Dr. Thomas Loftus: How private practice in spine is changing

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Thomas Loftus, MD, founder of the Austin (Texas) Neurosurgical Institute, has spent his career focused on complex minimally invasive spine surgery.

He founded his practice in July 2003 and continues to expand options for his patients. Here, Dr. Loftus discusses the most interesting technology developments and how he sees his practice evolving in the future.

Question: How do you think your practice will change in the next three years? What are you doing today to prepare?

Dr. Thomas Loftus: I feel private practice physicians like myself will be burdened even more by increasing government regulation, drug prescription monitoring requirements, and increased costs associated with staffing to address these regulations. We try to tackle these head-on as they arise so that we don't have to spend even more time trying to 'catch up' as the regulations become more complicated and restrictive to patient care. Over the next three years we are expecting this to increase unless much-needed deregulation is enacted by our government.

Q: What is the most dangerous trend in healthcare, spine or orthopedics today and why?

TL: By far the most dangerous trend is insurance treatment denials. There seems to be a trend to limiting patient spine care using arbitrary rules and regulations by the insurance company. While there may be an immediate cost saving for the insurance companies, the costs to the patient in additional doctor visits, lost wages, and the ultimately higher likelihood of pain medicine addiction are significant. The greatest danger is that these arbitrary guidelines created by insurance companies override the medical judgement of the treating surgeons. That will never lead to better care for the most important person in the equation: the patient.

Q: What emerging technology are you most interested in today and why?

TL: I feel that the increased recognition of and treatment of sacroiliitis is leading to rapidly growing technology in that area. The expansion of implant technology in SI fusions is providing surgeons with more treatment options for this condition. We are seeing more novel hardware technology, more novel instrumentation for screw insertion, and, I am sure, will be seeing an expansion of minimally invasive techniques for this area. I find this most interesting currently because we are now starting to successfully treat a condition that has been so elusive for so long in back pain management. It's a big win for the patients.

To participate in future Becker's thought leadership articles, contact Laura Dyrda at ldyrda@beckershealthcare.com

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