After 20 years in private practice, Robert S. Bray, MD, a neurological spine surgeon based in Marina del Rey, Calif., founded DISC Sports and Spine Center. Established in 2006, DISC has been able to not only withstand the pressures of today's healthcare environment, but also flourish. Dr. Bray began the practice with himself as a surgeon and five employees; now, the group includes 30 physicians and 170 employees. In addition to spine care, specialties at the practice include orthopedics, pain management and chiropractic sports medicine.
DISC has also become the official medical care provider for the United States Olympic Team, Red Bull athletes and the Los Angeles Kings. The practice also expanded this past August to a new surgery center in Newport Beach, Calif.
Here, Dr. Bray discusses the success of his business model.
1. Become vertically integrated. From the moment your patient walks through the door, you should be able to provide all services available for their episode of care. This means providing specialists in physical and occupational therapy, imaging services, nutritional specialists, anesthesiologists, surgeons and pain management, all under one roof. Becoming a multidisciplinary center is especially important for treating high level athletes who need quick coordinated care.
"At our practice, we saw 100 elite athletes last quarter," says Dr. Bray. "The reason they come to us is because we could provide complete care across the board. Surgeons must realize that in order to be a comprehensive sports center, you have to have everything, including services like acupuncture."
As an example, one recent patient at DISC was a film executive who was suffering from lower back pain. The executive was scheduled to travel across the country and participate in a charity bike ride with Lance Armstrong within a week of arriving at the practice. This timeline may have been tight for some groups, but at DISC the executive was able to see a chiropractor right away, who realized that the pain was more than a soft tissue problem. He then received an MRI on the same day and Dr. Bray found a tear in his disc. The executive left the office for a short time to attend a meeting, but then returned for a quick block and then went home for dinner. Two days later, he was on the bike ride and pain free.
"You need that level of integrated care at your center," says Dr. Bray. "The hottest trend in sports medicine is the ability to deliver full service care no matter what."
2. Provide patient care coordination. One of the reasons why DISC was able to contract with the U.S. Olympic Team and Red Bull athletes is their ability to provide quick coordinated care. The center has a VIP athlete coordinator to arrange each athlete's care before they arrive at the practice. Many times the athletes are flown in from locations around the country; once they arrive, the coordinator has their appointments with different specialists scheduled so the care is as seamless as possible.
"Our VIP athlete coordinator takes the call from Red Bull America or the Olympic athletes and coordinates their appointments," Dr. Bray says. "If a BMX Biker for Red Bull North America goes down, they want to call up and have the athlete imaged, diagnosed and treated the next day so they can return to practice as soon as possible. Many times, the treatments aren't surgical and we can provide them the same day. With that kind of concierge sports medicine, we were able to develop our relationships with elite athletes."
3. Invest in an outpatient surgery center. Even with the economic downturn, DISC's new multidisciplinary outpatient surgery center focused on orthopedics and spine care has been booming. Between the old and new surgery centers, DISC surgeons have performed more than 4,500 cases in the outpatient ASCs and never reported an infection. "Our surgery centers are built to really high standards and run very well," says Dr. Bray. "We are seeing high acuity, low volume cases becoming the mainstay for sports medicine surgery centers in the future. The center has to be built at a high level for these very complex cases and incorporated into the practice's overall business model."
DISC surgeons have been able to successfully perform knee and hip replacements, anterior lumbar interbody fusions, lateral lumbar interbody fusions and other spine procedure using pedicle screws. "We aren't just doing the little things; we are doing bigger surgical cases in the outpatient environment and seeing good outcomes," says Dr. Bray.
4. Broaden the types of specialists in the practice. Thinking outside the box is critical to achieving success despite the typical market challenges of the day. While some orthopedic and spine surgeons have spent a great deal of time defending surgical treatment as the only true method of care, DISC has embraced alternative care providers as patient demand has dictated.
"Athletes want soft tissue therapy, acupuncture, rehabilitation facilities, injury avoidance and biomechanics specialists as well as athletic trainers — not just a physician who will perform a knee scope," says Dr. Bray. "Incorporating all the different specialists has been the thrust of DISC for the past four years. You need to perform minimally invasive, top-quality surgery for your patients, but almost more than that you need the ability to provide all types of care."
