Laser Spine Institute's Dr. Michael Weiss on outpatient spine surgery


Tampa-based Laser Spine Institute hosted the inaugural Calusa Ambulatory Spine Conference in Streamsong, Fla., from Nov. 11 through Nov. 13, 2016. The conference offered spine care specialists information on the treatment of spine disorders in ambulatory settings.

Orthopedic spine surgeon Michael C. Weiss, DO, FAOAO, chairman of Laser Spine Institute's department of surgery, shares key takeaways from the conference and predicts how outpatient spine will progress in the industry.


Question: What were the main takeaways from the Calusa Ambulatory Spine Conference?


Dr. Michael Weiss: The Calusa Ambulatory Spine Conference is one of the industry's first-ever conferences devoted solely to outpatient spine surgery. Because all 85 attendees were interested in one singular focus, there was an incredible amount of collaboration among the diverse spine specialists at the conference. That type of synergy helped to enhance the sessions and experiences among what was a national audience.


With myself and Dr. Reginald Davis, Laser Spine Institute's director of clinical research, serving as course directors, we were pleased to offer 11.5 CMEs. We were also honored to host Dr. Richard Wohns of NeoSpine as a keynote speaker. This year's inaugural conference was held at Streamsong Golf Resort and Spa, a luxurious world-class resort in Central Florida, and we're already scouting locations for our 2017 conference.


Q: How will the recently proposed eight spine codes for the ASC payable list in 2017 impact the spine industry?


MW: The new spine codes provide fresh definitions that better describe certain surgical procedures, which shows that CMS is signaling a wider acceptance of the spine specialty in an ambulatory surgical setting. I would expect that belief to transcend to the other major payers.


Q: Payers have posed as obstacles for spine in ASCs. With the new payable codes, do you think they are warming up to the idea?


MW: I do feel strongly that payers are beginning to recognize the value and benefits of performing spine surgery in an ASC. Each major payer has its own methods of formulating reimbursements, but they all have a foundation built on the CMS guidelines. The creation and adoption of new codes under the 2017 Physician Fee Schedule signals a positive change and response toward reimbursement from the payer community.


Q: Do you see the shift toward outpatient spine continuing?


MW: There is absolutely a positive shift in the perception of spine surgery in an ASC, and it is primarily being driven by patients. Simply put, it is what patients want. They want the benefits of surgery in an ASC, including a lesser risk of complications and infection. Patients are recognizing the exceptional results that are being achieved in an outpatient setting with minimally invasive spine surgery.


Q: What are the most commonly performed spine procedures in the outpatient setting?


MW: There is a wide range of spine procedures that are commonly performed in an outpatient setting. Decompression surgeries for stenosis, disc surgeries and a number of minimally invasive fusion procedures and technology are all performed in Laser Spine Institute's ASCs.


Q: What are some key considerations before adding spinal surgery to a fully equipped center?  


MW: There are a number of precautions to consider before adding spine surgery to a center. It is imperative that the vetting of equipment, staffing and scheduling takes place prior to adding spine procedures. This includes everything from admitting, medical screening, anesthesia, nursing and post-op concerns on the medical side. On the operational front, cost containment is critical to success.


Maybe most importantly, my advice would be to hire folks who believe in your mission. At Laser Spine Institute, we stress a model that emphasizes the patient experience, and we take great strides to ensure the medical and corporate professionals we add to the team take that to heart. For the adoption of certain procedures, we've spent months and months training the staff to be able to perform some of these specialties in an outpatient setting. If you were to start a practice without properly exploring all of these areas, you would not be setting yourself up for success.


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