“When you get a hip fracture, there is a 30% chance that you die within the next year. Let’s say you have renal disease or something like that—the risk jumps to 50%. These patients not being able to be on the right medication because it’s financially hard to make these clinics work - is going to kill people because they aren’t going to get the care they need.”

– Dr. Russell Goode

In today’s episode, we’re taking a close look at how the buy-and-bill reimbursement model is breaking bone health in the United States. Our guest, Dr. Russell Goode, is a board-certified orthopaedic surgeon specializing in hip and knee replacement, including the anterior approach and robotic-assisted, muscle-sparing techniques. He has performed more than 8,000 fracture-related procedures and co-directs the Gulf Orthopaedics Bone Health Clinic in Mobile, Alabama, alongside his wife, Sarah.

Dr. Goode also serves on the board and executive committee of the American Society of Osteoporosis Providers, where he helps shape national efforts to close the fracture prevention gap. Drawing from his surgical expertise, leadership in bone health, and firsthand experience navigating complex reimbursement systems, he explains how buy and bill creates barriers to osteoporosis therapy, discourages prevention, and traps care in a reactive cycle. Together, we explore the unintended consequences of this model, discuss practical alternatives, and consider why orthopaedic surgeons—already on the front lines of fragility fractures—are uniquely positioned to realign incentives, expand access, and improve outcomes.

Biography:

Russell D. Goode, MD, FAAOS, is a board-certified orthopedic surgeon specializing in orthopedic trauma and adult reconstruction, practicing in Mobile, Alabama. He earned his Bachelor of Science degree in Chemistry with a minor in Biology from the University of South Alabama, where he also completed his medical degree at the Frederick P. Whiddon College of Medicine in 2010. Dr. Goode continued his training at the University of South Alabama Health System, completing his orthopedic surgery residency in 2015. He further specialized through a fellowship in orthopedic trauma at the University of Missouri School of Medicine in 2016.

Dr. Goode is highly skilled in managing complex and simple fractures, from wrist to shoulder and pelvis to toes, having performed over 8,000 fracture-related procedures. His expertise extends to adult reconstruction, with a focus on anterior total hip replacement and robot-assisted total knee arthroplasty, including muscle-sparing approaches, under the mentorship of Dr. Michael Granberry. He is also deeply committed to osteoporosis prevention and treatment, co-directing the Gulf Orthopaedics Bone Health Clinic alongside his wife, Sarah Goode, DNP, where they provide comprehensive care, including DEXA scans and advanced medication management for primary and secondary osteoporosis.

Affiliated with Mobile Infirmary Medical Center, Providence Hospital, and Springhill Medical Center, Dr. Goode is an active member of the American Board of Orthopaedic Surgery, the American Association of Hip and Knee Surgeons (AAHKS), the Orthopaedic Trauma Association, and the American Association of Orthopaedic Surgeons (AAOS). He serves as adjunct faculty at the Alabama College of Osteopathic Medicine and the University of South Alabama Department of Orthopaedics, where he trains residents in advanced orthopedic principles. Additionally, Dr. Goode is involved in innovation and product development, holding consulting agreements with Johnson & Johnson and Arthrex Medical, and serves as the primary investigator for clinical research with Precision Clinical Research in Mobile. He also oversees the Frederick N. Meyer Orthopaedic Residents Fund, a 501(c)(3) nonprofit supporting educational scholarships for orthopedic residents.