Latest / Becker’s Healthcare Podcast / Advancing Shoulder and Elbow Care in 2026 with Dr. Aaron Chamberlain of Intermountain Health: Part 1

Transcript

Advancing Shoulder and Elbow Care in 2026 with Dr. Aaron Chamberlain of Intermountain Health: Part 1 · Becker’s Healthcare Podcast

• 0:00
  Hi, everyone. This is Lucas Voss with Becker's
• 0:02
  Healthcare. Thanks so much for tuning in to
• 0:03
  the Becker's Healthcare podcast series. It's great to
• 0:06
  have you, and I'm excited to welcome you
• 0:08
  to part one of our series on the
• 0:11
  evolution of soldier surgery and the increasing shift
• 0:14
  to ASC
• 0:15
  Environments. And joining me for today's discussion,
• 0:18
  fantastic
• 0:19
  to have him, is doctor Aaron Chamberlaine. He's
• 0:22
  a board certified orthopedic surgeon with the Intermountain
• 0:24
  Orthopedic Specialty Group. His clinical interests include leading
• 0:27
  edge surgical management of shoulder and elbow problems,
• 0:31
  as well as innovative arthroscopic
• 0:33
  and open reconstructive surgical techniques. Doctor Chamberlain is
• 0:36
  passionate about advancing and innovating surgical care of
• 0:39
  the shoulder and elbow, which we'll hear about
• 0:41
  in a little bit. Doctor Chamberlain, it's great
• 0:43
  to have you. Thanks so much for being
• 0:45
  here today. Thank you, Lucas. It's good to
• 0:47
  be with you. Absolutely.
• 0:48
  We need to start at the beginning.
• 0:50
  How does one get into shoulder and elbow
• 0:54
  orthotics?
• 0:55
  I'd love to hear a little bit more
• 0:56
  about how you got into the space and
• 0:57
  then what interests you in the space.
• 1:00
  Yeah. I think it's, you know, as with
• 1:02
  many things, it's it's a long road and
• 1:04
  a series of decisions. Right? So from medical
• 1:06
  school, we we kind of have an an
• 1:08
  idea of what type of,
• 1:10
  you know, physician we wanna do and, you
• 1:12
  know, and types of things we wanna practice.
• 1:14
  And so a lot of us make a
• 1:15
  decision. We wanna go surgical versus nonsurgical. And
• 1:18
  once we've made a decision to go surgical
• 1:20
  and orthopedics is a is a common area
• 1:22
  to consider,
• 1:23
  within orthopedic surgery residency, one of the subspecialties
• 1:27
  you can select is shoulder and elbow surgery.
• 1:29
  And and one of the things that drew
• 1:31
  me to shoulder and elbow surgery was the
• 1:33
  the the kind of vast,
• 1:36
  diversity of surgical techniques we use, you know,
• 1:39
  anything from an arthroscopic
• 1:41
  minimally invasive technique to more,
• 1:43
  large reconstructive
• 1:45
  open surgical techniques and being able to manage
• 1:48
  and and try to try to manage everything
• 1:50
  from all from simple to complex in the
• 1:52
  shoulder
• 1:53
  rather than just doing, you know, part of
• 1:55
  that spectrum of care that there's subspecialty of
• 1:58
  shoulder and elbow surgery.
• 1:59
  And that training lends itself well to
• 2:02
  that, kinda be the master of the joint,
• 2:03
  so to speak, and be the the subject
• 2:05
  matter expert.
