Dr. Nick Shamie: How the pandemic will continue to hit spine practices long after the surge

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Nick Shamie, MD, chief of orthopedic spine surgery and vice chairman of international affairs at the David Geffen School of Medicine at UCLA, outlines how the coronavirus pandemic has affected his practice and how he expects the spine field to proceed as a result.

Question: How has the pandemic affected your practice and plans for the future?

Dr. Nick Shamie: The pandemic has significantly impacted our volume in our clinic and the OR. The impact was obviously due to the mandate that the hospitals and healthcare facilities need to stand prepared for an exponential growth in COVID-19 patients needing supportive care. We have flattened the curve in Los Angeles and fortunately did not see the same surge that occurred in New York, but we are not yet through it completely and still need to monitor this fluid situation for the next year or two.

As we open our doors to in-person visits versus telemedicine and begin performing elective surgeries, we may continue to have lower volumes due to patients' fear of hospitals as a place with higher concentration of COVID 19 patients. Furthermore, with high level of unemployment and decrease in number of individuals with employer sponsored health insurance, we will see a decrease number of high cost elective surgeries unaffordable by individual patients. This will perhaps promote less invasive and lower costs surgeries that can be performed in surgicenters or as an outpatient in hospitals.

We will have to continue isolating our COVID 19 patients and staff caring for them in designated locations within our facilities to minimize the risk of nosocomial infections. We need to gain the trust of our communities by showing them that hospitals and surgical facilities remain safe havens for healthy patients' elective surgical needs.

Q: What are the most exciting opportunities for you moving forward?

NS: I believe the healthcare field has gained a renewed and positive attention from our society; people recognize how 'essential' and committed healthcare workers are to our communities. We have seen decades of scrutiny and bad press chipping away at the 'doctor-patient' relationship. I believe we can use this opportunity to foster even more trusting relationship in our mission of 'healing humankind.....one patient at a time.'

Q: What does the "new normal" look like for spine surgeons?

NS: We have implemented changes in our practice, like social distancing and following recommendations of CDC to keep our patients and staff safe while still offering the best care for our patients. This means more telemedicine, doctors and patients wearing mask during visits, and procedural changes in our day-to-day routines to increase efficiency and safety for all. But also, this 'pause' has forced us to realize how important it is to work together ... and together we will prevail. Perhaps the 'new norm' will encourage us to be better versions of ourselves.

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