Dr. ChoSamuel Cho, MD, is an orthopedic spine surgeon and Assistant Professor of Orthopaedics and Neurosurgery at the Icahn School of Medicine at Mount Sinai in New York. Dr. Cho has expertise in scoliosis surgery, minimally invasive surgery, intervertebral disc biology and cervical spinal surgery. He spends one week each year practicing outside of the U.S. through global outreach programs. Here he discusses why he chose his field, current topics in orthopedics and his upcoming medical mission to China.
Dr. Jason Brodkey on spine centersMedical care is more coordinated today than ever, and spine specialists are beginning to form groups and organizations that will provide comprehensive treatment for back pain patients. The Spine Center Network, developed by Prizm Development, Inc., two years ago, is a national network of credentialed Spine Centers of Excellence for payors and consumers to choose truly multidisciplinary spine care settings. Currently, there are 18 spine centers across the United States, including Ann Arbor Spine Center in Ypsilanti, Mich., where Jason Brodkey, MD, practices.
Published in Spine
Dr. Michael Hisey on spine surgeryTexas Back Institute has spent the past three decades building a large spine practice, and with the ever-changing healthcare environment, an adaptable growth plan is more important now than ever.

"We are spending a lot of resources on growth and it's a very exciting time," says Michael Hisey, MD, President of Texas Back Institute. "We are in a time where everyone expects change. You have to be in a position to take advantage of that; those who do will succeed. Everything is going to be redistributed and you want to be in a position to help decide how that gets redistributed to the benefit of stabilizing your practice and treatment for your patients."

Here are five ideas for spine practice growth in today's healthcare environment.

1. Merge with other providers.
Merge or engage in formal partnerships with other providers, in your community. Work with them to build relationships which can more effectively facilitate patient care. This could help leverage your collective negotiating power.  

2. Build a presence in an underserved market.
Another growth strategy includes filling the need for spine specialists in an underserved community. The practice could bring on another surgeon for a new location in the community; often the local hospital will partner with the spine practice for the recruitment of a new physician in the market.  

"Bring in the new surgeon and place him in the community with a potential for growth," says Dr. Hisey. "The hospital and the practice will support him with marketing infrastructure and staff."

However, don't expect the additional cases from a new surgeon to grow the practice's profitability. "Growth is beneficial to us for negotiating power and to leverage overhead, but we don't expect the newer surgeons to add to the overall profitability," he says.

3. Affiliate with other groups in saturated markets.
In a well-served market, it's beneficial for surgeons and groups to affiliate with other groups in the community to grow their economies of scale instead of developing a new business or crowding others out of the market.

"It takes a while, perhaps two or three years to really develop a practice and hit a stride," says Dr. Hisey. "It's a faster growth strategy to team up with people who are already there. However, you have to understand and account for personalities in the groups when you are partnering. It's important for everyone to work well together."

4. Cover more of the episode of care.
Seek opportunities to bring more care under your group's control.

"If you can negotiate better prices for the hospital systems and have influence over these costs, you will be in a better position for contracting for bundled payments," says Dr. Hisey. "The more pieces of the episode of care you have control over, the better place you'll be for the final deal."

5. Strategically align instead of bringing other specialists into the group.
Depending on your referral network, it may make more sense to strategically align with non-operative and pain management specialists instead of bringing them into your group.

"Most referral networks are composed of family practice physicians, neurologists and other pain specialists who take care of the patients until they need surgery," says Dr. Hisey. "If you have those specialists in your practice, you could cut yourself off from potential referral sources. However, it is also important to balance this against the need to meet the demands of those patients and referral sources requesting a multidisciplinary approach."

Texas Back Institute offers a multidisciplinary approach either through our own physicians or in cooperation with other physicians in our market.  

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Wednesday, 01 May 2013 15:11

Dr. James Califf Joins OrthoCarolina

James Califf, MD, a board-certified orthopedic surgeon, has joined the Charlotte, N.C., practice OrthoCarolina.
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spineA recent study of five year data for patients who underwent cervical total disc replacement or anterior cervical discectomy and fusion show a five-fold difference in reoperation rates, according to a study published in Spine.
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The StabiLink MIS Spinal Fixation System from Southern Spine received FDA clearance and the CE Mark.
Five spine surgeons discuss how to reduce healthcare costs without compromising care.
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Thursday, 18 April 2013 16:47

7 Spine Surgeons in New Leadership Roles

Luiz Pimenta, MD, has been named the president of the International Society for the Advancement of Spine Surgery.
Published in Spine
Dr. Bryan Oh on hospitalsBryan Oh, MD, a neurosurgeon with a special interest in spine surgery at BASIC Spine in Orange, Calif., talks about how spine surgeons can build a healthy relationship with hospitals and where these relationships may be heading in the future.
Published in Spine
Dr. Bryan Oh on spine surgeon leadershipBryan Oh, MD, a spine surgeon at BASIC Spine in Orange, Calif., discusses five steps for surgeons to run an efficient operating room team that achieves better outcomes.

1. Take lead of the team.
Spine surgeons should take a leadership role to ensure everyone on the surgical and patient care team is contributing cohesively. "The surgeon has to function as the team leader," says Dr. Oh. "They have to improve team morale and acknowledge team members who do their job well."

Part of that leadership is organizing communication and delegating responsibilities. Surgeons may not be able to communicate with every team member individually, but they can communicate with the charge nurse, who would then be responsible for delivering the message.

2. Understand everyone else's role.
Part of leading the operating room team is understanding the value everyone else brings to the process. "The surgeon has to familiarize himself with everything in the process, not just the surgery part," says Dr. Oh. "He has to know what goes on in the pre-op, what surgical techs are doing and the PACU process to anticipate problems and communicate solutions effectively."

There should be a formalized meeting with the operating room team before surgery so everyone understands their role and will be able to communicate effectively if an issue arises. "The nurse who checks the patient before surgery should know potential issues, so the surgeon and anesthesiologist should communicate that well," he says.

3. Make sure everyone takes ownership for the patient.
The patient isn't just the surgeon's responsibility; everyone on the team contributes to patient care. "When operating room personnel feel they take ownership of the patient, that improves outcomes," says Dr. Oh. "Surgeons have to encourage that and the people on the OR team should buy into that concept. When they understand that person on the table is their patient too, things go a lot better."

4. Follow surgery protocol.
There should be protocol in place for every surgical procedure so everyone from the admitting nurse to the recovery staff knows the plan for patient care. "Generally, this is something the surgeon takes the lead in developing, but they can gain input from everyone," says Dr. Oh. "Patients have better experience and outcomes when the process is formalized. This leads to higher patient satisfaction scores because it doesn't look like we are trying to reinvent the wheel with every patient."

5. Build positive team culture.
The OR team should have a positive attitude and a good working relationship to provide patients with the best care. Everyone must work together to admit the patient, make sure the surgery is performed safely and help them through the recovery process.

"First and foremost, everyone has to realize they are part of the process," says Dr. Oh. "They are on the patient's treatment team, so they are involved in achieving the best outcome possible."

Doctor Bryan Oh is board certified in Neurological Surgery and received his medical training at Stanford University with a residency in neurosurgery and fellowship in spine surgery at  the University of Southern California. Dr. Oh was a faculty member at the University of Texas at Houston Medical School and was Director of Neurotrauma for the busiest Level One Trauma Center in the United States.

He is a reviewer for the journals Neurosurgery and World Neurosurgery as well as a member of several prestigious societies, including the Congress of Neurological Surgeons and the American Association of Neurological Surgeons. You can follow him on Facebook, Twitter and Google+.

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