Dr. Dwight Tyndall describes his idea of a perfect spine practice

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Spine surgeon Dwight Tyndall, MD, has practiced with Orthopaedic Specialists of Northwest Indiana in Munster for the past 21 years.

For 10 years, Dr. Tyndall has served as a clinical staff member in the department of orthopedic surgery at Indiana University School of Medicine in Indianapolis. In 2019, he opened his private practice, Dr. Spine, with locations in Munster and St. John, Ind.

Here, he discusses how a single-payer system would impact spine and what a perfect spine practice looks like for him.

Note: Responses are lightly edited for style and clarity.

Question: How does the U.S. healthcare system compare to other countries you have worked in or traveled to?

Dr. Dwight Tyndall: I have had the chance to travel to both developed and developing countries and the major distinction is that in developing countries, there is great emphasis on primary and preventive care. In developed countries, there is more access to specialized care.

Q: What healthcare changes do you foresee occurring after the 2020 presidential election?

DT: I do not see much change in the U.S. healthcare system, regardless of who wins the election. The changes in the U.S. healthcare system will be evolutionary toward a more defined single-payer system. In a sense, we currently have a 'single' payer system since all payers index their payments to Medicare. However, over time, we will see an extension of Medicare with private insurers managing the plans as they do now with Medicare and Medicaid.

Q: What impact would a single-payer system have on spine care in the U.S?

DT: A single-payer system will decrease spine payments toward current Medicare rates and payments for all age groups.

Q: In an ideal world, what does a perfect spine practice look like for you?

DT: The perfect spine practice would be a multidisciplinary practice with the spine surgeon and nonoperative spine specialist/mid-tier working in concert. The mid-tier/nonoperative spine specialists would serve as the initial intake with patients who failed nonsurgical treatment and would be referred to the surgeon if they desired a surgical option. 

In this way, the spine surgeon only sees operative candidates while the vast majority of patients would be treated with the appropriate medications and other modalities. This type of arrangement would be very cost-effective and streamline patients' paths through the system.

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