Dr. Derick Johnson performed nearly half of Holland Hospital’s joint-replacement surgeries last year. Courtesy Holland Hospital
Dr. Derick Johnson personally performed 450 joint replacement surgeries last year for Holland Hospital.
That’s nearly half of the hospital’s record 930 replacements in 2018, a number that has steadily increased from 278 in 2006. The rest of the procedures are completed by a couple of other surgeons in one other practice.
The hospital expects the total number of replacements to reach 1,000 this year, according to Kristie Dennett, Holland Hospital orthopedics program manager.
Johnson said up to 70 percent of his patients come from more than 110 ZIP codes, which he said comes from word-of-mouth recommendations he believes are because of his use of new technology that allows for decreased pain, shorter hospital stays and quicker recoveries.
Johnson said he completes an average of about 10 to 12 of the 60-minute procedures in a week, sometimes as many as six per day. The majority of patients are discharged in less than one day, with some hip replacements done as same-day outpatient procedures.
Johnson said he plans to set a maximum for himself of about 500 procedures per year.
When Johnson joined Holland Hospital in 2013, he said it was common for patients to spend three days in the hospital following these procedures.
He joined after completing a fellowship in his specialty, and Holland Hospital became the first in West Michigan and second in the state to offer minimally invasive anterior-approach hip replacements, which he said he believes is a key to pain relief and quicker recoveries because the work is completed between muscle layers rather than cutting into the muscle.
He said he also was the first in West Michigan to use Stryker’s MAKO robotic-assisted technology for total knee replacements, resulting in the same scores for pain and range of motion at two weeks that he previously saw at six weeks. Rather than manually cutting, he works with a 3D reconstruction of the patient’s knee to inform the robot’s software exactly where to operate.
“Then that robotic arm will kind of guide and mill that bone like a CNC machine accurately and precisely every time,” he said.
While the technology is important, Johnson said he believes there are multiple factors that contribute to decreasing the length of hospital stays. It starts with educating the patients through a class and other resources, as well as prehab and rehab. A lot of the procedures are completed with spinal anesthetics, not sedatives.
In 2017, the hospital added a nurse navigator to provide additional patient support during the joint replacement experience.
He added the hospital has invested a lot of time and money toward bettering the program. In 2014, Holland Hospital opened its Spine and Orthopedic Inpatient Care Unit, with specially designed features for joint patient recovery, such as private rooms and in-house rehab services.
He said there also is a lot of effort toward studying outcomes and patient-reported outcomes, as well as how the hospital competes with other members of the Michigan Arthroplasty Registry Collaborative Quality Initiative.
“People in health care can kind of feel like a number, and I think that art kind of gets lost,” Johnson said.
“I feel that it's the patient experience that's done through my office, through the hospital process and the team approach … that's the key to bringing word-of-mouth to patients back to us over time.”