"With changes in healthcare on the horizon, I've been curious about the role of out-of-pocket, elective procedures in the salary of orthopaedic surgeons. Any insight would be appreciated"
I frankly don't really understand your question? "Elective" procedures are not routinely "out-of-pocket" for patients since you're not talking about elective cosmetic procedures such as plastic surgery. ACL reconstruction and rotator cuff repair are technically "elective" of course but are always covered by insurance plans since they often cause significant functional disability.
In general, Orthopaedic surgeons salaries remain very high for now but obviously everyone is watching to see what changes will be forthcoming in the near future.
Good luck --
wnl