The disruptors spine surgeons are excited, worried about

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Healthcare disruptors, from emerging technologies to retailers entering the fray, are already changing the future of the industry.

Four spine surgeons discuss the disruptors that have their closest attention.

Note: Responses were lightly edited for clarity.

Question: Large companies such as Amazon and Walmart have made pushes into the healthcare industry. Which of these disruptors are you most excited about? Which one worries you most?

John Burleson, MD. Hughston Clinic Orthopaedics (Nashville, Tenn.): Although consolidation within an industry has been happening for years, consolidation like this across multiple business sectors (inside and outside of healthcare) is very concerning. Although physicians can find themselves in jail for a variety of activities deemed to be an "internal referral," companies who acquire pharmacies, drug manufacturing, companies and clinics can refer only to themselves without fear of penalty. They can also deny coverage for medications made by other companies or simply deny their customers the ability to visit competing pharmacies, etc. Currently, some Cigna plans do not allow their customers to go to CVS pharmacies due to their agreement with a competing insurance company. At the end of the day, this type of consolidation will likely yield profits for large companies and their shareholders, but it will undoubtedly be bad for the patients and eventually the physicians as well. 

Harel Deutsch, MD. Midwest Orthopaedics at Rush (Chicago): AI is the most exciting and most worrisome potential disruptor. AI can improve healthcare quality but can also cause disruption that will dramatically change the marketplace.

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: I am excited about neither.  The issue with retailers entering the healthcare space is much the same story as corporate medicine we see practiced all over this country. Opinion-makers are obsessed with growth. This works well in retail and trade, but not with human lives. These companies can create megaclinics, where costs are initially low, patients don't see actual doctors, and when they close due to insolvency, the patients are left high and dry and/or with substandard care and no one held accountable.

Vladimir Sinkov, MD. Sinkov Spine (Las Vegas): I do not think either company has the skills and tools to manage or even understand the complexities of the United States healthcare system to offer any significant change or disruption. Both companies mostly sell goods. Due to their size, they are able to offer those goods at lower prices with easier ways to access them. They can certainly try to commoditize healthcare services by hiring a lot of physicians and other healthcare professionals and then offering healthcare services at a lower price with better access. With the current shortage of physicians and other healthcare professionals and with the complexities of providing adequate healthcare, this would not work.

Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Expansive and comprehensive healthcare delivery is obviously better for society and our citizens, and making this point the focus of either corporation's intent is laudable. Health awareness, access and portability will thrive and flourish when it becomes "top of mind" and increasingly prevalent as a societal reminder in everyday life.  

Which corporation's impact in that delivery will be forthcoming as the socioeconomic strata for these two entities is disparate in their population served.    

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