In the year since Gulfshore Business last took an in-depth look at the health care landscape in Southwest Florida, a hot topic in medicine has become a big part of the conversation: musculoskeletal, or MSK for short.
As the aging — and still very active — population in Southwest Florida continues to grow, a focus on orthopedic care and surgeries is growing in tandem, with MSK offerings becoming the backbone, if you will, that is fueling the engines of three major acute-care health systems in the area.
And while those systems see these advanced service line offerings as enabling those who live here to receive world-class health care without leaving home, Naples Comprehensive Health and Physicians Regional in Collier County and Lee Health in Lee County also are setting their sights on Southwest Florida becoming a destination for orthopedic surgeries that will attract patients from outside the region.
Hospital For Special Surgery At NCH
For NCH, the idea for a free-standing orthopedic hospital started, as many large projects do in Southwest Florida, with Patty and Jay Baker.
The Bakers are one of the region’s most active and recognized philanthropic couples, and had high praise for the Hospital for Special Surgery in New York City — the world’s leading academic medical center focused on musculoskeletal health — after Jay Baker was a surgical patient there.
As a member of the board at nonprofit NCH, he offered to connect the health care system’s president and CEO, Paul Hiltz, with the powers-that-be at HSS. Hiltz, Baker and others from the NCH leadership team toured HSS in New York, met its leadership and came away convinced the partnership would be a good one.
The rest, as they say, is history.
A $20 million fundraising challenge grant from the Bakers lifted the project off the ground, and in November 2023, NCH broke ground on the Patty & Jay Baker Pavilion, a 100,000-square-foot facility scheduled to open this spring on the NCH North Naples Hospital campus that will be the home of HSS at NCH and will include The Kapnick Foundation Ambulatory Surgical Center. Total costs for the project are estimated at $140 million.
Hiltz said the goal set by Jay Baker and the rest of the board was to make HSS at NCH one of the best orthopedic hospitals in the country, offering a state-of-the-art facility that would become a destination for comprehensive outpatient and inpatient MSK services, and make it possible for those who live here not to have to travel for specialized surgery.
“We believe we’ve done that. We believe it’s got the very latest and greatest; Arthrex has also been involved in helping design and equip the building,” Hiltz says, referencing the role of the privately held Naples-based medical devices company in the project. “We’re really excited about how that is changing orthopedic care in this region.”
Building a ‘world-class’ orthopedic center
In addition to the latest in technology and equipment, Hiltz said NCH — which recently was named one of Healthgrades’ top 50 hospitals in the country — also has been recruiting doctors for what he said will be a “world-class” orthopedic center.
One of those physicians, Dr. David Backstein, was recruited to be the medical director for HSS at NCH; he was formerly at the University of Toronto where he led the division of orthopedics at Mount Sinai Hospital. Dr. Sheeraz Qureshi, based at HSS in New York City, serves as chief medical officer of HSS Florida.
Backstein, a surgeon specializing in primary and revision total knee replacement, said he was drawn to the project for the opportunity to help build it from the ground up.
“As a surgeon, the number one thing for me is to have a self-contained orthopedic center,” Backstein says. “This is an opportunity to have an exclusively self-contained orthopedic facility that we, for lack of a better word, can control. We can control the patient experience better. We can control the type of surgery that’s being done, and we can control our quality. And we’re not going to be bumped by somebody whose aorta ruptured and our whole [surgical] day is canceled. It’s going to be our facility, and we’re going to do the volume that we feel we can do safely.”
Available procedures at the new hospital will include spine and interventional spine surgeries; foot and ankle surgeries; hip and knee arthroplasty; sports medicine surgery; nonoperative sports medicine; physical medicine rehabilitation; and musculoskeletal injury care.
Backstein has special expertise in minimally invasive and robotic techniques. And while the facility will include the very latest in technology, including robotic capabilities, he said it will be the surgeons who make the difference.
“More important than having the machines is that we’ve got surgeons that are adept at using them,” he says.
Elevating the experience
During a recent hard-hat tour of the construction site off Immokalee Road in Naples, HSS at NCH Vice President Justin Blohm offered a behind-the-scenes glimpse at some of the areas of the hospital that will make it elite, including the ambulatory surgical center that will incorporate Arthrex designs and equipment, and an observation theater for physician education.