• 2:07
  And then along with that interest, I I
• 2:09
  was,
• 2:10
  fortunate,
• 2:11
  to work alongside some fantastic mentors. So in
• 2:14
  my residency,
• 2:15
  doctor Rick Mattson, who's, considered one of the
• 2:17
  father figures in shoulder shoulder surgery in The
• 2:20
  United States and north in the world, really,
• 2:22
  working alongside him in residency along with doctor
• 2:25
  Winston Warm. And then doing a a shoulder
• 2:27
  and elbow fellowship was kind of that next
• 2:29
  decision where, you know, trying to follow follow
• 2:33
  doctor Mattson's lead,
• 2:35
  and and his guidance and went into the
• 2:36
  shoulder and elbow fellowship at Washington University in
• 2:38
  Saint Louis and was able to work with,
• 2:40
  again, some fantastic mentors in doctor Ken Yamaguchi,
• 2:43
  doctor Lisa Gallitz,
• 2:44
  doctor Jay Keener,
• 2:46
  at WashU in Saint Louis and had a
• 2:48
  great, experience there, learned a ton about shoulder
• 2:51
  and elbow surgery, and was able to stay
• 2:53
  on there as faculty,
• 2:54
  for a little over a decade, as part
• 2:56
  of the shoulder and elbow,
• 2:58
  faculty,
• 2:59
  before joining Intermountain Health,
• 3:01
  a few years ago.
• 3:03
  Feel like your title should just be a
• 3:04
  master of joints. I love that. That's a
• 3:06
  fantastic title to have. And, again, speaking of
• 3:09
  titles, you certainly have a a unique role
• 3:11
  within Intermountain Health. I was wondering if you
• 3:13
  can talk a little bit about what your
• 3:15
  day to day looks like there,
• 3:16
  and how you really see health care evolving
• 3:19
  in your space, but also certainly beyond.
• 3:22
  Yeah. So my title within and my role
• 3:24
  within Intermountain Health is so I'm the senior
• 3:26
  medical director for the Musculoskeletal
• 3:28
  Clinical Program. So orthopedics essentially for our for
• 3:32
  our system. It's one of the larger health
• 3:34
  systems, in the country, and so we have
• 3:36
  a large large geography. But my role is
• 3:38
  to oversee and and guide, clinical best practice,
• 3:42
  and innovation
• 3:43
  care delivery of for orthopedics for our health
• 3:46
  system.
• 3:47
  On a day to day basis, my my
• 3:49
  time is roughly split half and half between
• 3:51
  my administrative role as well as my clinical
• 3:53
  practice that I that I continue to work
• 3:55
  with. But my what really intrigued me about
• 3:58
  this role and this job with Intermountain is
• 4:00
  the opportunity
• 4:02
  to kinda work in an area that I'm
• 4:03
  passionate about, which is how do we innovate
• 4:05
  and solve the bigger picture problems we see
• 4:07
  within health care.
• 4:09
  How do we solve and work toward more
• 4:11
  affordable health care, better clinical outcomes, more efficiency?
• 4:14
  How do we innovate in a way that
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  takes advantage of the,
• 4:17
  the technologies that we see evolving, and how
• 4:19
  can they best help us in health care
• 4:21
  and specifically within musculoskeletal
• 4:23
  care. So that's that's my my role and
• 4:25
  my area of focus, within my senior medical
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  director
• 4:29
  role within Intermountain in addition to my clinical
• 4:31
  practice.
• 4:32
  And you spoke a little bit about how
• 4:34
  how health care is evolving and, obviously, some
• 4:36
  of the challenges that we're seeing that that
• 4:37
  are evolving with
• 4:39
  health care certainly here this year,
• 4:41
  into next year.
• 4:43
  And we've seen a lot of this impact,
• 4:45
  especially practices like yours in terms of shoulder
• 4:49
  cases really migrating rapidly to ASC settings primarily.
• 4:53
  What do you think has driven that specific
• 4:56
  shift, and what impact has it had on
• 5:00
  both patients, but then also certainly on providers?
• 5:03
  Yeah. The shift to ASCs has been one
• 5:05
  of the biggest,
• 5:06
  changes we've seen in musculoskeletal
• 5:08
  care over the last several years.
