Changes in spine care Dr. Dalip Pelinkovic wants to see and future trends in the field

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Dalip Pelinkovic, MD, is a board certified orthopedic surgeon subspecializing in spine surgery with Suburban Orthopaedics in Chicago. 

Dr. Pelinkovic discusses what changes he'd like to see in spine and what trends he foresees developing in the field.

Question: What changes would you like to see in spine care over the next five to 10 years?

Dr. Dalip Pelinkovic: Less involvement of payers and hospitals in directing spine care. This should be directed by physicians and experts, not by lobbyists or investors. Spine surgeons are closely involved in operative and postoperative care of their patients. Low incidence but high consequence events such as neurological deficits demand immediate accessibility, treatment and close follow up. Healthcare systems and payers are aware that a good spine surgeon will never put quality of care at stake and will provide that for every single one of their patients 24/7. Mostly we provide this service at no additional cost because of ethics and in order to decrease liability.

Raising the awareness among spine surgeons that this can be done in an outpatient setting for the appropriate patient may decrease cost for the patient and should translate in better reimbursement by the healthcare carrier.

Q: Can you tell me some of your non-negotiable patient safety rules?

DP: Access to healthcare. This is a very broad topic. In general patient safety should never be jeopardized at any time in any way. Knowing the patient, diagnosis and pertinent studies is my first safety rule. Proper diagnosis and treatment plan established by the surgeon himself helps to navigate the individual patient through all stages of outpatient surgery. This supersedes all algorithmic OR protocols for obvious reasons. 

Q: What in your opinion is the most important trait for a spine surgeon to exhibit in the operating room?

DP: Situational awareness. In addition to being competent in treating a certain diagnosis with a specific procedure, the most important trait is situational awareness. This allows the surgeon to identify a potential or evolving issue. Without micromanaging the staff, or anesthesia, he should be able to quickly identify and correct shortcomings. 

Q: What do you see as the next big trend in spine?

DP: Simplified, sophisticated surgical instruments and approaches in contrast to technology/industry driven expensive spine care. 

I do think that peel packed sterile implants off the shelf may be a great asset for ASCs. It simplifies logistics, sterilization, reduces trays and OR setup time.

Hand in hand with simplified, sophisticated surgical instruments and approaches, it may eliminate the need of industry driven expensive spine care which necessitates in hospital care. 

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