Some spine practices and health systems are rapidly expanding into new markets, but for local physicians that isn’t always a bad thing.
Two spine surgeons talk about the opportunities new players in their markets bring.
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. Becker’s invites all spine surgeon and specialist responses.
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Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CST Tuesday, April 14.
Editor’s note: Responses were lightly edited for clarity.
Question: When you watch a larger group expand into your market, what’s your honest first reaction: threat, opportunity, or noise? Why?
Vijay Yanamadala, MD. Hartford (Conn.) HealthCare: I see opportunity, but not for the reason most people assume.
When a large health system or private equity-backed group moves into a market, the instinct is to circle the wagons. I’ve watched colleagues do it. The energy goes into protecting referral patterns, locking up OR time and defending turf. That’s a losing game.
My honest first reaction is: What are they bringing that we aren’t? Large groups expand into markets for a reason. Usually it’s volume — they’ve identified unmet demand. The more interesting question is whether that demand is for the right things. In spine, a lot of unmet demand is actually overtreated demand such as patients who’ve been told they need surgery by someone who wasn’t asking hard enough whether they did.
So when I see a large group enter my market, I ask: are they going to raise the standard of care, or industrialize the existing one? The answer tells me whether I need to compete or simply continue doing what I’m doing well. Surgeons with a clear point of view who operate less but better and who can articulate why tend to attract the patients that large groups actually struggle to serve: the complex, the skeptical, the ones who’ve already been somewhere and weren’t helped.
The threat is noise. The opportunity is differentiation.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Depending on hospital affiliation and practice preferences would best answer this question. Our current market has two large health systems, each with a saturated list of spinal practitioners. Many are either proximate to training in their perspicacity or disinclined to append complex patients or cases. Those divested in surgical centers usually refer more comorbidly afflicted or financially disenfranchised to other locations for care, (which is another subject within itself), yet these patients represent the majority of complex patient management.
Regional trauma centers, by and large, shoulder the community responsibility of healthcare needs to the highest acuity patients, and rightly so. Providers with energetic minds and willing participants with patient-centric principles are wholeheartedly welcome in any community.
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