John W. Hinchey, MD recently joined Ortho San Antonio and recently sat down with TOA to conduct a Q&A to discuss his thoughts on the future of orthopaedics in Texas.
Dr. Hinchey received his undergraduate degree from Southern Methodist University. He later attended The University of Texas Health Science Center at San Antonio (UTHSCSA) for both medical school and residency training. Dr. Hinchey then continued his training with a fellowship in Shoulder and Elbow reconstruction, where he worked with world renowned surgeons at both UTHSCSA and the Mayo Clinic in Rochester, MN. He is board certified in Orthopaedic Surgery by the American Board of Orthopaedic Surgery, and is a member of the American Shoulder and Elbow Surgeons (ASES) Association.
Dr. Hinchey treats all orthopaedic injuries, and subspecializes in the treatment of shoulder and elbow issues.
For the past five years, Dr. Hinchey provided care for our nation’s veterans as a full-time orthopaedic surgeon at the Audie L. Murphy VA Hospital in San Antonio, TX. He currently is the Assistant Chief of Orthopaedics, and the Chief of the Shoulder and Elbow service. In addition, he is the Assistant Program Director for the Rockwood Shoulder and Elbow Fellowship and holds a position of Adjunct Assistant Professor at UTHSCSA.
Dr. Hinchey is one of the Texas Orthopaedic Association’s five AAOS Board of Councilors.
The following is a Q&A that TOA recently conducted with Dr. Hinchey.
TOA: What was your experience in the VA like?
John Hinchey: Working at the Audie L. Murphy VA (ALMVA) in San Antonio for the last five years as a full-time orthopaedic physician has been a wonderful experience. I thoroughly enjoyed taking care of our nation’s veterans and working with the rotating residents and fellows from the associated medical school. The orthopaedic service line at the ALMVA is a very busy service: We have at least one operating room running and full clinics each day. I originally decided to join the ALMVA team in 2013 for a variety of factors, but the number one reason was that I could not turn down the opportunity to help take care of our nations’ heroes, while at the same time play a role in the education and training of future orthopaedic surgeons.
TOA: How did you choose your new practice?
John Hinchey: In late 2017, a colleague and friend presented me with an opportunity to join Ortho San Antonio. I could not pass up the chance to expand my practice, while still assisting veterans at the VA on a part-time basis. Each physician in our group practices a different subspecialty, but we all complement each other, and are encouraged to be involved in “outside activities” we each find meaningful.
TOA: What changes have you witnessed in orthopaedics since you began your residency?
John Hinchey: Since I started my residency in 2007, I have witnessed a great number of changes over the 10-plus years. When I started training there were no duty hour regulations, and EMRs were just being talked about. During my training, I had to transition from paper charts to electronic charts and begin logging duty hours to meet the ACGME requirements. Oversight of residents has increased, which I feel is a good thing in general, but there still needs to be a graduated ladder of responsibility ultimately ending in essentially full autonomy toward the end of training.
I have seen many advances in “technology” and new implants, most of these without any evidence, just a higher price tag behind them. I personally still practice by the motto of a mentor and current partner of mine, Jesse DeLee, MD: “Never be the first one to adopt usage of a new product.” I have also seen aspects of medicine with excellent evidence which have changed my practice, such as the usage of tranexamic acid (TXA) in arthroplasty.
TOA: Where do you see orthopaedics in Texas ten years from now?
John Hinchey: In my opinion, we will witness a number of changes in medicine over the next decade. Most of these changes will most likely be legislative and/or regulatory mandated. For example, there is the legislative mandate to check the Prescription Monitoring Program (PMP) starting in September 2019. This will be a large change for most physicians, especially those still using paper charts, and the mandate will necessitate interoperability between EMRs and the PMP. In addition, “scope of practice” issues are always on the legislative watch list.
Specifically in regards to orthopaedic surgery, I have watched an increase in the number of residents and fellows choosing to be a hospital- or system-employed surgeon after training, compared to the number who are accepting a position with an academic or private practice setting. I am worried that over time this trend will grow, which could slowly diminish the autonomy of practice. If this occurs, surgeons may not be able to choose the implants of their choice, they may be told which patients to treat, their practice setting could be limited, and the amount they work may be controlled.
TOA: You are active in the political nature of medicine. Why is this important to you?
John Hinchey: I am highly involved in what is commonly referred to as “organized medicine” at a local, state, and national level by sitting on multiple boards and committees. I feel it is very important to protect the doctor-patient relationship, the practice of medicine, and improve appropriate access to care for patients.
As I have always been told, “if you are not at the table, then you are on the menu.” If physicians do not advocate for the practice of medicine and their specialty, then who will do it for us? I have seen the direct effects of legislative/regulatory actions which have impacted the way medicine is practiced. One of the most memorable legislative wins is Texas tort reform in 2003, which changed the medical landscape in Texas by increasing access to medical care and the number of physicians practicing in Texas. We continuously always have to defend tort reform and showcase its benefits to the public.