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DISC has also become the official medical care provider for the United States Olympic Team, Red Bull athletes and the Los Angeles Kings. The practice also expanded this past August to a new surgery center in Newport Beach, Calif.
Here, Dr. Bray discusses the success of his business model.
1. Become vertically integrated. From the moment your patient walks through the door, you should be able to provide all services available for their episode of care. This means providing specialists in physical and occupational therapy, imaging services, nutritional specialists, anesthesiologists, surgeons and pain management, all under one roof. Becoming a multidisciplinary center is especially important for treating high level athletes who need quick coordinated care.
"At our practice, we saw 100 elite athletes last quarter," says Dr. Bray. "The reason they come to us is because we could provide complete care across the board. Surgeons must realize that in order to be a comprehensive sports center, you have to have everything, including services like acupuncture."
As an example, one recent patient at DISC was a film executive who was suffering from lower back pain. The executive was scheduled to travel across the country and participate in a charity bike ride with Lance Armstrong within a week of arriving at the practice. This timeline may have been tight for some groups, but at DISC the executive was able to see a chiropractor right away, who realized that the pain was more than a soft tissue problem. He then received an MRI on the same day and Dr. Bray found a tear in his disc. The executive left the office for a short time to attend a meeting, but then returned for a quick block and then went home for dinner. Two days later, he was on the bike ride and pain free.
"You need that level of integrated care at your center," says Dr. Bray. "The hottest trend in sports medicine is the ability to deliver full service care no matter what."
2. Provide patient care coordination. One of the reasons why DISC was able to contract with the U.S. Olympic Team and Red Bull athletes is their ability to provide quick coordinated care. The center has a VIP athlete coordinator to arrange each athlete's care before they arrive at the practice. Many times the athletes are flown in from locations around the country; once they arrive, the coordinator has their appointments with different specialists scheduled so the care is as seamless as possible.
"Our VIP athlete coordinator takes the call from Red Bull America or the Olympic athletes and coordinates their appointments," Dr. Bray says. "If a BMX Biker for Red Bull North America goes down, they want to call up and have the athlete imaged, diagnosed and treated the next day so they can return to practice as soon as possible. Many times, the treatments aren't surgical and we can provide them the same day. With that kind of concierge sports medicine, we were able to develop our relationships with elite athletes."
3. Invest in an outpatient surgery center. Even with the economic downturn, DISC's new multidisciplinary outpatient surgery center focused on orthopedics and spine care has been booming. Between the old and new surgery centers, DISC surgeons have performed more than 4,500 cases in the outpatient ASCs and never reported an infection. "Our surgery centers are built to really high standards and run very well," says Dr. Bray. "We are seeing high acuity, low volume cases becoming the mainstay for sports medicine surgery centers in the future. The center has to be built at a high level for these very complex cases and incorporated into the practice's overall business model."
DISC surgeons have been able to successfully perform knee and hip replacements, anterior lumbar interbody fusions, lateral lumbar interbody fusions and other spine procedure using pedicle screws. "We aren't just doing the little things; we are doing bigger surgical cases in the outpatient environment and seeing good outcomes," says Dr. Bray.
4. Broaden the types of specialists in the practice. Thinking outside the box is critical to achieving success despite the typical market challenges of the day. While some orthopedic and spine surgeons have spent a great deal of time defending surgical treatment as the only true method of care, DISC has embraced alternative care providers as patient demand has dictated.
"Athletes want soft tissue therapy, acupuncture, rehabilitation facilities, injury avoidance and biomechanics specialists as well as athletic trainers — not just a physician who will perform a knee scope," says Dr. Bray. "Incorporating all the different specialists has been the thrust of DISC for the past four years. You need to perform minimally invasive, top-quality surgery for your patients, but almost more than that you need the ability to provide all types of care."
Related Articles on Orthopedic Surgery:
10 Biggest Concerns for Orthopedic Surgeons in 2012
8 Strategies for Orthopedic Practice Community Outreach
7 Opportunities & Challenges for ASC Orthopedic Surgeons in 2012