Dr. Robert Gewirtz: AI in spine, changing patient populations and the future of outpatient procedures

Written by Alan Condon | August 19, 2019 | Print  | Email

Robert Gewirtz, MD, is a fellowship-trained neurosurgeon with Mount Carmel Central Ohio Neurological Surgeons in Westerville. 

Dr. Gewirtz completed a residency in neurosurgery at The Cleveland Clinic. He completed a fellowship in neurosurgical trauma at Allegheny General Hospital in Pittsburgh and a fellowship in cerebrovascular surgery at Stanford University Medical Center in Palo Alto, Calif. 

Here, Dr. Gewirtz discusses the big ways spine is evolving.

Question: How do you see artificial intelligence impacting spine surgery?

Dr Robert Gewirtz: I think AI will be part of the reading process for imaging studies in the future. However, spine surgeons will still need to be able to review and interpret their own studies indefinitely. AI will also be a powerful research tool. I can see a day when an AI program will assign a probability score for each patient, utilizing their imaging studies and clinical factors, to help determine optimal therapy for our patients. The dark side will be insurance companies using AI to deny coverage for treatment or surgery based on a similar score. 

Q: How has your patient population changed over the past 5 years? How do you expect it to evolve in the future?

RG: My patients continue to get older and less healthy. BMIs continue to go up, but smoking is trending down. It seems everyone is on an anti-platelet or anticoagulant therapy. 

Q: How can surgery centers improve profits without increasing patient costs or sacrificing quality?

RG: Surgery centers that do a high volume will have a lower fixed cost per case. New models of reimbursement for CMS and Medicare patients have to be explored so that we can deliver care in the outpatient setting, but not at a loss.

Q: How do you see outpatient spine procedures developing in the future?

RG: Outpatient spine will continue to grow and become more sophisticated. I think hospitals will be incentivized to invest in or own these centers and move as many patients as possible into our arena. This will be necessary as more spine physicians become employed and less entrepreneurial.

More articles on Q+As:
Dr. Adam Bruggeman: A spine surgeon's most important OR trait and bundled benchmarks in spine
Dr. Khoi Than: Most interesting technology in spine today, and a trend to watch
Dr. Stephen Hochschuler and the formation of Texas Back Institute

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies here.