Burnout Among Existing Surgeons Was Rising, Recruitment Efforts Were Falling Short, and the Future of the Orthopedic Program Was in Serious Doubt.

The Issue: A Hospital System Facing an Uphill Battle

A prominent regional hospital system in the northeastern United States faced a growing crisis in its orthopedic surgery program. Despite a strong reputation and a commitment to quality care, the program was faltering: elective surgery volume had stagnated, trauma cases were being transferred out at an unsustainable rate, and inconsistent surgical coverage was eroding staff morale and community trust.

Each patient transfer was more than a lost revenue opportunity — it meant fragmented care, frustrated patients, delayed treatments, and missed chances to build community loyalty. Administration faced a catch-22: without 24/7 trauma coverage they couldn’t retain surgical talent or justify program expansion; but without volume and infrastructure they couldn’t recruit the talent needed to make growth sustainable.

Traditional coverage models — relying on overworked full-time staff, expensive and disjointed locum tenens providers, or partial call coverage — were no longer viable. The hospital system needed a different, scalable approach.

Case Study Summary

How the Surgicalist Model helped a hospital increase local access to care and achieve Level II Trauma Designation.

The Partnership: Finding a Scalable, Modern Solution

Hospital leadership partnered with Synergy Health Partners to implement a fractional surgical coverage and strategic program-development model. Rather than using short-term patches, Synergy proposed a lasting solution: a Surgicalist Model designed to rebuild the orthopedic service line from the inside out.

Synergy’s approach is based on predictability, continuity, and integration. The Surgicalist Model uses a shift-based, team-oriented structure where surgeons commit to scheduled blocks of clinical time (typically 7–10 consecutive days). These Surgicalists are not transient; they become embedded in hospital culture and operations.

Unlike locum tenens or moonlighting arrangements, Surgicalists take part in quality initiatives, serve on committees, collaborate with emergency and hospitalist teams, and ensure reliable access to both urgent and elective surgical care, day and night.

The Solution: A New Surgeon Coverage Plan Takes Shape

Implementation began at the hospital with the highest trauma transfer rate and the largest orthopedic coverage gaps. Synergy deployed three full-time orthopedic Surgicalists who rotated on predictable, recurring shifts.

Those surgeons provided:

• Comprehensive trauma call coverage 24/7/365
• Collaboration with the system’s full-time staff and partners
• Greater standardization of clinical workflows
• Participation in hospital quality and operational meetings

Because Surgicalists worked scheduled blocks rather than being continuously on-call or spread thin across obligations, they delivered consistent, high-quality care while maintaining professional balance — a critical factor in reducing physician burnout.

Deliberately Designed to Scale

As volume and outcomes improved, the system expanded Synergy’s presence to a second and third hospital campus, ensuring continuous orthopedic coverage at multiple sites. Synergy worked with system leadership to align performance goals with coverage metrics, creating financial and clinical accountability.

Upping the Ante: Level II Trauma Center Designation

The hospital system later asked Synergy to help pursue Level II Trauma Center designation. Synergy provided guidance, milestone reporting, and operational pivots to create round-the-clock orthopedic surgical access. Synergy also advised on improvements in related areas such as neurosurgery, anesthesiology, and critical care.

Because a highly integrated Surgicalist team was already in place, meeting stringent designation requirements became achievable. Ultimately, the system was granted Level II Trauma Center status.

The Result: A Transformed System with a Resilient Future

By the second year of the partnership, the orthopedic program’s success led to the addition of a third hospital site. Over six years, the system transformed from unstable coverage and high transfer rates to a regional leader in orthopedic care.

Key outcomes:

• 40% growth in orthopedic surgical volume
• Expansion from 2 to 3 hospital campuses with full orthopedic coverage
• 24/7/365 trauma call coverage at all sites
• Successful recruitment of 8 full-time and 4 part-time orthopedic surgeons
• Addition of 2 dedicated advanced practice providers (APPs)
• Achievement of Level II Trauma Center designation in Year 6

Beyond the metrics, the system saw dramatic reductions in patient transfers, improved scheduling efficiency, higher staff satisfaction, and better alignment between administrative goals and clinical performance. Patients now receive timely, expert care close to home.

The Virtuous Cycle

Predictable coverage led to improved care, which drove higher volumes, which justified further investment. That investment supported recruitment and retention, allowing the program to strengthen over time.

Closing Thoughts: Partnerships Are Integral to Success

This case demonstrates how hospital systems and strategic partners can align around a vision for sustainable, integrated surgical care. The Surgicalist Model is not just a coverage fix — it’s a clinical strategy that addresses burnout, inconsistency, coverage shortages, and lost revenue.

By choosing Synergy Health Partners, this hospital system gained continuity, performance, and a clear path forward.

“Our approach to each facility is different as we work from the inside out to create a customized plan that doesn’t simply provide coverage, but that also examines pain points, stringently monitors processes, sets goal horizons, and collaborates intensively with hospital staff. We aren’t a vendor; we’re your team’s partner.”
— Dr. Richard Makowiec, MD, MBA, Chief Medical Officer