The Incision Point

The Incision Point

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Are Hospital Systems Driving Out Their Best Surgeons?

Unpacking one surgical team's radical decision to buy a van, battle a non-compete, and build an independent statewide joint replacement institute.

Dr. Michael Meneghini's avatar
Dr. Michael Meneghini
Sep 18, 2026
∙ Paid

Orthopedic surgery relies on dedicated clinical teams meticulously building high-quality programs to deliver excellent patient care. In an era of increasing administrative creep and dwindling resources, hospital systems are increasingly prioritizing management expansion over clinical support, leading to a regression to the mean for high-performing physicians.

This systemic healthcare transition has gradually and inadvertently devalued the providers who actually generate revenue and care for patients. Despite grueling schedules and clinical excellence, surgical specialists frequently find themselves trapped in restrictive non-compete agreements, unable to freely innovate or advocate for their teams without facing massive geographic penalties. Faced with hospital dysfunctionality, one surgeon decided to step outside the traditional healthcare system entirely.

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