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  I I think, in my opinion, we were
• 5:13
  shifted and pushed in that direction a little
• 5:15
  bit with COVID where being in the hospital
• 5:18
  became a problem and and bigger challenge for
• 5:20
  us. And so we collectively, in our profession,
• 5:23
  I think, learned
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  how we can help patients get out of
• 5:26
  the hospital or have have the surgery done
• 5:29
  in a non inpatient way. So whereas many,
• 5:32
  many years ago, patients would stay multiple nights
• 5:34
  in a hospital, we quickly we had been
• 5:36
  moving in that direction, and I think COVID
• 5:38
  accelerated that learning process of how do we
• 5:40
  safely and effectively
• 5:42
  help patients get through a surgical episode and
• 5:44
  then and be out of the hospital. And
• 5:46
  with that,
• 5:47
  alongside that, I should say, there was the
• 5:50
  the the ASC strategy that came came to
• 5:52
  bear and became a little more accelerated around
• 5:54
  that same time point where it became clear
• 5:56
  that, you know, with, with some of the
• 5:58
  early experience, we could provide a better patient
• 6:00
  experience,
• 6:01
  better outcomes in in most cases,
• 6:04
  and have it, cost less to the patient
• 6:07
  and cost less to the system to have
• 6:09
  it done in AAC. And so with the
• 6:11
  clinical learnings we have shifting from an inpatient
• 6:13
  to more outpatient total joint replacement surgery,
• 6:16
  Along with that, the economics of the ASC,
• 6:19
  I think those
• 6:21
  there's been two pretty powerful drivers
• 6:23
  to get more cases to the ASCs.
• 6:26
  And now we see that that, you know,
• 6:28
  health plans,
• 6:29
  are are also kind of accelerating that. They've
• 6:32
  they've we've seen a lot of partnerships
• 6:34
  with health plans where they're trying to provide
• 6:36
  incentives to providers to drive cases toward ASC
• 6:39
  where the claims expense savings is substantial on
• 6:42
  the health plan side. We also see patients,
• 6:44
  now more and more requesting for their cases
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  to be done to ASC. They experience everything
• 6:49
  from something as simple as just finding parking
• 6:51
  and getting into the building, you know, having
• 6:53
  efficient, you know, an an efficient time efficient
• 6:56
  experience in the in the for their surgery
• 6:59
  day,
• 7:00
  and then having a more kind of a
• 7:02
  a a personal touch, to their to their
• 7:05
  surgical experience we can provide at the ASC.
• 7:07
  So I think, you know, moving forward, we're
• 7:09
  gonna continue to see that drive,
• 7:12
  from the patient standpoint,
• 7:14
  in their experience as well as the health
• 7:16
  health plan or health insurance standpoint as well.
• 7:19
  And then I should say for the providers,
• 7:21
  it's my favorite place to work is in
• 7:22
  a is in our surgical center. I mean,
• 7:24
  we have great efficiencies. We got a great
• 7:26
  team. People care, you know, put the patient
• 7:29
  first, and we're able to make decisions in
• 7:31
  a more nimble way around how do we
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  think this is gonna positively affect the the
• 7:35
  care of patients we see, and we can
• 7:37
  we can enact those changes quickly.
• 7:39
  I I was going to say or or
• 7:40
  ask rather,
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  what's for you? What's the you've mentioned a
• 7:44
  couple of them, but what's sort of the
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  number one biggest advantage
• 7:47
  of performing these cases in that ambulatory setting
• 7:51
  for you as a surgeon versus actually being
• 7:53
  in a hospital?
• 7:54
  Yeah. So for me as a surgeon where
• 7:56
  my primary concern is how is my patient
• 7:58
  my the patient gonna feel and and what's
• 8:00
  their experience gonna be like. I feel most
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  confident as a provider that I can create
• 8:05
  and and provide that experience for my patient,
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  number one. Number two, you know, I can
• 8:10
  I can be I I'm passionate? I think
• 8:12
  a lot of my colleagues are passionate around
• 8:14
  how do we help health care be more
• 8:15
  affordable.
• 8:16
  I I know, and I I as part
• 8:18
  of my job, I can see the the
• 8:20
  the expense the the difference in expense to
• 8:22
  the health plan and the patient in many
• 8:24
  cases
• 8:25
  around doing the surgery at the ASC versus
• 8:27
  in a hospital setting. So we're clinically appropriate.
• 8:29
  I feel feel pretty strong that I'm able
• 8:32
  to save the patient money in their pocket,
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  and that's one of the things that I
• 8:34
  feel strongly about in general is how do
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  we help our patients feel like health care
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  is more affordable,
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  and, you know, and accessible in that way.