On the first floor, the 100,000-square-foot Baker Pavilion includes the 20,000-square-foot Kapnick Foundation Ambulatory Surgical Center, with five operating rooms. The remaining 80,000 square feet includes clinic space, outpatient and inpatient rehabilitation, 15 private inpatient beds and five additional operating rooms on the second floor; the third floor will contain the imaging area for MRIs, CTs and two X-ray suites, with two additional rooms for office-based procedures, according to Blohm.
“We’re elevating the experience and also the expertise for our patients, meaning there are no generalists in this facility,” Blohm says. “Having surgeons here that are hyper-focused on the types of surgeries they do just elevates the quality and level of care that we can provide. There are phenomenal orthopedic surgeons in this community; however, with our growing community and our active population, the need for specialists in the orthopedic realm is growing every day.”
Lee Health Musculoskeletal Institute
Like NCH, Lee Health in Fort Myers is focusing on a new hospital, one that will serve as home to the Lee Health Musculoskeletal Institute.
The system, which converted from a public to a private nonprofit in November, broke ground in late January on a new 53-acre health care campus in Fort Myers that will include a 168-bed acute care hospital and the new Musculoskeletal Institute that the system also sees becoming a destination for those needing orthopedic surgery.
The new hospital will include 400,000 square feet of hospital space; 125,000 square feet of medical office and ambulatory surgery space; and an 18,000-square-foot central energy plant.
The new Lee Health Fort Myers campus, with a total estimated cost of $481 million, will be located at 4453 Challenger Blvd., with the first phase of construction slated for completion in 2028. Lee Health officials said the current flagship hospital, 227-bed Lee Memorial on Cleveland Avenue, which also recently was named to Healthgrades’ ranking of the top 50 U.S. hospitals, will remain open through 2027 to provide emergency care, inpatient beds and surgical services until the new hospital is fully operational.
Asked at the groundbreaking ceremony what the new campus will mean for health care in the county, Lee Health CEO and President Dr. Larry Antonucci said the system will be able to “expand and grow” with the rapidly growing region.
“As we run this state-of-the art facility here, it’s going to house a hospital, an outpatient surgery center and an office building to begin with, but there is a lot of room to do other things,” Antonucci says. “But mostly it’s going to be housing our Lee Health Musculoskeletal Institute, and that’s where I think we’re going to see incredible innovation over the next 20 years.”
In keeping with the goal of becoming a health care destination, future plans may include a hotel that could accommodate patients having surgery or other treatment after their discharge from the hospital, Antonucci said.
“There aren’t any immediate plans, but there is a space here for a hotel, so we anticipate that very well may be something that’s added in the future,” he says. “We’re not in the hotel business, but having a hotel adjacent to an orthopedic, a musculoskeletal hospital is a very common thing. People can have surgery, they can spend the night, come back to therapy and then maybe go home the next day.”
The 168-bed acute care hospital will include 24 ICU beds, a 44-bed emergency department and 10 inpatient operating rooms. The medical office building will include eight state-of-the-art operating rooms, which will be home to the Lee Health Musculoskeletal Institute.
Bringing specialists together on one campus
Health care executive Duke Walker was recruited from Ascension Columbia St. Mary’s Hospital in Milwaukee in 2023 to serve as vice president of operations for musculoskeletal medicine throughout the Lee Health system. Musculoskeletal services include orthopedics, spine, neurosurgery, trauma, physical medicine, imaging and rehabilitation.
Walker said the Lee Health Musculoskeletal Institute will provide “next-level care for the residents of Southwest Florida.”
“For the Musculoskeletal Institute, the new campus will be the hub, but we will have regional sites, as well, including Coconut Point, Surfside and Cape Coral,” he says. “So, we’re still going to service the entire region.”
He said the new campus will allow Lee Health to bring more specialists together for collaboration in patient care.
“These could be orthopedic surgeons, neurosurgeons and even rheumatologists,” Walker says. “And that’s powerful: You can bring that many specialists together on one campus in a beautiful new facility with the latest technology.”
Walker said the Musculoskeletal Institute will offer a full range of orthopedic surgeries and will have expanded capabilities when it comes to surgical spaces and the latest technology, including robotics.
“What we’re trying to design here is really comprehensive musculoskeletal care,” he says. “It’s multidisciplinary, and it’s something like you might receive if you went to a big metropolitan area like Atlanta, but you don’t have to do that. You can get that right here.”
