How Dr. Vladimir Sinkov opened his solo spine practice in the midst of the COVID-19 pandemic

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Despite the widespread disruptions caused by the COVID-19 pandemic, Vladimir Sinkov, MD, opened his independent practice, Sinkov Spine Center, June 1.

Managed by Dr. Sinkov's wife, Mariel Sinkov, PharmD, the Las Vegas-based center plans to build its patient population and provide the latest in minimally invasive spine care, including robotic spine surgery, with full autonomy over proceedings.

Dr. Sinkov spoke to Becker's Spine Review about challenges he faced opening the practice, when he hopes to reach maximum patient volumes and goals for the rest of the year.

Question: What drove you to start your own spine practice?

Dr. Vladimir Sinkov: I've been practicing spine surgery for about 10 years. In January, I thought I was going to start building my own practice to have full control of what's going on and provide the highest quality of care to my patients. The COVID-19 pandemic slowed us down a lot, but we opened our doors June 1 and are now seeing patients.

I think this will enable me to combine the newest and best technology with personal care, where I'm not in a rush to try and match the economic demands of running a big practice with high overheads. I can spend time with each patient, make them comfortable, explain everything in detail and treat them as best I can.

Q: What were the biggest challenges in getting the practice up and running on June 1?

VS: There were three challenges. One was insurance contracts. Getting credentials with payers, so I can see patients with those insurances is taking a lot longer due to the pandemic. The insurance companies have been a lot slower processing this. Unfortunately, we had to turn some patients away because we are not in their network and they're not capable of paying in cash, so we cannot bill their insurance yet.

Getting vendors and supplies has also been a challenge. I had to go through three contractors until I could find the right vendor. It was almost impossible trying to find supplies and personal protective equipment in March. We signed up with a medical supply company to help us, but because we were a first-time client, they prioritized already established clients for a lot of high demand items such as face masks, gloves and hand sanitizer. Fortunately, we've been able to acquire enough PPE in time to open.

Also, reassuring patients that we are taking all the necessary precautions and it is safe for them to seek treatment. A lot of patients are referred by primary care offices, which have been closed, so that has also been a challenge in getting patients in the door. It is all easing up and getting better, but the ramp-up will be slow and gradual.

Q: When do you hope to reach maximum patient volumes?

VS: Usually you can tell by how the practice goes, but there are so many variables right now. We are all at the mercy of the governor of our particular state. Assuming everything continues the way it is now, with the number of coronavirus-related illnesses declining and businesses starting to reopen, I think I should reach a full schedule in three months on Sept. 1.

Q: How big of an impact would a potential 2nd COVID-19 wave have on your practice and the orthopedic field in general?

VS: That will depend on a lot of variables, including how bad the spike is, if we have better treatments by then, how close we are to a vaccine and if enough people develop herd immunity. From what we know about this disease, 80 percent of people are asymptomatic or have very little symptoms and may not have realized that they've had the virus. If we give it three more months with most people not experiencing many symptoms, by the time the fall and flu season hits, we may have a lot more immunity than we have right now as a society.

I think a second wave won't be as bad as most of the harm came from reaction to the illness rather than the illness itself. Unfortunately, that harm will appear later in terms of the neglect of other healthcare problems, businesses closing and people losing their income and insurance. A lot of that harm we haven't seen yet, but as time moves on we are going to start realizing how harmful that was. If it were to happen again, we should think objectively and use the data at hand to decide how to proceed. I hope the decision will be made more objectively, rather than just shutting everything down.

Q: What are your goals for the first seven months of your practice? What do you hope to achieve?

VS: Like every surgeon, I'd like to be busy operating, helping patients and hopefully have a full clinic. I think I will reach that within this time frame. My goal is to build up to a level where I am busy and provide the best service to my patients as possible, and do that in my own practice with full control of how things happen. 

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