supply chain, risk management. So I could still call on the same people. And instead of it taking 30 days, it might take 45 or 60. Here's what it looks like now in the average health system in the United States. Our Lady of Noah Air Conditioning is now part of a 10-hospital, 2-ambulatory surgery center, at least, health system.