The Problem
Even before the federal spending bill signed in July 2025 introduced sweeping changes, rural hospitals across the United States were already under immense strain. Many were closing their doors, leaving communities with fewer healthcare options and forcing patients to travel long distances for essential services. These closures placed even greater pressure on the remaining facilities, many of which lost millions of dollars in revenue each year due to inconsistent surgeon availability.
In West Virginia, nearly all rural communities are classified as Health Professional Shortage Areas (HPSAs) and Medically Underserved Areas (MUAs) under federal guidelines. Recognizing the critical need for local surgical access, one forward-thinking hospital in the state set out to establish a dedicated orthopedic surgery program—a service that had long been unavailable to its patients.
However, launching a full surgical department from scratch posed an enormous challenge, especially for a rural hospital facing limited resources and recruitment barriers.
The Solution
The hospital’s leadership partnered with Synergy Health Partners to design, staff, and manage a new Surgicalist program for orthopedic surgery.
Surgicalists are fractional surgeons who are dedicated to a single hospital and work on a predictable rotation schedule—typically seven to ten consecutive days per month—providing call coverage and inpatient consultations. Unlike temporary locum tenens physicians, Surgicalists integrate into the hospital team, participate in committees, and collaborate closely with local staff and administrators to strengthen operations and expand services.
Synergy’s team took a comprehensive approach, building the orthopedic surgery program from the ground up. This included:
- Establishing clinical infrastructure, vendors, and supply chains.
- Creating and staffing an outpatient clinic.
- Recruiting and onboarding three full-time Surgicalist physicians.
- Launching both general and emergency surgical services to meet community needs.
- Promoting the new orthopedic program to patients in the surrounding area.
The result was a fully operational orthopedic department capable of providing continuous coverage and a wide range of surgical services.
The Result
Through the partnership with Synergy Health Partners, the West Virginia hospital gained the ability to offer 24/7/365 coverage for both general and emergency surgery. The hospital also successfully staffed a full orthopedic department capable of providing fracture services, elective procedures, follow-up care, and post-operative support.
Over the past five years, Synergy has continued to support the hospital’s growth, maintaining a team of three full-time and two part-time providers who handle orthopedic surgery, general surgery, and emergency department coverage. The results have been transformative:
- 115% growth in patient volume within the first few years.
- Patient satisfaction consistently above 90%.
- Improved access to care for a medically underserved population.
“The real results of this partnership between a West Virginia hospital team with a goal and Synergy Health Partners demonstrate the true value of a Surgicalist program for any hospital—particularly those in rural areas,” said Dr. Richard Makowiec, MD, Chief Medical Officer of Synergy Health Partners.
“As a practicing orthopedic surgeon, I know firsthand that this is a high-stakes, high-revenue field that demands a better staffing solution than what’s traditionally available. Fractional surgeon staffing through the Surgicalist model expands access to care, increases patient volume, and maintains high satisfaction—driving more referrals and supporting a healthier bottom line.”
Summary
The Surgicalist Model has proven to be a sustainable and strategic approach to healthcare delivery in rural environments. It helps hospitals attract and retain surgeon talent while creating a work environment that supports balance and long-term retention. For physicians, it offers flexibility and predictable schedules. For hospitals, it ensures consistent coverage and reliable access to surgical care.
Ultimately, this partnership demonstrates how Synergy Health Partners’ Surgicalist programs can empower hospitals to meet community needs, improve patient outcomes, and achieve measurable growth.