Competitive differentiators
What does Walker think will set the Lee Health Musculoskeletal Institute apart from the freestanding HSS at NCH facility?
“I think our missions are a little bit different, where HSS started out really heavily focused in orthopedics,” he says. “Our thought here is to be a little bit more comprehensive than that, to have these other specialties like neurosurgery, rheumatology, physical medicine, rehabilitation, pain management, anesthesia, and we’re building that as part of a full-service hospital.
“Our campus, you’re going to have full specialist support,” he says. “Let’s say you need a total knee replacement, and you have a heart issue or other medical problems. If you have it there (on the new Lee Health campus), you’ve got a full brand-new hospital and a specialist like Dr. [Malissa] Wood and her cardiac team, as well.”
Physicians Regional Healthcare System
While Naples-based Physicians Regional, the only for-profit system of the three, does not have a standalone facility dedicated to MSK practice, Market CEO Scott Lowe said the system is proud of its offerings and the advances in technology offered in orthopedics.
From a system growth perspective, Lowe said he is “very excited about the MSK side of things.”
Physicians Regional features a full range of orthopedic procedures, including for foot and ankle; hand and wrist surgery; hip resurfacing; laminectomy; reconstructive surgery; shoulder surgery; spine surgery including discectomy, laminectomy, spinal fusion and vertebroplasty; and total replacement of the hip, knee, shoulder and elbow.
Staying competitive with new technologies
Asked about staying competitive with NCH and Lee Health in the MSK realm, Lowe said, “Honestly, we’re already there.”
“I think they’re doing a better job than us as far as selling what they’re developing,” he says. “We’re already doing over 3,000 orthopedic and spine cases a year. That’s across all three campuses — and in particular, we’ve got our North campus that has 20 dedicated inpatient beds and four operating rooms specific to MSK services; that’s all we do at that portion of the hospital.”
Data provided by a system spokesperson showed a total of 4,500 MSK (orthopedic and spine) cases in 2024, with an increase of 5% to 7% expected in 2025.
The Physicians Regional North campus, which features Mako and ROSA surgical robots used in knee replacements, has been designated an Orthopedic Center of Excellence, Lowe said, and early this year, the system’s Pine Ridge campus also was named as a Center of Excellence in robotic and minimally invasive surgery by nonprofit patient safety organization Surgical Review Corporation.
“At the Collier campus we added a Globus robot, a [minimally invasive] neurosurgery and spine robot, which is pretty exciting for the community because that reintroduced spine surgery to that campus,” Lowe says. “We just added an ORBEYE surgical microscope, which does 4K 3D imaging to better support our neurosurgeons in that endeavor.
“So, again, just a lot of technology growth. Some of it is growth in the way we’re doing the procedures, but some of it is just a new way of doing things, a replacement of an older procedure or older method of performing that type of care. The [population] growth is going to continue in Southwest Florida, so we want to make sure we’re on the forefront of that and we’re delivering on the highest level of care that we possibly can.”
One example of that technology growth is the Globus Excelsius robot. Dr. Amanda Sacino, a Naples-based neurosurgeon in practice at Physicians Regional, recently gave WINK News a look at how the robot’s technology works in brain and spine surgery.
“Excelsius is the only robot used in both the brain and the spine,” she explained. “Tools are slid into the body through a single arm paired with a high-powered vision system. It allows doctors to operate in small spaces and it helps us to be more accurate if we have to place hardware into the body. It also helps us to be more accurate through the use of navigation if we have to make different cuts in the bone to, say, take out arthritic tissue, or to remove a tumor or to help with a fracture in the spine.”
Sacino said that because it’s a “smaller” surgery, “it’s less taxing on the body and also it’s less pain-causing, and it helps [patients] to recover quickly after surgery.”
Partnering with community physicians
Lowe said that in addition to the investments in robotic care, Physicians Regional also continues to develop partnerships with doctors and surgeons in the community.
“We’re very proud of the MSK services that we’ve been able to develop and foster,” Lowe says. “And one of the things we’ve done is to develop those relationships with our community-based physicians, the ones that are already in this town that are already very well trained and are as good as some of the HSS physicians that are coming into this community. We’ve partnered with them, and we want to continue to foster that relationship.”
