Orthopedic Surgery Center & Sports Medicine: Dr. Raul Marquez, Chief Executive Officer

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As many solo practitioners in today’s healthcare market find themselves merging with or entertaining employment opportunities with hospitals, finding a balance between independence and partnership with a large organization can be challenging.

Dr. Raul Marquez, of the Orthopedic Surgery Center & Sports Medicine in Edinburg, Texas, seems to have struck a balance in being a solo practitioner that works with a large healthcare organization to provide cost-effective, high-quality orthopedic care for his patients.

Dr. Marquez’s practice is located on a medical campus that includes Cornerstone Regional Hospital, which is part of the South Texas Health System, a rehabilitation hospital, a gym, and physician offices.

“I enjoy independence in my practice,” Dr. Marquez said, “but there is an advantage to being part of a large hospital system. I have been part owners with the hospital for about 15 years, and the relationship with a multi-hospital system provides the advantage to my patients of having access to all the services they need on one campus and to my business from an insurance standpoint.”

At his office, he is able to provide a full complement of services from X-ray, open MRI and other imaging services, to in-house physical therapy.

A reputation for quality and innovation

Dr. Marquez primarily sees patients for total joint replacement and reconstruction. He has been serving patients in the Rio Grande Valley for more than 17 years and is a proponent of new technology and innovation.

In 1999, Dr. Marquez designed and patented a mobile-bearing knee implant known as the RAM Mobile Bearing Knee. The design was developed in conjunction with Encore Orthopedics in Austin, Texas.

As minimally invasive surgery becomes more common and more often requested by patients, Dr. Marquez has met this demand by utilizing a computer-assisted navigation system, the OrthoPilot Navigation system by Aesculap. As with robot-assisted surgery, the system helps remove human error in measurements or implant alignment, providing a procedure with long-lasting results.

Dr. Marquez has been a leader in using the system and travels throughout North America, Europe, and Canada to train other surgeons on the implantation of prosthesis using the navigational system.

Offering cost-effective care

All medical organizations are being asked to do more with less these days, and orthopedics is no exception. Originally from Mexico City and operating hospitals in Mexico, Dr. Marquez has a unique point of view on the value of providing cost-effective surgeries.

“Medical tourism is gaining popularity these days,” he said. “Patients can go outside the United States to receive the same operation for much less, about $10,000. Mexico, India, and countries in South America have strong medical tourism. But in the United States, patients are protected 100 percent with liability insurance and other guarantees. With medical tourism, they’re on their own.”

To encourage more patients to stay in the United States for joint-replacement procedures, Dr. Marquez has developed a total-joint program that provides the surgery for a similar price to other countries. This requires him to negotiate with the hospital, the prosthesis manufacturers, and himself for his own fees.

“We all have to come to an agreement on price, but it can be done,” he said. “My vision is to let physicians know we can do the same procedures in this country for one-third the normal charge.”

Bringing about these negotiations in light of reduced payments and healthcare reform is extremely difficult. Dr. Marquez said that as long as reform continues to reduce fees for medical providers, there is less incentive to be in the business.

“Medicine is one of few businesses where we are lucky if we maintain the same pay every year, whereas many other employment sectors get yearly raises,” he said. “Twenty years ago when I started total joint replacement, Medicare reimbursed about $3,000. Now, the reimbursement rate is about $1,200.”

These reductions do change the business model he has provided over the years, as patients face reduced access to care and Dr. Marquez must make more cost-conscious decisions on prostheses.

“With less money available, it limits the type of prostheses and tools we are able to use in surgery,” he said.

However uncertain the future may be, Dr. Marquez is dedicated to finding solutions for providing affordable care. He is focusing on expanding services and educational initiatives. His practice provides community outreach to patients, educating them on procedures and ensuring they have realistic expectations.

He also provides educational programs that are focused on teaching physician assistants, nurses, and other allied health practitioners about expectations and costs. Dr. Marquez said it’s important that physicians also understand the true cost of surgeries and the difference in cost in providing those surgeries in a hospital.

“I have experience in the hospital side and office side, and I find that we are able to produce more affordable care by knowing the real cost of our work.”

-by Patricia Chaney

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