PubMed abstract / permitted excerpt

INTRODUCTION: Racial disparities in total joint arthroplasty (TJA) utilization are persistent and well-characterized. Improving surgeon workforce diversity may attract patients from diverse backgrounds. We sought to determine whether the recent hiring of an arthroplasty surgeon of underrepresented minority (URM) background in a predominantly non-URM arthroplasty practice was associated with increased patient diversity. METHODS: We retrospectively reviewed all primary and revision elective TJAs by six arthroplasty surgeons at our institution from September 2022 to September 2023. Primary outcomes included patient age, sex, and race/ethnicity. Secondary outcomes included patient-reported outcome measures (PROMs) at preoperative and 3-month postoperative follow-up. Comparison cohorts included the following: (1) a recently hired URM attending surgeon; (2) a recently hired non-URM attending surgeon; and (3) four senior non-URM attending surgeons. Unpaired t-tests were used to compare means for continuous variables and chi-squared tests for qualitative variables. RESULTS: Overall, 2,101 patients were included, and 168 patients were included in group 1 (URM surgeon), 75 in group 2 (non-URM surgeon); and 1,858 in group 3 (non-URM senior surgeons). Compared with groups 2 and 3, patients within group 1 comprised a markedly greater proportion of female, Black, and Hispanic/Latino patients (64.8%, 33.3% and 59.7%, respectively, P < 0.01). Racial and ethnic demographic differences persisted when examining patients treated by the non-URM division in the year before the hiring of the URM surgeon. Subgroup analysis of URM patients showed markedly improved SF-12 mental scores for URM patients treated by the URM surgeon compared with those treated by senior surgeons (P < 0.05). CONCLUSION: Compared with an experience-matched non-URM surgeon and non-URM senior surgeons in the same division, the URM surgeon saw a markedly greater proportion of minority patients in their first year of practice. Hiring diverse orthopaedic faculty may represent a viable strategy for improving health care utilization for minority patients in arthroplasty practices.