By Caroline Lewis
Over the past 150 years, the Hospital for Special Surgery has honed an international reputation for restoring mobility to professional athletes, weekend warriors and aging baby boomers. It’s a great niche. But HSS is a independent specialty hospital in a New York area market where hospital mergers are commonplace. HSS will remain a holdout, said Louis Shapiro, its chief executive of nine years.
How is HSS different from other hospitals?
We’re organized around one type of disease: musculoskeletal. We’re not the only place in the country like this, but it’s more unique than common. When you only do one thing and you do a lot of it, and all your systems are organized around it, you tend to produce a better health outcome. 
What’s your strategy for remaining independent during this consolidation wave?
The challenge is it’s incumbent upon you to demonstrate your value. If we’re not better than the competition, then what’s the point? We have a very complicated strategy that includes growing and innovating and changing how we do things. Organizations that are just trying to control the market are risking making health care overcommoditized.