What Are the Main Differences Between Private and Public Orthopedic Services?

What Are the Main Differences Between Private and Public Orthopedic Services?

Are you dealing with persistent knee pain after running? Do you have recurring episodes of low back pain that affect your work and sleep? Or does your child need an orthopedic consultation and you don't know where to get an appointment faster?

Choosing between the public and private systems influences the time until diagnosis, access to investigations, and the way you continue your recovery. For many active adults, amateur athletes, or patients in post-operative recovery, these differences matter a great deal. Here is what you need to keep in mind!

What do public and private orthopedics mean?

In the public system, consultations, investigations, and surgical procedures are reimbursed through the National Health Insurance House (CAS), if you are insured. In most cases, access is based on a referral from your family doctor.

In the private system, as a rule, you pay for the consultation and investigations, and appointments are made directly, without a referral. You can choose your doctor and the time slot, and many clinics offer integrated diagnostic and recovery services. Some private clinics, such as Centrokinetic, also offer services reimbursed by CAS, within certain limits.

Both systems have advantages and limitations. The right decision depends on the urgency of your case, your budget, and your expectations regarding time and comfort.

Access to consultations: waiting times and flexibility

The public system

For a public orthopedic consultation:

• you need a referral;
• scheduling depends on the monthly CAS quota;
• waiting lists can vary from a few weeks to a few months;
• in traumatic emergencies, patients are taken in quickly through the emergency room.

Delaying evaluation in musculoskeletal conditions can lead to worsening pain and long-term limitation of mobility. For example, a meniscus tear left untreated in time can promote the degradation of the joint cartilage.

If you have a stable condition that is not an emergency, the public system can be a suitable option, especially if you have a limited budget.

The private system

In the private system, you can book an appointment directly with the doctor of your choice. In many cases, the consultation takes place within 24–72 hours. Within the orthopedic services, you can choose a doctor sub-specialized in the knee, shoulder, hip, or spine.

Common advantages:

• online or phone booking, without a referral (paid) or with a referral (reimbursed);
• extended time slots, including evenings;
• the possibility of having investigations done on the same day;
• directly choosing your doctor.

For an athlete who has a competition in two weeks and complains of shoulder pain, quick access to a consultation and imaging can make the difference in establishing a correct treatment plan.

Costs: what is covered and what do you pay?

Public orthopedics

In the public system:

• consultations and surgeries are reimbursed through CAS;
• hospitalization is covered;
• imaging investigations are free with a referral;
• certain implants or materials may involve additional costs.

There are, however, limitations. For knee or hip replacements, the waiting time can be several months. In addition, not all hospitals have premium implants or can offer minimally invasive techniques. Post-operative recovery is also done through a referral and within the limit of the sessions available through CAS.

Private orthopedics

In the private system, each service has a clearly displayed fee. As a rule:

• the orthopedic consultation has a fixed fee, if you opt for direct payment;
• investigations (MRI, ultrasound, X-ray) are paid separately;
• surgical procedures vary depending on complexity.

An important advantage is the transparency of costs and the possibility of discussing the complete plan in advance: surgery, hospitalization, recovery. Quick access to diagnosis and treatment reduces the rate of complications and the duration of functional incapacity, especially in ligament or degenerative injuries. Access to reimbursed consultations, investigations, and recovery programs is subject to certain limitations.

Access to investigations and technology

The public system

Imaging investigations such as MRI or CT require prior scheduling. In busy centers, the wait can take weeks or months. Equipment varies from one hospital to another. Some units use modern equipment, others older machines.

The major advantage is zero cost for the insured patient. The main limitation is the time until the investigation is performed.

The private system

In the private system, you can quickly get an MRI. Common benefits:

• fast scheduling;
• equipment dedicated to musculoskeletal imaging;
• interpretation performed by radiologists experienced in orthopedic pathology;
• integration of results directly into the treatment plan.

Early imaging evaluation is recommended in cases of persistent pain or joint instability, to avoid worsening of the injuries. For reimbursed investigations, waiting times vary.

Surgical procedures and hospitalization

In public hospitals

Orthopedic surgeries, including hip replacement or ligament reconstruction, are reimbursed through CAS. Waiting times can be longer for elective procedures.

Common characteristics:

• shared wards;
• limited selection of implants;
• post-operative check-ups scheduled with a referral.

For many patients, this option remains financially accessible and adequate, especially if the condition allows postponement.

In the private system

The procedure is scheduled faster, and the patient discusses directly with the surgeon the type of implant and the technique used.

Frequently encountered advantages:

• individual rooms;
• minimally invasive techniques, where indicated;
• personalized monitoring;
• quickly scheduled post-operative check-ups.

Early mobilization and recovery started immediately after surgery reduce the risk of complications and support the return to daily activities.

Continuity of treatment and medical recovery

Proper recovery directly influences the final outcome. Without physical therapy and monitoring, the operated joint can remain stiff, and the pain can persist.

Recovery in the public system

• requires a referral;
• includes a limited number of reimbursed sessions;
• appointments are made based on availability;
• sometimes there is a lack of direct communication between the orthopedist and the physical therapist.

For common conditions such as low back pain or knee pain, continuity and adapting the program to the patient's progress are very important.

Recovery in the private system

In integrated centers, the orthopedist works directly with the recovery team. The plan is constantly adjusted, depending on progress.

You usually benefit from:

• detailed functional evaluation;
• personalized plan;
• access to modern physical therapies;
• constant monitoring.

Early intervention and personalized treatment increase the chances of a stable recovery. For example, at Centrokinetic you can benefit from a unique recovery method, under the guidance of professionals.

Summary comparison

For a clear picture, here are the main differences:

Why do a correct evaluation and early intervention matter?

Musculoskeletal conditions are one of the main causes of disability worldwide. Early diagnosis and appropriate treatment reduce the risk of long-term functional limitation.

A complete evaluation involves:

• a detailed clinical consultation;
• appropriate investigations;
• an explanation of the treatment options;
• establishing a personalized plan.

Do not postpone the consultation if the pain persists for more than a few weeks, if the joint locks up, or if your mobility decreases. Early intervention simplifies treatment and reduces the risk of complications. Book an orthopedic consultation now.

Frequently asked questions

Do I need a referral for a private orthopedist?

Not necessarily. You can book an appointment directly, without a referral. The doctor will recommend the necessary investigations after the consultation. At Centrokinetic you can also access reimbursed services, with a referral.

Can I combine the private system with the public one?

Yes, it is possible. For example, you can have investigations done privately and surgery in a public hospital, or vice versa. You can also benefit from services reimbursed by CNAS in private clinics.

How do I know whether I need surgery or can follow conservative treatment?

Only a clinical and imaging evaluation can determine this. In many cases, conservative treatment – medication, physiotherapy, physical therapy – provides good results. The doctor will explain the risks, benefits, and any contraindications for each option.

Disclaimer: This material is for informational purposes and does not replace a medical consultation.

Sources:

• "Pachete de Servicii Medicale." Casa Nationala de Asigurari de Sanatate, 2025. Accessed 8 Apr. 2026.