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Stefano Bini, M.D., was born in Italy, grew up in Australia, went to high school in San Francisco and completed his residency at UC San Francisco, where he’s now a professor of orthopedic surgery. He also completed a fellowship at Rizzoli Orthopaedic Institute in Italy and obtained a second M.D. from the University of Florence.
Dr. Bini’s love of the O.R. and technology inspired him to launch the Digital Orthopaedics Conference San Francisco (DOCSF), which is dedicated to advancing high-tech surgical solutions. The Most Interesting Man in Surgery is currently on a worldwide sabbatical to learn more about healthcare’s digital transformation. We chatted a few weeks before he left to discuss his dedication to advancing technological solutions within orthopedic care.
The possibility of becoming a surgeon didn’t cross your mind as a kid. What changed?
I thought I’d be an international lawyer, traveling the world and mastering different languages. My father’s friend was a gastroenterologist and invited me to rounds with him when I was about 16 years old. One of his patients had a massively swollen abdomen, and I watched as he began to drain the excess fluid with a large needle. I came to, flat on the floor, as a group of docs revived me with smelling salts. That wasn’t the best introduction to medicine, but I was intrigued by the collective effort of the physicians. I saw that patient care was collaborative and intellectually challenging. It drew me in.
What inspires your constant desire to keep pushing patient care forward?
I like figuring out the appropriate match for the technology of today so that we can get to the promise of tomorrow. During my fellowship training in Italy, the level of creativity exhibited by European surgeons was astounding. When I returned from my fellowship, my surgical techniques were at least a decade ahead of my more conservative peers. This eye-opening experience shifted my perspective and made me more open to alternative surgical approaches.
What appeals to you about the technological aspects of orthopedic surgery?
I participated in landmark research on the use of smartphones to conduct remote physical therapy. That research connected me to leaders in the tech industry, and I’ve remained involved because it’s important to strengthen the connection between healthcare professionals and tech experts. That’s the idea behind DOCSF. The conference brings together thought leaders from both sides of the table to collaborate on solutions to common issues.
What added value does enabling technology provide in orthopedic care?
Let’s look at robotic-assisted knee replacement. Surgeons strive to balance the joint’s ligaments before making bone cuts, and robots allow them to tailor their approach based on what’s optimal for each specific knee. This has transformed the procedure, allowing them to do things that weren’t previously possible. Surgeons might be willing to sacrifice a bit of surgical efficiency in exchange for technology that helps them achieve better outcomes.
Yet surgeon adoption of enabling technology remains stagnant. Are you discouraged?
Not at all. Orthopedic business models are founded on the notion that technology will yield improved speed, efficiency or cost-effectiveness. But the actual results don’t often align with anticipated advantages. Sometimes, what proves valuable isn’t what was expected or promoted. We also tend to place too much emphasis on what technology can and can’t do based on unreasonable assumptions of what’s possible. Over the past 15 years, we’ve digitized nearly the entire healthcare system. This digital transformation serves as the groundwork for future advancements. Is that pace too sluggish? I don’t think so. Let’s maintain a realistic viewpoint. We’ve achieved a lot in less than two decades.
