The Rothman Model – Part II

Written by John J Mangan MD1, Wesley H Bronson MD, MSB1, Nathan A Snyder BS1, Mayan Lendner BS1, Christina Vannello RN, BSN1, Taolin Fang MD1, Mike West MBA, CPA1, Alexander R. Vaccaro MD, PhD, MBA1 | March 04, 2019 | Print  |

This article is a portion of a book titled "Challenges, Risks and Opportunities in Today's Spine World " edited by Stephen Hochschuler, MD, Frank Phillips, MD, and Richard Fessler, MD. You can find links to the previous chapters at the end of this article.

Over the next several weeks, we will be looking at various spine care models around the US. In the next two chapters we will be looking at the Rothman Orthopaedic Institute model.

Rothman – Part 2 After looking at the philosophy and infrastructure of the Rothman Model, part 2 will take a deeper look at Research and Innovation. You can find The Rothman Model – Part I here.

Research and Innovation

The Rothman Institute has been committed to research and innovation since its inception in 1970. Today, the practice has a research institute that is comprised of 60 full-time research staff members. Each year the Rothman Institute produces primary literature that changes the management strategies and practice patterns for musculoskeletal pathologies. The Rothman Institute has been a leader in research of degenerative and traumatic spinal pathologies for decades.

Research at the Rothman Institute is driven by capturing patient data. For over a decade, the practice has collected data on all inpatient spine service consults, which include patients with acute spinal cord injury, fractures and other traumatic injuries to the spinal column, tumors and infection. This data continues to help define the natural history of spinal pathologies and allows the department to produce innovative surgical techniques, devices and management strategies.

Researchers at The Rothman Institute have been awarded grants from the Orthopedic Research and Education Foundation, The North American Spine Society, The Cervical Spine Research Society, as well as NIH Research Project Grants. There are also opportunities for researchers to receive funding directly from the practice. This access to funding promotes the output of high quality research generally associated with traditional academic institutions. From 2010 to 2014, The Rothman Institute was recognized by the Journal of Arthroplasty as the leading contributor to the top orthopedic journals in the nation. The Rothman Institute’s spine department has been recognized as the number one contributor to spine research in Northeast Pennsylvania, the most academically productive region in the country for this type of research.

The research performed at the Rothman Institute promotes innovation. A true value of the practice’s philosophy and commitment to obtaining patient outcomes data is the ability to study the natural history of musculoskeletal pathologies and the different treatment modalities that are employed. This understanding provides the framework and background for innovation. A great example of this is in post-operative physical therapy. Through studying patient outcomes and comments following post-operative physical therapy it was identified that most patients felt their time, energy and money could be better utilized. In response to this finding, the practice now employs an online physical therapy regime that teaches patients how to do exercises at home, on their own schedule, and send feedback to their physician electronically about their progress. This initiative costs only a fraction of the cost of traditional physical therapy and is overwhelmingly supported by the majority of patients.

Conclusion
The Rothman Institute remains dedicated to providing high quality, patient-centered care, while simultaneously pursuing high level clinical and basic science research. Through its unique privademic model, the group is able to obtain the benefits of the private practice model, with physician incentive to providing value-based care, increased autonomy, and more freedom to advance technologies and ideas that are more limited in a purely academic setting. At the same time, the focus on research and innovation, aided by its academic affiliations, permits physicians within the group to make meaningful contributions to the literature and help improve patient outcomes globally. With the changing healthcare environment, privademic models such as The Rothman Institute may become increasingly attractive to new physicians who wish to combine the benefits of private practice with a strong academic focus.

Previous chapters:

Challenges, risks and opportunities in today's spine world

Spine care - Balancing cost with innovation

What are big data and predictive analytics

Predictive Analytics and Machine Learning

The HSS Spine Care Model, Part 1

The HSS Spine Care Model, Part 2

The Rothman Model, Part 1

The History of Texas Back Institute

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