Clinical Considerations in Spine Surgery & Pain Management: 4 Key Observations

Spine

At the 12th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + the Future of Spine, June 12 in Chicago, Richard Wohns, MD, founder and president, NeoSpine; Richard Kube, MD, founder, owner and CEO, Prairie Spine and Pain Institute; and Kiran Chekka, MD, partner, Premier Pain Specialists, participated in a panel discussion on key clinical considerations and trends in spine surgery and pain management.

Here are four key observations from the discussion:

 

1. According to Dr. Kube, figuring out the right payer mix is the biggest challenge for physician practices and, ultimately, demonstrating good outcomes and cost-effectiveness is what drives payer negotiations. "I go to the payers and showing them the difference in cost between having me perform cases at a surgery center versus performing them at a hospital," said Dr. Wohns.

 

2. Contracting with surgery centers can be an issue for anesthesiologists, said Dr. Chekka. Pain management and anesthesia development can allow higher acuity cases into centers that accept them. However, not every center is ready to support all cases. Additionally, reimbursement changes over the past year are causing additional challenges. "There are so many changes taking place in the pain management industry at the moment that nobody knows what is going to happen. So hedge your bets," he said.

 

3. Diversifying the types of cases performed at an ambulatory surgery center is also helpful in terms of keeping the center and a physician's practice alive and thriving. "Also, incorporate direct-to-patient marketing campaigns," said Dr. Kube. "Around 25 to 30 percent of referrals at my center are internet-based. We regularly have people coming in from a state away."

 

4. Keeping a work-life balance is important, and being in private practice and performing cases at ASCs helps physicians keep that balance. Dr. Wohns, who is also a 4th degree black belt in Tae Kwon Do and a competitive tennis player, credits the ability to perform spine surgery in an outpatient setting as the reason he could focus on his other interests. "I find that an ASC is the best place to work," he said. "Treat it well and it will treat you well. It became such an efficiency factor in my life and performing outpatient surgeries allowed me to do other things."

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