Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses. Next week's question: What is your biggest concern about emerging spine technologies?
Please send responses to Heather Linder at firstname.lastname@example.org by Wednesday, Jan. 23, at 5 p.m. CST.
Q: What are your professional resolutions for 2013?
Ara Deukmedjian, MD, Neurosurgeon and CEO, Deuk Spine Institute, Melbourne, Fla.: [I want to] help put medical decision making power back in the hands of patients and out of the clutches of insurance companies and their phony hired "doctors" paid to deny care to beneficiaries.
Jeffrey Goldstein, MD, Director of Spine Service, NYU Langone Medical Center's Hospital for Joint Diseases: In 2013 I will continue to provide care for my patients based on high level evidence and clinical experience while keeping the patient first and foremost. I will also continue to participate with our spine societies to develop algorithms for provision of care which seek to maximize patient outcomes through an efficient, cost-effective healthcare system. In order to improve spine care in the U.S., we also need to continue to focus on training of our residents and fellows as well as educating our peers.
J. Brian Gill, MD, Orthopedic Spine Surgeon, Nebraska Spine Center, Omaha: I would like to grow my practice 5 percent in new patient and surgical volume. I would like to add one new technique to my armamentarium of surgical options. I would like to further develop my relationships with referring providers.
Hooman Melamed, MD, Orthopedic Spine Surgeon, Marina Del Rey (Calif.) Hospital: To continuously learn and become better skilled surgeon in order to serve my patients and deliver the most optimum outcome.
Thomas Roush, MD, Founder, Roush Spine, Lake Worth, Fla.: 2013 will be a year of great uncertainty to our profession and its future. The "good old days" of seeing patients and delivering exemplary care alone are quickly ending. The year 2013 will see an incredible influx of non-surgeon involvement in the delivery of patient care. My goal as a surgeon and patient advocate is to become much more involved in the political side of our profession in order to preserve the long tradition of world class spinal care established by our surgeon predecessors. I plan to be involved in the health policy debate from the early stages in order to frame the future of spine care delivery rather than continue to be reactionary. As with all bureaucratic decisions, once policy is established, it is quickly transformed into immutable status. I encourage all of my surgeon colleagues to become more politically active locally so that we can take a stand of which our future patients may be proud. We didn't choose this profession based on the sociopolitical element, but it has been thrust upon us to the point of necessary participation.
Jeffrey Wang, MD, UCLA Spine Center: My goals for 2013 are to try to keep positioning our department for the future. I personally want to continue to build our department into an integrated team within our healthcare system. On a larger scale, I want to continue to work with awareness and education of spine surgeons through our major spine societies on a national and international level, to try to improve outcomes for our spine patients.
Christian Zimmerman, MD, Neurosurgeon, Idaho Neurological Institute, Boise: The reported success rate for a New Year's resolutions has been as low as 12 percent; hence, substituting the phrase "acts of volition" may be more measurable and seem less contrived.
Beleaguered scrutiny by insurance carriers and the uncertainty of unfunded federal mandates rue the day. Health Exchanges, cost per unit case and unified clinical organizations are the latest jargon, yet, the metrics and their aggregate shadow every surgeon in every specialty on biannual clip. A vexation soon not to change.
Conversely, acknowledging a system of self-accounting or constructive improvement lags behind the performance issue. The macroeconomics of slimming hospital margins emboldens the slow code of stratifying any method for shaking the cages, or implementing corrective change.
Fortunately, as an employee of one of the largest medical systems in the country, the comparisons and contrasts of one's performance is weighted against colleague and competitor. Annually, the data points shift, yet the expectations of internal and external forces remain the same. The act of volition for members of the assemblage should be a secured position within the Gaussian Distribution for ICD 9-CM codes, (722.10, 724.02, 723.0, 722.0). Bearing solely in mind that long term patient care and spinal health outcome's define the person.
Specific to the fitness of any hospital system is the voodoo concept of cost containment.
Surgeon realization and input will predicate our being left out of any decision process in the future. Civilian committee review pertaining to spinal implant constructs and orthobiologics usage are being fashioned and implemented, with trickle down consequence.
Resolving to change may require real "acts of volition," unless of course, you failed to keep last years resolution.
More Articles on Spine:
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Dr. Andrew Cappuccino Sues NuVasive for $660k
7 Spine Surgeons on Professional Resolutions for 2013 FeaturedWritten by Heather Linder | Friday, 18 January 2013 15:38
Seven spine surgeons discuss goals for their practice heading into 2013.Last modified on Monday, 28 January 2013 19:10
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