Podcast Summary: Becker’s Healthcare Podcast – Dr. Nolan Wessell

Episode Date: December 8, 2025
Guest: Dr. Nolan Wessell, Assistant Professor and Well-being Co-Director, Department of Orthopedic Surgery, Division of Spine Surgery, University of Colorado School of Medicine
Host: Carly Beam

Overview

This episode features Dr. Nolan Wessell, an orthopedic spine surgeon and Well-being Co-Director at the University of Colorado School of Medicine. The conversation explores physician burnout, well-being initiatives, technological and policy trends in spine surgery, the impact of AI on practice efficiency, challenges posed by reimbursement shifts, and the importance of physician advocacy.

Key Discussion Points and Insights

Dr. Wessell’s Background and Role

• Grew up in Wisconsin, trained in Detroit, currently practicing and teaching in Colorado (00:23).
• Majority of his clinical work is in south metro Denver, with some practice at the university’s main campus (00:57).

The Burnout Crisis in Orthopedic Surgery

• Burnout is widespread among healthcare workers, especially heightened post-COVID (01:33).
• “Currently about 40% of active orthopedic surgeons endorse symptoms consistent with burnout and depression. Over the course of an orthopedic surgeon’s career, upwards of 60 to 65%... may suffer from symptoms of burnout and depression.” — Dr. Wessell (01:44)
• Burnout contributes to early attrition, which is particularly concerning given the increasing need for orthopedic care (02:20).
• Well-being initiatives at the University of Colorado include serving providers’ wellness in addition to patients’ needs, with an evolving focus (02:46).

Training the Next Generation and Shifting Culture

• Work-life balance is a central theme for younger surgeons and trainees compared to an older “work, work, work” mentality (03:48).
• Colorado’s outdoors culture supports prioritizing personal well-being alongside professional dedication (04:16).
• “People really want to make sure that they’re taking care of their own well-being in conjunction with caring for patients.” — Dr. Wessell (04:39)

Technological Trends: Robotics and Artificial Intelligence in Spine Surgery

• Robotics and AI are rapidly shaping the future of spine surgery, with more personalized preoperative planning and custom 3D-printed implants (05:15).
• Robotics in spine is still developing compared to more established use in general surgery (05:48).
• High costs are a current barrier; expected to decrease as technology matures (06:15).
• Academic centers play a crucial role in leading research and smart deployment of grant funding to accelerate innovation (07:00).
• “If we have technologies that allow us to do more or a broader spectrum of surgeries in a more ambulatory setting with smaller incisions and reduced recovery, that’s going to change the game in terms of orthopedic care.” — Dr. Wessell (07:47)

The Role of Academic Medical Centers and Funding Dynamics

• Academic centers have the infrastructure and funding access to drive technological advancement and absorb policy shifts (08:00).
• Institutional financial architecture, such as robust endowments and cash reserves, can buffer academic operations against government funding fluctuations (08:30).
• Importance of building financial resilience as political priorities and healthcare funding inevitably shift (09:14).

AI and Efficiency: Real-Life Impact on Patient Care

• AI-driven passive listening and note-taking systems save Dr. Wessell and his nurse practitioner up to 90 minutes a day each (10:38).
• “I can leave a patient’s room, walk back to my workstation and by the time I get there, my note is written... That has given me back upwards of 90 minutes a day.” — Dr. Wessell (10:53)
• Gains in efficiency allow more time for patient access and personal wellness, or capacity to add 200–300 patients per year to the practice (11:38).
• Enhanced presence with patients: “I’m really focused on what the patient is saying and can develop that more personalized interaction.” (12:22)

Systemic Disruptors: Declining Reimbursements and Care Deserts

• Declining reimbursements have a serious impact; a cited study showed orthopedic surgeons suffering a 31% drop in inflation-adjusted income over 25 years (13:11).
• These changes risk fostering “care deserts” by forcing smaller community providers to close essential services (13:23).
• “If we’re not careful, we’re going to see those same trends trickle over into other specialties.... I’m concerned that not enough red flags are popping up amongst the individuals and organizations that have the ability to influence how funding is allocated.” — Dr. Wessell (14:22)
• Close observation of the 2026 CMS fee schedule and its anticipated impacts (14:44).

Physician Advocacy and the Power of Organized Voice

• Dr. Wessell is active in advocacy through the Colorado Orthopedic Society, monitoring local and national regulatory issues (15:10).
• Physicians need to secure “a seat at the table” to influence healthcare policy and resource allocation (15:00).
• Direct impact can be seen in how the Society has improved healthcare regulation within Colorado (15:45).

Collaborative Effort: Engaging Patients and Policymakers

• Need for greater transparency with patients to foster understanding of the stresses and challenges in healthcare (16:04).
• “If we can bend the ear of patients, hopefully we can bend the ear of our politicians to start to move towards a more sensible policy...” — Dr. Wessell (16:26)
• Emphasis on collaboration, not adversarial relationships, between healthcare providers, patients, and policymakers (16:49).
• “The 99.9% of healthcare providers I know… genuinely care about the well-being of their patients and… do far above and beyond what patients even realize to… help people return to a quality of life that they want.” — Dr. Wessell (16:55)

Notable Quotes & Memorable Moments (Timestamps)

• Burnout Figures:
  “Currently about 40% of active orthopedic surgeons endorse symptoms consistent with burnout and depression...” (01:44)

• Future of Spine Surgery:
  “Integration of kind of robotics and artificial intelligence and kind of patient-specific surgical plans is where spine surgery is headed.” (05:10)

• On AI Note-Taking:
  “That has given me back upwards of 90 minutes a day... You can get some of your personal or family time back, which is fantastic... or that might open up availability for two to four patients a week.” (10:53–11:18)

• On Declining Reimbursements:
  “Orthopedic surgeons have taken a 31% hit on inflation-adjusted income over the last quarter century... This has led to care deserts.” (13:11)

• Advocacy Role:
  “I like the advocacy side of things. I sit on the executive board for the Colorado Orthopedic Society, which is actually a really fun and rewarding role. ... There have been numerous instances where I feel like we’ve really made a difference.” (15:10–15:45)

• Engaging Patients and Policymakers:
  “If we can bend the ear of patients, hopefully we can bend the ear of our politicians to start to move towards a more sensible policy that really improves the value of the care that we provide...” (16:26)

Important Segment Timestamps

| Time | Segment | |--------|------------------------------------------------------------------------| | 00:23 | Dr. Wessell’s Background and Clinical Focus | | 01:33 | Discussion of Burnout and Well-being Initiatives | | 03:40 | Generational Shifts in Work-Life Balance in Surgery | | 04:54 | Trends in Robotics & AI in Spine Surgery | | 06:47 | Barriers of Cost & Role of Academic Centers | | 08:30 | Adapting to Shifting Government Funding | | 10:03 | Adoption of AI: Impact on Clinic Workflow and Efficiency | | 13:11 | Declining Reimbursements and the Rise of Care Deserts | | 15:00 | Physician Advocacy and Organized Medicine | | 16:01 | The Value of Collaboration and Patient-Provider-Policy Engagement |

Summary & Takeaways

This episode offers an inside look at the clinical, operational, and systemic challenges facing spine surgeons today. Dr. Wessell shares personal anecdotes and expert perspectives on burnout, the necessity of work-life balance, and how innovation—particularly AI—is reshaping efficiency and care models. He raises the alarm on declining reimbursements and their risk of expanding healthcare deserts, underscoring the importance of organized physician advocacy. His vision emphasizes collaboration, transparency, and patient engagement as essential to evolving the healthcare system for everyone’s benefit.