• 8:42
  And so for me and then thirdly, it's
• 8:45
  obviously more efficient for me. I I have
• 8:47
  the same team that I work with every
• 8:48
  every time I operate. I can, you know,
• 8:50
  affect change, and we can make decisions that
• 8:53
  are,
• 8:53
  that help the process be more safe, more
• 8:56
  higher quality, and more efficient.
• 8:58
  So for a provider that that having that
• 9:00
  ability to affect change like that like that,
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  I think, is is a big deal.
• 9:05
  Speaking
• 9:06
  of efficiencies, I think we'd be remiss if
• 9:08
  we didn't talk about technology and a little
• 9:10
  bit about the innovation that's been happening in
• 9:12
  this space. Again, not just this year, but
• 9:14
  probably over the last five years and certainly
• 9:16
  heading into 2026.
• 9:17
  And, certainly, patient expectations are are changing as
• 9:21
  well. They they continue to shape the outpatient
• 9:23
  orthopedic space.
• 9:25
  How do you see this technology,
• 9:27
  this innovation that's happening so rapidly on a
• 9:30
  regular basis impacting the space? And, certainly, if
• 9:33
  you could talk about the patient expectations too
• 9:34
  that are rising on a consistent basis,
• 9:37
  as well.
• 9:38
  Yeah. So our again, starting with the patient,
• 9:40
  our patients are expecting, and I think rightly
• 9:43
  so,
• 9:44
  high precision, you know, experience when it comes
• 9:46
  to a surgical intervention, they're expecting precision.
• 9:48
  They want to know that we are doing
• 9:50
  everything we can to minimize
• 9:52
  complications while maximizing their opportunity for a good
• 9:55
  outcome.
• 9:56
  And so we need, as a profession, to
• 9:58
  continue to identify and then leverage any technology
• 10:01
  that helps
• 10:02
  meet those expectations in the patient. And so
• 10:04
  to do that, you know, as far as
• 10:06
  identifying how do we, you know, minimize
• 10:08
  complications, I think any technology that helps us,
• 10:12
  be more precise to avoid outliers as far
• 10:15
  as surgical technique or implant positioning, things like
• 10:18
  that that may affect, patient outcomes. I think
• 10:21
  it's our job and our responsibility to to
• 10:23
  find those opportunities to minimize those kind of
• 10:26
  complications.
• 10:28
  We wanna utilize everything
• 10:29
  anything that helps us technically to perform the
• 10:32
  procedure better in a more precise way to
• 10:35
  understanding data. You know, how do we identify
• 10:37
  what are we doing that's helping patients? You
• 10:39
  know?
• 10:39
  Data is is gold nowadays with with health
• 10:42
  care among other industries. But within health care,
• 10:45
  we need to do a better job and
• 10:47
  and leverage the technology we have available to
• 10:49
  understand
• 10:51
  outcomes. When we make decisions as providers,
• 10:53
  are we measuring and how are we measuring
• 10:56
  to understand the effect that it has on
• 10:57
  the patient outcome? Does it make a difference?
• 10:59
  Yes or no? To what extent is it
• 11:02
  making a difference? How much should we be
• 11:04
  paying for such a technology because of the
• 11:06
  difference it's making? So that's where utilizing that
• 11:08
  data and understanding
• 11:10
  the effects of our decisions, I think, goes
• 11:12
  a long way as well.
• 11:14
  Doctor Chamberlain,
• 11:15
  the master of joints. I'm establishing this happening.
• 11:18
  Thank you so much for your time and
• 11:20
  insights today. It's fantastic to have you.
• 11:22
  Thank you. Thanks for letting me join you.
• 11:24
  Absolutely. We also want to thank our podcast
• 11:27
  sponsor, the Pew's and Theys. Make sure to
• 11:29
  come back for part two of our series
• 11:31
  tomorrow and tune in to more podcasts from
• 11:33
  Becker's Healthcare Care by visiting our podcast page
• 11:36
  at beckershospitalreview.com.