'Put patient care back in the hands of the physician': What we heard in September

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Spine and orthopedic experts and leaders in September spoke with Becker's Spine Review about topics from payer negotiations to skills they want to accomplish.

1. "I would put patient care back in the hands of the physician. Too many healthcare decisions are being made by administrators that don't prioritize the doctor-patient relationship. Each patient is unique and the treating doctor is best suited to address the healthcare needs of that patient. We have moved from providing individualized healthcare to population health where the needs of an individual don't matter anymore. Physicians are called providers not doctors, and the quality and access to healthcare has declined. We have increased the burden on physicians by adding bureaucratic roadblocks. We spend more time documenting and doing peer reviews than we do taking care of patients. In the end, the patient suffers the most." — Ramy Elias, MD, of Center for Advanced Orthopedics & Sports Medicine at Cerritos (Calif.) Surgery Center, on what he would change in the spine and orthopedic industry.

2. "The challenge with any group that's growing is maintaining the culture. We have had a really good culture at Panorama, and part of that has been because we still feel like we're one group and have grown organically. I guess what I feel in the future is we're most likely going to grow much more rapidly. I think one of the challenges is going to be for us to try to maintain the culture that we've always really loved and enjoyed."— Mark Conklin, MD, of Golden, Colo.-based Panorama Orthopedics, on the top challenge he anticipates after two management service organizations merged.

3. "If one has to contract with payers, come armed with outcome data such as ODI, NDI and postop med usage. Certain payers will be reasonable and want to retain good surgeons in their network. Make sure you have carve-outs for certain procedures such as disc replacement or endoscopic surgery that provide good value. Remuneration should be commensurate with the quality of work you do, and restoring your patient to health and functionality." — Brian Gantwerker, MD, of the Craniospinal Center of Los Angeles, on how to negotiate with payers for the best contracts possible.

4. "I would like to master full endoscopic spine surgery including endoscopic fusion surgery. I also would like to master navigation and robotic-assisted surgery to incorporate with endoscopic technique. This will be the least invasive technique that can be done safely in the ASC. Several studies in Asia and Europe show comparable outcomes in selected patients. I also would like to master artificial disc replacement and start looking at awake spinal surgery in an ASC setting." — Issada Thongtrangan, MD, of Microspine in Scottsdale, Ariz., on what skill he wants to learn in the next five years.

5. "Ever since our days as co-chief residents together in 1995 at the Tufts Orthopedic program in Boston, we all knew Dr. William Levine was destined for orthopedic greatness. Bill’s passion for orthopedic education is unparalleled. He is arguably the greatest orthopedic mentor of his generation. Diversity has always been a priority for Dr. Levine in the choice of his fellows and residents. Dr. Levine’s lineage of Columbia Orthopedic fellows and residents is spread across all the top orthopedic programs in our country and around the world. He is one of the most influential orthopedic educators of our time. I am privileged to call him my friend and colleague." — Scott Sigman, MD, of OrthoLazer Orthopedic Laser Centers in Rochester, N.Y., on a leader he looks up to.

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