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Orthopaedic Practice Setting Opinions: Heat Maps for a Hot Topic.

Zachary N Jodoin¹, Daanish Sheikh¹, Morgan Gable¹

¹UT Health San Antonio Department of Orthopaedics, San Antonio, Texas.

JB & JS Open Access

|October 20, 2025

Summary

Orthopaedic surgeons weigh practice settings carefully. Academic roles offer education and reputation, while private and privademic settings provide greater autonomy and income. California surgeons report lower satisfaction, particularly with compensation.

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Area of Science:

Orthopaedic Surgery
Surgical Practice Management
Medical Economics

Background:

Orthopaedic surgery practice setting selection is critical but often based on anecdotal evidence.
A lack of comparative data exists on surgeon experiences across different practice models.
This study addresses the need for quantitative data on the strengths and weaknesses of various orthopaedic practice environments.

Purpose of the Study:

To quantify and compare the perceived strengths and weaknesses of academic, private, hospital-employed, and privademic practice settings for orthopaedic surgeons.
To identify key factors influencing surgeon satisfaction across different practice models and geographic locations.

Main Methods:

An anonymous online survey was distributed to orthopaedic surgeons in Texas and California.
Respondents reported practice setting, subspecialty, and employment location.
Surgeons rated practice environments on autonomy, salary, ancillary income, education, research, administrative burden, reputation, community respect, and work-life balance.

Main Results:

Academic surgeons prioritized research, reputation, and education, but reported low ancillary income.
Private practitioners valued autonomy, salary, and ancillary income, but rated education and research poorly.
Hospital-employed surgeons reported no highly rated categories, while privademic surgeons were favorable across autonomy, salary, and income.
California surgeons perceived lower autonomy, work-life balance, and compensation compared to other regions.

Conclusions:

Distinct tradeoffs exist between orthopaedic practice models, with academic settings emphasizing professional growth and private/privademic settings offering greater financial and autonomous benefits.
Regional differences, particularly in California, may significantly impact surgeon satisfaction, especially concerning compensation.
Findings provide data to inform orthopaedic career planning and healthcare workforce policy decisions.